Background…
The Speech and Hearing Center, Inc. is
a not-for-profit, 501 (C) (3), agency serving northeast Florida
and southeast Georgia. We provide high-quality audiology
and speech/language pathology services to the community.
Our operating expenses are defrayed by revenue for services,
the sale of hearing aids, grants (United Way of Northeast
Florida, City of Jacksonville, Jessie Ball duPont Fund, Sertoma)
and donations.
The Center is a member of the National Association
of Speech and Hearing Centers.
Locations:
DOWNTOWN:
1128 North Laura Street
Jacksonville, FL 32206
MANDARIN:
12627 San Jose Blvd., #503
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Effective Date: 04/14/03
This notice describes how medical information about
you may be used and disclosed and how you can get access to this information.
Please review it carefully. If you have questions, the Speech & Hearing
Center Privacy Contact is Dawn Lamb at 904-355-3403.
This Notice of Privacy Practices describes how we may use
and disclose your protected health information to carry out treatment, payment
or healthcare operations and for other purposes that are allowed or required
by law. It also describes your rights to access and control your protected
health information. Protected Health Information is information about you that
may identify you and that relates to your past, present or future health or
to related health services that you have received.
We are required to abide by the terms of this Notice of Privacy
Practices. While we reserve the right to change these Practices, and, while
those changes will be effective upon all health information we have at the
time of the change, we will make the revised Notice of Privacy Practices available
to you.
I. Uses and Disclosures of Protected Health Information
- Uses and Disclosures that do NOT require your
consent. We are
allowed by law to utilize your
Protected Health Information for activities related to your treatment,
to facilitate payment, and to run our healthcare operations. In addition,
there are certain other allowed uses and disclosures that occur which
we are required to include in this notice. Below are examples of
the types of uses and disclosures of your Protected Health Information
that occur at Speech & Hearing Center, Inc.
- Treatment: We will use and disclose your Protected
Health Information to provide, coordinate or
manage your hearing and/or speech/language health care. This includes
the coordination of your hearing and/or speech/language health care
with 3rd parties such as ENT physicians. For example, your audiogram,
speech/language evaluation, name, date of birth, medical condition, etc.
may be sent to an ENT physician to whom we may refer you for a medical
condition we observe.
- Payment: We will use and disclose the minimum necessary
of your Protected Health Information to invoice your insurance carrier,
or appropriate referral source that has authorized payment for services
rendered to you by Speech & Hearing Center, Inc.; or when it
is the responsibility of the patient to make payment(s), to engage
the services of an outside collection agency to collect payment(s)
in default.
- Healthcare Operations: We will use and disclose your Protected
Health Information in the normal course of running our Healthcare Operations.
Your name, contact information, hearing aid S/N, etc. become integral
parts of our business records, allowing us to coordinate our business.
- Fund Raising: We may use and disclose your Protected Health Information
in order to contact you regarding fundraising for the Speech & Hearing
Center, Inc.
- Other Health Related Activities: We will use and
disclose your Protected Health Information to
contact you regarding follow up services, future appointments, treatment
options, new products that are available. For example, we may call
you to check on how well you are adapting to use of your hearing aid
and to schedule an appointment.
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- Uses and Disclosures that REQUIRE your Authorization. We
are prevented by law from using or disclosing your Protected Health
Information for most purposes other than listed in (1.) above or
(3.) below, unless we have your Authorization. Your authorization
will be requested using the Speech & Hearing Center, Inc. Authorization
for Use of Protected Health Information form. Your authorization
may be revoked at any time you choose by contacting us in writing.
- Other Uses and Disclosures that May be Made with Your Consent,
Authorization or Opportunity to Object. There are a variety
of rare conditions under which we are either required or allowed to
use or disclose your Protected Health Information. You have the opportunity
to agree or object to the use or disclosure of all or part of your
Protected Health Information. If you are not present or able to object
or agree, we may, using professional judgment, determine whether the
disclosure is in your best interest. If so, only the Protected Health
Information that is relevant to your health care will be disclosed.
The following list outlines conditions and entities under which we
would/must use or disclose:
- As part of a US Food and Drug requirement or investigation.
- When under court order in response to a subpoena, discovery request
or other lawful process.
- For law enforcement purposes as long as applicable legal requirements
are met.
- To Coroners or Funeral Directors as allowed by law.
- For Research, provided the research has been reviewed by a Research
Board and protocols for your privacy have been established.
- For Military Activity and National Security, including for the purpose
of determining your eligibility for VA benefits.
- As required by Worker’s Compensation Laws.
- When required by the Secretary of the Dept. of Health and Human Services.
- When you request such use or disclosure.
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