THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED ABOUT HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY. The policy of Eastern Urology Associates, PA is to protect the confidentiality, integrity and security of the protected health information (PHI) of our patients and to prevent unauthorized access to, or the use or disclosure of such information. We are required by law to maintain the privacy of your health information and provide you with this notice of our duties and obligations. This policy applies to patients who are current or former patients of Eastern Urology Associates, PA. Individually identifiable health and personal information or any information obtained by Eastern Urology Associates, PA in connection with providing healthcare treatment, obtaining payment and related health care operations. This relates to past, present or future information that Eastern Urology Associates, PA receives from you as our patient. Eastern Urology Associates, PA collects personal information in order to learn about your medical history, medical conditions, render treatment and collect payment for our services. We gather this information from your patient forms, health questionnaires and other forms you will be asked to complete from time to time. In addition, we will assemble information based on our discussions and conversations with you, your personal representative and your family members. Your healthcare plan or insurance carrier may provide information to our office. We will use this information to provide caring and quality medical care to you. Examples include diagnosis, treatment and communications such as follow up and appointment reminders, as well as treatment alternatives or other health related benefits. As part of our standard treatment and healthcare operations, we may share information with a facility such as a hospital, laboratory, diagnostic service or healthcare provider to efficiently coordinate your treatment plan. For contracted insurers, your information will be used for claims management and to obtain payment from your insurance carrier. As required by your insurance contractor, we will exchange data with your insurance carrier for activities such as eligibility, benefit and coverage determinations, precertification and utilization review. For worker's compensation, information about a work-related condition can be exchanged with the employer. Your information is maintained in our office in our practice management computer system. We also maintain information about you in your medical chart. Eastern Urology Associates, PA limits the access to your PHI to those employees and business associates who need to know that information. With some limitations, you have the right to inspect, amend, copy and receive an accounting of disclosures of your medical and billing records.
Effective Date: April 14, 2003  Eastern Urology Associates P.A. 48 Medical Park East Drive Suite 350 Birmingham, AL 35235 Tel: 205.838.3040 Fax: 205.833.3627 VIEW MAP >> 
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