This notice describes how medical information about you may be used and disclosed and about how you can get access to this information.  Please review it carefully.

The Patient Information Protection Plan covers individually identifiable personal health, financial and demographic information (known as Protected Health Information or PHI) created or maintained by this practice. We are required to provide patients with this notice of our obligations and privacy practices.  Federal law requires we protect PHI and allows for its use to carry out treatment, payment, or other health care operations (TPO).

Treatment refers to those activities required to provide quality patient care, and includes discussion of PHI with staff when necessary and sharing medical information with hospitals, diagnostic services or specialists.  Payment refers to obtaining payment or reimbursement, determining eligibility or coverage, and other billing activities.  These activities often involve third parties such as your insurance company, a third party administrator (TPA) designated by your insurance company, or a billing service we may contract with.  Other Healthcare Operations include authorizing referrals to other providers, utilization reviews conducted by your health plan or quality reviews conducted by health care providers.

TPO disclosures will include all pertinent medical information to other health care providers for treatment purposes and to insurers or third party administrators (TPA) when required to process claims.   Montgomery Family Medicine will communicate results, directions, and reminders to patients via mail, telephone or electronic means.  This communication is vital to our provision of good and complete healthcare and we will take reasonable precautions to ensure confidentiality and protect PHI.

It is the policy of this practice to protect your privacy and not to permit the disclosure of PHI for any non-routine reasons without expressed written and revocable authorization from the patient that must include the nature, time frame and receiver of the data to be released.  Non-routine disclosures are those for other then TPO and include patient mailing lists to third parties and information to an employer for employment decisions.  The practice must disclosure PHI when required by law or in the interest of public health. 

All employees are counseled on the importance of confidentiality and sign an Acknowledgement of Confidentiality.  Employees discuss PHI only to the extent required to carry out TPO.  PHI is used or accessed only on a need to know basis.  PHI is stored in our practice management computer system and in medical charts.  The Chief Operating Officer is responsible for ensuring compliance with, and training on, the Patient Information Protection Plan.  Questions or concerns may be addressed to him by calling our office at (334) 396-9100.  Montgomery Family Medicine reserves the right to change this policy and the most recent version of it is posted and available in our lobby and posted on our web site.  We are required to abide by the most current version.  Possible violations of rights listed here may be reported, without adverse consequence, to the COO at the above number or to the Secretary of HHS.

Notice of Individual Rights
Patients are encouraged to read this notice and will be provided a copy if they desire.  When giving reasonable, written notice, patients have the right to review health information, amend incomplete or inaccurate records, request alternative methods for communicating PHI, request special accommodation and restrictions on the use of PHI for TPO and know who has accessed PHI for non-routine reasons.  Montgomery Family Medicine is not obligated to agree to any special restrictions and will not agree to any that unreasonably hampers the provision of TPO.  Only an officer of the practice may agree to restrict the use of PHI or change how PHI is normally used to carry out TPO.