Patient Privacy

Aysegul C. Soyer, M.D.

Brenda R. Crum, CSFNP
Potomac Professional Village
1930 Opitz Blvd.
Woodbridge, Virginia 22191
Phone: 703-497-9950

Aysegul C. Soyer, M.D.
Brenda R. Crum, CSFNP
Notice of Privacy Practices

Effective Date: April 14, 2003 (Revised May 11, 2010)

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. We understand that medical information about your health is personal. Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP is required by law to maintain the privacy of your health information, to follow the terms of this Notice, and to provide you with this notice of our legal duties and privacy practices with respect to your health information. We are required to follow the terms of the Notice that is currently in effect.

How Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP May Use or Disclose Your Health Information

Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP protects the privacy of your health information. For some activities, we must have your written authorization to use or disclose your health information. However, the law permits Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP to use or disclose your health information for the following purposes without your authorization:

For Treatment Information obtained by the Practice will be used to provide, coordinate, or manage your health care and related services. We may disclose health information about you to health care professionals and other persons who are involved in providing your health care. For example, we would disclose your health information as necessary to a home health agency that provides care to you or to another physician to whom you have been referred to ensure that the physician has the necessary information to diagnose and treat you.

For Payment We may use and disclose your health information so that medical treatment services may be billed to, and payment may be collected from, you, an insurance company or a third party.

For Health Care Operations We may use and disclose health information about you for practice operations. We may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may call you by name in the waiting room when your physician is ready to see you. Unless you provide us with alternative instructions, we may call your home with appointment reminders and send other materials related to your health care to your home. These uses and disclosures are necessary to run the Practice and make sure that you receive information important to your health care.

As Required by Law We will disclose your health information when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety We may use and disclose health information when necessary to prevent a serious threat to his/her health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Public Health Risks We may disclose your health information for public health activities. These activities generally include the following: (1) to prevent or control disease, injury or disability; (2) to report reactions to medications or problems with treatments; (3) to notify people of recalls of products they may be using; (4) to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and (5) to notify the appropriate government authority if we believe a person has been the victim of abuse, neglect or domestic violence (we will only make this disclosure if you agree or when required or authorized by law).

For Health Oversight Activities We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities, which are necessary for the government to monitor the health care system, include audits, investigations, inspections and licensure.

Lawsuits and Disputes If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court order or administrative order. We may also disclose health information in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request (which may include written notice to you) or to obtain an order protecting the information requested.

For Specific Government Functions Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP may disclose health information for the following specific government functions: (1) health information of military personnel, as required by military command authorities; (2) health information of inmates, to a correctional institution or law enforcement official; (3) in response to a request from law enforcement, if certain conditions are satisfied; and (4) for national security reasons.

Business Associates Business Associates must directly comply with applicable HIPAA law, regardless if present Business Associate agreements require such. Health Information Exchanges, E-Prescribing portals, and Regional Health Information Exchanges are classified as Business Associates. Business Associates subject to enforcement, civil, and criminal penalties.

Marketing/Sale of PHI Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP are prohibited from receiving direct or indirect remuneration in exchange for a patient’s PHI without the patient’s authorization. Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP are prohibited from selling PHI for marketing purposes.

Opt-Out for Fundraising Communications Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP must present patients with clear and conspicuous opportunities to opt out of receiving fundraising communications.

Criminal Penalties Individuals – including employees of covered entities – also are subject to criminal penalties.

Civil Monetary Payments and Settlements Civil penalties and settlements will go to the Office of Civil Rights and be allocated to enforcement of HIPAA.

When Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP May Not Use or Disclose Your Health Information

Except as described in this Notice Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP will not use or disclose your health information without your written authorization. If you do authorize Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

You Have the Following Rights With Respect to Your Health Information

Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP cannot disclose self-pay (i.e., paid in full by you) services to health plans if you object to such. You have the right to inspect, request a copy or receive an electronic copy of your health information via CD-ROM, USB drive, web site or similar options. Furthermore, you have the right to direct Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP to transmit an electronic copy of your record to another entity or person as long as the Practice maintains the health information except as restricted by law. Your health information usually will include treatment and billing records. To inspect copy or electronically transmit your health information, you must submit a written request to the Practice. We may charge you a fee for the costs of copying, mailing, transmitting or other supplies that are necessary to grant your request. You have the right to request that Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP to amend your health information that is incorrect or incomplete. To request an amendment, you must submit a written request to the Practice along with the reason for the request. Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP is not required to amend health information that is accurate and complete. Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP will provide you with information about the procedure for addressing any disagreement with a denial. You have a right to receive an accounting of disclosures of your health information we have made after April 14, 2003 for purposes other than disclosures (1) for Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP treatment, payment or health care operations, (2) to you or based upon your authorization and (3) for certain government functions. To request an accounting, you must submit a written request to the Practice. You must specify the time period, which may not be longer than six years. You may request communications of your health information by alternative means or at alternative locations. For example, you may request that we contact you about health matters only in writing or at a different residence or post office box. To request confidential communication of your health information, you must submit a written request to the Practice. Your request must state how or when you would like to be contacted. We will accommodate all reasonable requests. If you would like to exercise one or more of these rights, contact the Practice or submit a written request to Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP, HIPAA Privacy, 1930 Opitz Boulevard, Woodbridge, Virginia 22191. When possible, Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP will use limited data sets or de-identified information to satisfy the minimum necessary standard. Covered entities may not rely solely on requesting entities to determine what constitutes minimum necessary. Instead, Aysegul C. Soyer, M.D. and Brenda R Crum, CSFNP must determine for ourselves what is the minimum necessary data it can release to satisfy the requesting entity’s needs. Clarifying guidance on what constitutes minimum necessary must be issued by the Secretary of Health and Human Services no later than August 18, 2010.

Changes to this Notice of Privacy Practices

Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP reserves the right to change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have about your child as well as any information we receive in the future. Any revised Notice will be posted in the Practice’s offices. Upon request, we will provide a revised Notice to you.

For More Information or to Report a Problem

If you have questions or would like additional information about Practice privacy practices, you may contact HIPAA Privacy, Aysegul C. Soyer, M.D. and Brenda R. Crum, CSFNP, 1930 Opitz Blvd, Woodbridge, Virginia 22191 Phone: 703-497-9950 or Fax: 703-497-9956. If you believe your privacy rights have been violated, you can file a complaint with the Compliance Officer at the above address, or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.