Our dermatology practice, Sheard & Drugge, PC,
has the responsibility to treat all patient information with the
utmost discretion, and confidentiality, and to prohibit improper
release in accordance with the confidentiality requirements of the
state and federal laws and regulations. Protected health information
includes information related to claims, medical records and other
personally identifiable records. Disclosure of your protected health
information within our dermatology practice is on a need-to-know
basis. All employees are required to sign a confidentiality agreement
as a condition of employment whereby they agree not to request,
use or disclose protected health information of our dermatology
practice patients unless necessary to perform their job. Disclosure
of your protected health information to persons outside our dermatology
practice is done only pursuant to authorization from you or in conjunction
with appropriate nondisclosure agreements.
Under our dermatology practice's confidentiality policy,
you have the right:
- To inspect and copy records containing patient
identifiable health information.
- To approve the release of protected health information
about you beyond the uses authorized at the time of enrollment.
- To request our dermatology practice's written procedures
regarding your rights to confidentiality.
Providing Consent to Release Protected
The written authorization you provide at the time
of enrollment is valid for all dependents covered by your plan.
This authorization allows our dermatology practice to use protected
health information for the purposes listed below:
- Submitting Insurance Claims.
- Quality Assurance Reviews.
- Administering your Health Care.
- Complying with government requirements, research,
You may authorize our dermatology practice to release
protected health information to a third party for all other purposes
by signing a written authorization which you may revoke at any time.
Examples of other purposes include: release of information to your
attorney or release of information requested by a third party to
process a workers' compensation or automobile insurance claim.
If you lack the ability to consent to the release
of your protected health information, your legally appointed representative
may authorize release of the information and may have access to
Use of Information for Quality Assurance and
Outcomes Assessment Activities
Internal use and disclosure of protected health information
for quality assurance purposes is limited to those with a need to
know based on their job functions. Any disclosure of protected health
information to external peer review panels or consultants is done
so only after the external party signs a confidentiality agreement.
Inspecting Your Health Information
If you wish to inspect or obtain copies of your protected
health information, please send your written request to Sheard and
Drugge, PC, 50 Glenbrook Road Suite 1C, Stamford, CT 06902. We will
arrange a convenient time for you to visit our office for inspection.
We will provide copies to you for a nominal fee. If your request
for inspection or copying of your protected health information is
denied, we will provide you with the specific reasons and an opportunity
to appeal our decision. We are committed to protecting the confidentiality
of your health information.