HIPAA Notice of Privacy Practices

Our organization is dedicated to maintaining the privacy of your individually identifiable health information.
This Notice describes how medical information about you may be used and disclosed and how you may obtain access to this information. The terms of this Notice apply to all records containing your health information that are created or retained by our organization. Please review it carefully. You have the right to obtain a paper copy of this Notice upon request.

Patient Health Information

Under federal law, patient health information is protected and
confidential. Patient health information includes information about your
symptoms, test results, diagnosis, treatment, and related medical
information. Your health information also includes payment, billing, and
insurance information.

How We
Use Your Health Information

We use health information about you for treatment, to obtain payment,
and for health care operations, including administrative purposes and
evaluation of the quality of care that you receive. We are permitted to use
or disclose your health information, even without your permission, for the following purposes:

Treatment: We will use
and disclose your health information to provide you with medical treatment or
services. For example, nurses, physicians and other members of your treatment
team will record and use it to determine the most appropriate course of care.
We may also disclose the information to other health care providers who are
participating in your treatment, such as pharmacists who are filling your
prescriptions, and to authorized family members who are helping with your

Payment: We will use
and disclose your health information for payment purposes. For example, we
may need to obtain authorization from your insurance company before providing
certain types of treatment. We will submit bills and maintain records of
payment from your health plan.

Healthcare operations: We will use and disclose your health information to conduct
our standard internal
operations, including proper administration of records, evaluation of the
quality of treatment and to assess the
care and outcomes of your case
and others like it.

Special Uses

We may use your information to contact you with appointment reminders.
We may also contact you to provide information about treatment alternatives
or other health-related benefits and services that
may be of interest to you. We may contact you
for fundraising purposes, but you have the right to opt out of receiving such communications.

We participate in the Chesapeake Regional Information
System for our Patients (CRISP), a regional health information exchange
serving Maryland and D.C. As permitted by law, your health
information will be shared
with this exchange in order to provide faster access, better coordination of
care and assist providers and public health officials in making more informed
decisions. Refer to our Communications Notification form if you prefer to opt
out of this program.

Other Uses and Disclosures

We may use or disclose identifiable health information about you for
other reasons, even without your consent. Subject to certain requirements, we
are permitted to give out health information, without your permission, for
the following purposes:

Required by Law: We
may be required to report gunshot wounds, suspected abuse or neglect, or
similar injuries and events.

Research: We may use
or disclose information for approved medical research.

Public health activities: As
required by law, we may disclose vital statistics, diseases, information
related to recalls of dangerous products, and similar information to public
health authorities.

Health oversight: We
may be required to disclose information to assist in investigations and
audits, eligibility for government programs, and similar activities.

Judicial and administrative proceedings: We may
disclose information in response to an appropriate subpoena or court order.

Law enforcement purposes: Subject to certain restrictions, we
may disclose information required by law enforcement officials.

Deaths: We
may report information regarding deaths to coroners,
medical examiners, funeral directors,
and organ donation agencies.

Serious threat to health or
safety: We may use and disclose information when necessary to prevent
a serious threat to your health
and safety or the health
and safety of the public or another

Military and special
government functions: If you are a member of the armed forces, we may
release information as required by military command authorities. We may also
disclose information to correctional institutions or for national security

Workers’ compensation: We
may release information about you for workers
compensation or similar programs providing benefits for work-related injuries or illness.

Business associates:
We may disclose your health information to business associates or third
parties that we have contracted with to perform agreed upon services.

We do not engage in selling your health information, however if we do,
we will obtain your written authorization
before we are permitted to sell your
health information. In all other situations, including marketing
activities, we will ask for your written authorization
before using or
disclosing any identifiable
health information about you. If you choose to sign an authorization to disclose information,
you can later revoke that authorization to stop any future uses and disclosures.

Individual Rights

You have the following rights
with regard to your health information. Please contact the privacy officer
for exercising these rights.

restrictions: You may request restrictions on certain uses and disclosures
of your health information. You have the
right to restrict disclosures of your health
information to your
health plan for payment
and health care operations purposes (and not for treatment) if the disclosure

pertains to a health care item or service for which you paid out-of-pocket in full. If
requesting a restriction for a health care item or service for which you paid
out-of-pocket in full, we will honor your request, unless the disclosure is necessary
for your treatment or is required by law. For all other restriction requests, we are not
required to agree to such restrictions.

communication: You may ask us to communicate with you confidentially
by, for example, sending notices to a special address or not using post-cards
to remind you of appointments.

Inspect and obtain copies: In most cases,
you have the right to look at or get a copy of
your health information. An administrative
fee may apply.
We have the right to deny your request.

information: If you believe that information in your record is
incorrect, or, important information is missing, you have the right to
request that we correct the existing information or add the missing
information. Amendment requests must be made in writing.

Accounting or disclosures:
You may request a list of instances where we have d is closed health
information about you for reasons other than treatment payment, or health
care options.

Breach notification:
We are required to notify you in the event of a breach
of your unsecured protected health
information, and will do so accordingly.

Our Legal Duty

We are required by law to protect and maintain the privacy of your
health information, to provide this notice about our legal duties and privacy
practices regarding protected health information, and to abide by the terms
of the notice currently in effect.

Changes in Privacy Practices

We may change our Privacy Practices at any time. Before we make a
significant change in our policies, we will change our Notice and post the
new Notice in the waiting area. You can also request a copy of our Notice at
any time. For more information about our privacy practices, contact the
Privacy Officer listed below.


If you are concerned that we
have violated your privacy rights, or, you disagree with a decision we made about your
records, you may contact the person listed below. You also may send a written
complaint to the U.S.
Department of Health
and Human Services. The person listed below will provide you with
the appropriate address upon request. You will not be penalized in any way
for filing a complaint.

Contact Person

If you have any questions, requests, or complaints, please contact:

Capital Digestive Care
ATTN: Privacy Officer

12510 Prosperity Drive, Suite 200 Silver Spring, MD 20904