In: Nursing
Construct a notice of privacy policy (NPP) for your current employer if you work in healthcare (do not just copy your organization's existing one). If you do not work in healthcare or do not want to use your current employer for this assignment, please use either the USA Urgent Care Clinic or USA Medical Center as your organization.
You should keep your NPP as short and simple as possible while still insuring that all necessary information is included. Remember that your target audience is your patients, so make sure the NPP is written in terms that they can understand.
You may use NPPs that are available online as a starting point, but I want you to sufficiently customize them so that they are appropriate for your organization. Keep in mind that many of the NPPs found online may not satisfy current requirements.
USA MEDICAL CENTRE
Notice of Privacy Practices
Patients Acknowledgment
Patient name:_______________________________ Date of birth:__________
I have received and understand this practice's Notice of Privacy Practices written in plain language. This notice provides in the uses and disclosure of protected Health information that may be made by this practice, my individual rights and practice's legal duties with respect to my protected health information. This includes but it is not limited to:
* A statement that this practice is required by law to maintain the privacy of protected health information.
* A statement that this practice is required to abide by terms of notice currently in effect.
* Types of uses and disclosures that this practice is permitted to make for each of following purposes: treatment, payment and each of health care operations.
* A description of each of the following purposes for which this practice is permitted or required to use or disclose protected Health information without my written consent or authorization.
* A description of uses and disclosures that are prohibited or materially limited by law.
* My individual rights with respect to protected health information and a brief description of how I may excercise these rights in relation to:
- The right to complain this practice if I believe my privacy rights have been violated, and that no actions will be used against me in the event of such a complaint.
- The right to request restrictions on certain uses and disclosure of my protected health information and that this practice is not required to agree to a requested restriction.
- The right to amend protected health information.
- The right to inspect and copy protected health information.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of the Notice of Privacy Practices from this practice upon request.
This practice reserves the right to change the terms of Notice of Privacy Practices and to make new provisions effective for all protected health information that it maintains. If change occur, this practice will provide me a revised Notice of Privacy Practices upon request.
Signature: ________________________________ Date:_____________
Relationship to patient(if signed by a personal representative of patient):_________________________________