Privacy Policy for De Anne Harris Collier, M.D., P.A. - Dermatology



At Skin and Cancer Associates, we are committed to treating and using protected health information about you responsibly. This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This Notice is effective 04-15-03 and applies to all protected health information as defined by federal regulations. ( revised 9/13)

Understanding Your Health Record/Information

Each time you visit Skin and Cancer Associates, a record
of your visit is made. Typically, this record contains your
symptoms, examination and test results, diagnoses,
treatment, and a plan for future care or treatment. This information, often referred to as your health or medical

record, serves as a:

  • Basis for planning your care and treatment,

  • Means of communication among the many health

    professionals who contribute to your care,

  • Legal document describing the care you received,

  • Means by which you or a third-party payer can verify

    that services billed were actually provided,

  • A tool in educating heath professionals,

  • A source of data for medical research,

  • A source of information for public health officials

    charged with improving the health of this state and

    the nation,

  • A source of data for our planning and marketing,

  • A tool with which we can assess and continually

    work to improve the care we render and the
    outcomes we achieve,

    Understanding what is in your record and how your
    health information is used helps you to: ensure its
    accuracy, better understand who, what, when, where, and
    why others may access your health information, and

make more informed decisions when authorizing disclosure to others.

Y our Health Information Rights

Although your health record is the physical property of Skin and Cancer Associates the information belongs to you. Y ou have the right to:

• Obtain a paper copy of this notice of information practices upon request,

• Inspect and copy your health record as provided for in 45 CFR 164.524,

• Request we amend your health record as provided in 45 CFR 164.528,

• Obtain an accounting of certain disclosures of your health information as provided in 45 CFR 164.528,

• Request communications of your health information by alternative means or at alternative locations,

• Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522, and

• Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

• If you have paid for services “out of pocket” in full and in advance, and you request we do not disclose PHI related solely to those services to a health plan, we will accommodate your request, except where we are required by law to make a disclosure.

Our Responsibilities

Skin and Cancer Associates is required to:

• Maintain the privacy of your health information, • Provide you with this notice as to our legal duties and privacy practices with respect to information we

collect and maintain about you,
• Abide by the terms of this notice,
• Notify you if we are unable to agree to a requested

restriction, and
• Accommodate reasonable requests you may have to

communicate health information by alternative
means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will post a revised notice.

We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example: Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.

We may also provide other physicians or subsequent health care providers with copies of various reports that should assist him or her in treating you.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health operations.

For example: Your information may be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Business associates: There are some services provided in our organization through contacts with business associates. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do to protect your health information, however, we require the business associate to appropriately safeguard your information.

Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, of your location, and general condition. We may call to confirm appointments and communicate lab results.

Communication with family: Health professionals, using
their best judgment, may disclose to a family member, other
relative, close personal friend or any other person you
identify, health information relevant to that person’s

involvement in your care or payment related to your care.

Research: We may disclose information to researchers
when an institutional review board that has reviewed the
research proposal and established protocols to ensure the
privacy of your health information has approved their


Marketing: We may contact you to provide appointment
reminders or information about treatment alternatives or
other health-related benefits and services that may be of
interest to you.

Food and Drug Administration (FDA): We may disclose to
the FDA health information relative to adverse events with
respect to food, supplements, product and product defects,
or post marketing surveillance information to enable

product recalls, repairs, or replacement.

Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

For More Information or to Report a Problem

If have questions and would like additional information, you may contact the practice’s Privacy Officer, Darlene Tomlinson at 1-888-479-6415 Ext 636.

If you believe your privacy rights have been violated, you can file a complaint with the practice’s Privacy Officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below:

Office for Civil Rights

U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201


Skin and Cancer Associates

Revised September 2013