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SUN DOWNSTATE MEDICAL CENTER
UNIVERSITY HOSPITAL OF BROOKLYN
POLICY AND PROCEDURE
No.
Subject:NOTICE OF PRIVACY PRACTICESPrepared by:Shoshanna Milstein___Reviewed by: HIPAA Policy & Procedure Team
HIPAA
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How to fill out notice of privacy practices
How to fill out notice of privacy practices
01
Read the notice of privacy practices provided by your healthcare provider or organization
02
Understand the information regarding how your medical information is collected, used, and protected
03
Fill out any required fields in the notice, such as providing your contact information or signing a consent form
04
Ask any questions or seek clarification on any parts of the notice that you do not understand
05
Submit the completed notice back to your healthcare provider or organization
Who needs notice of privacy practices?
01
Patients receiving healthcare services
02
Individuals seeking medical treatment or services
03
Anyone providing medical services or handling patient information
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What is notice of privacy practices?
Notice of privacy practices is a document that explains how a healthcare provider may use and disclose protected health information.
Who is required to file notice of privacy practices?
Healthcare providers, health plans, and healthcare clearinghouses are required to file notice of privacy practices.
How to fill out notice of privacy practices?
Notice of privacy practices can be filled out by including information about how protected health information is used and disclosed, patient rights, and contact information for the privacy officer.
What is the purpose of notice of privacy practices?
The purpose of notice of privacy practices is to inform patients of their rights regarding their protected health information and how it may be used or disclosed.
What information must be reported on notice of privacy practices?
Information that must be reported on notice of privacy practices includes the provider's privacy policies, how protected health information is used and disclosed, and patient rights.
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