Restriction of Use or Disclosure of Protected Health Information (PHI) Policy

Effective date of policy: April 14, 2003

A patient/employee has the right to Request that the use and disclosure of his protected health information (PHI) be restricted for treatment, payment, and health care operations (TPO), as well as restricting disclosure to certain people, such as family members.

PRC does not have to agree to such requests.

The restriction request must be in writing, be specific as to what information is covered by the request, whether it covers use, disclosure, or both, and to whom these limitations apply.

If PRC agrees to the request, it will honor the request except when overriding laws or emergencies apply.

The agreement to restrict health information use and/or disclosure of treatment, payment, or health care operations may be terminated at any time, in writing, by the patient, or by the practice for health information created or received after the date of the notice.