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NOTICE OF PRIVACY PRACTICES
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW CAREFULLY.
The
Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a
federal program that requires that all medical records and other
individually identifiable health information used or disclosed by us in
any form, whether electronically, on paper, or orally, are kept properly
confidential. This Act gives
you, the patient, significant new right to understand and control how your
health information is used. HIPAA
provides penalties for covered entities that misuse personal health
information.
As
required by HIPAA, we prepared this explanation of how we are required to
maintain the privacy of your health information and how we may use and
disclose your health information.
We
may use and disclose your medical records only for each of the following
purposes: treatment, payment,
and health care operations.
- Treatment means providing, coordination, or managing health care and related services by one or more health care providers. An example of this would include a physical examination.
- Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example would be sending a bill for your visit to your insurance company for payment.
- Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis and customer service. An example would be an internal quality assessment review.
We
may also crate and distribute de-identified health information by removing
all references to individually identifiable information.
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.
Any
other uses and disclosures will be made only with your written
authorization. You may revoke
such authorization in writing and we are required to honor and abide by
that written request, except to the extent that we have already taken
actions relying on your authorization.
You
may have the following rights with respect to your protected health
information, which you can exercise by presenting a written request to the
Privacy Officer:
- The right to request restrictions on certain uses and disclosures information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
- The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.
- The right to inspect and copy your protected health information.
- The right to amend your protected health information
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of this notice from us upon request.
We are required by law to maintain the
privacy of your protected health information and to provide you with
notice of our legal duties and privacy practices with respect to protected
health information.
This
notice is effective as of April 14, 2003 and we are required to abide by
the terms of the Notice of Privacy Practices currently in effect.
We reserve the right to change the terms of our Notice of Privacy
Practices and to make the new notice provisions effective for all
protected health information that we maintain.
We will post, and you may request, a written copy of a revised Notice
of Privacy Practices from this office.
You
have recourse if you feel that your privacy protections have been
violated. You have the right
to file a written complaint with our office or with the Department of
Health & Human Services, Office of Civil Rights, about violations of
the provisions of this notice or the policies and procedures of our
office. We will not retaliate against you for filing a complaint.
Please
for more information:
For
more information about HIPAA or to file a complaint:
The US Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
(202) 619-0257
Toll Free: 1-877-696-6775
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