This notice describes how medical information about you may be used and disclosed and how you can get accessto thisinformation. Please review it carefully
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry outtreatment, payment, and healthcare operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Protected Health Information, or PHI, is information about you, including demographic information, thatmay identify you and that relates to your past, present, or future physical or mental health or condition and related healthcare services.
Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operations of the physicians practice, and any other use required by law.
Payment
Your protected health information will be used as needed to obtain payment for your health care services.
Healthcare Operations
We may use or disclose, as needed, your protected health information in order to support the business activities of your physician's practice. These activities include but are not limited to quality assessment, employee review, training of medical students, and licensing. For example, we may call you be name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointments.
We may use or disclose your protected health information in the following situations without your authorization: as required by law, public health issues, communicable diseases, health oversight, abuse or neglect, food and drug administration requirements, legal proceedings, law enforcement, coroners, funeral directors, organ donation, research, criminal activity, military activity, and national security. Under the law, we must also make disclosures to you, and when required by the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.
Other Permitted & Required Uses and Disclosures
Disclosure will be made only with your authorization or opportunityto object unless required by law. You may revoke this authorization atany time, in writing, except to the extent that your physician or the physician's practice has taken an action in reliance on the use or disclosure indicated in the authorization.
Your Individual Rights:
1. You have the right to inspect and receive a copy of your protected health information. Our practice will accept such requests in writing. Under federal law, however, you may not inspect or receive a copy of the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits accessto protected health information.
2. You have the right to request a restriction on the disclosure of your protected health information This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to familymembers or friends whom may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Your physician is not required to agree to a restriction that you may request. If a physician believesit isin your best interest to permituse and disclosure of our protected health information, yourhealth information will not be restricted. You then have the right to use another healthcare professional.
3. You have the right to request to receive confidential communications from us by an alternative means or at an alternative location
4. You have the right to obtain a paper copy of this notice from us
5. You have the right to receive an accounting of certain disclosure we have made, if any, of your protected health information. We reserve the right to change the terms of this notice and will post any changesin our waiting areas. You then have the right to object as provided in this notice.
Complaints
You may file any complaints with the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. We will not retaliate against you for filing a complaint.
