Required by Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Our Commitment to your Privacy:
Our practice is dedicated to maintaining the privacy of your protected health information. We are required by law to maintain the confidentiality of health information that identifies you. We are required by law to provide you with this notice of our legal duties, and of the privacy practices that we maintain in our practice concerning your protected medical records. The terms of this notice apply to all of the protected medical records that identifies you which are created or retained by our practice.
Uses & Disclosures/Releases:
Treatment. Your health information may be used by our staff or released to another health care professional in order to evaluate your health, diagnose medical conditions and to provide treatment. For example, we may ask you to have laboratory tests (such as blood or urine tests), and we may use the results to help us reach a diagnosis or we might disclose your health information to a pharmacy when we order a prescription for you. Many of the people who work for our practice - including, but not limited to, our physician and our nurse - may use and/or release your protected health information in order to treat you or to assist others in your treatment, and to inform you of potential treatment options or alternatives. Additionally, we may release your health information to others who may assist in your care, such as your spouse, children, parents or friends. For example, if you have a family member or friend bring you to the office for treatment, the family member or friend may have access to your medical information.
Payment. Your health information will be used to bill and collect payment for the services and items you may receive from us. We may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We may use your health information to obtain payment from third parties that may be responsible for such costs, such as family members. Lastly, we may use your protected health information to bill you directly for services and items.
Health Care Operations. Our practice may use your protected medical records to operate our business. For example, we may use your protected medical records to evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for our practice.
Disclosures Required By Law. Our practice will release your health information without your permission when we are required to do so by federal, state or local law to law enforcement agencies, to support law enforcement investigations, and to comply with government-mandated reporting. For example, we are required by law to report to the Department of Health and Welfare, or organizations contracted by the same, to support the Cancer Registry
Other Uses and Releases Require Your Authorization. Release of your protected health information or its use for any purpose other than those listed above required your written authorization. If you change your mind, you may provide a written revocation of the authorization; however your decision to revoke the authorization will not affect or undo any use or release of information that occurred before your notified us of your decision.
Additional Uses of Information:
Appointment Reminders. Our practice may use your information to contact you and remind you of an appointment, including contacting family members identified by you if we cannot reach your at your home or place of work.
Health-Related Benefits and Services. Our practice may use your protected medical records to inform you of health-related benefits or services that may be of interest to you.
Your Rights Regarding Your Medical Records: You have rights regarding the protected medical records that we maintain about you, including:
Duties of this Office:
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices. We also are required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Privacy Practices:
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice at your next office visit.
Complaints:
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to the following address. If you have a request to restrict, amend or correct your medical records, you may request the appropriate form from our office, complete it and return it to the following address:
If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address. You will not be penalized or otherwise retaliated against for filing a complaint.