Privacy
Policy
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.
This Health Insurance Portability & Accountability Act
of 1996 (HIPAA) is a federal program that requires 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 rights 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 have prepared this statement 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, coordinating, or managing heath
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 of this
would be sending a bill for your visit to your insurance
carrier for payment.
Health care operations include 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 create 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, expect to the extent that we have already
taken action relying on your authorization.
You 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
discloses of protected health 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 to 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 June
10, 2002, 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 review
Notice of Policy Practices from this office.
You have
recourse if you feel that your privacy protects have been
violated. You have the right to file a formal, 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 contact us for more
information, by asking to speak to our Privacy Officer or
for written inquires, note “Attention Privacy
Officer”.
For more information about HIPAA or to file a
complaint:
The U.S. 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