NOTICE OF PRIVACY PRACTICES
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, initiate payment, or conduct health care operations and for other purposes permitted or required by law. The medical practice reserves the right to make changes in the Notice of Privacy Practices. The Notice describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
For a more complete and detailed version of this Privacy Practice Notice, make your request known at the front desk.
We understand that medical information about you and your health is personal, and we are committed to protecting it. A record of the care and services you receive at this practice is created and maintained at this location.
We are required by law to:
- Make sure that medical information that identifies you is kept private.
- Provide you this Notice of our legal duties and privacy practices regarding your medical information.
- Follow the terms of the Notice that is currently in effect.
The following categories describe ways that we use and disclose medical information about you:
- Health care operations
- Third-party business associates, such as billing or transcription
We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. Your name and address may be used to send you a newsletter about out practices and the services we offer. You may contact our Privacy Officer to request that these materials not be sent to you.
Other use and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke this authorization, at any 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.
You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of all of part of your protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the protected health information that is relevant to your health care will be disclosed.
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your healthcare. We may use or disclose your protected health information in an emergency treatment situation.
We may use or disclose your protected health information in the following situations without your consent or authorization:
- Required by Law
- Public Health
- Communicable Diseases
- Health Oversight
- Abuse or Neglect
- Food or Drug Administration
- Legal Processing
- Law Enforcement
- Coroners, Funeral Directors, and Organ Donation
- Worker’s Compensation
- Sale of Closure of the Practice
- Inspect and copy your protected health information
- Request a restriction of your protected health information
- Request to receive confidential communications from us by alternative means or location
- Have your physician amend your protected health information
- Receive an accounting of certain disclosures we have made, if any
- Receive a paper copy of this Notice from us
- File a complaint
You may file a complaint to our office or to the Secretary of Health Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy officer of your complaint. You will not be penalized or retaliated against for filing a complaint.