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NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY |
The Health Insurance Portability & 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 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 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 healthcare operations
• Treatment means providing, coordinating, or
managing health care and related services by
one or more health care providers. An example of this would be a physical
exam.
• 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 company for payment.
• Healthcare 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 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, except to the extent that we have already then actions 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 disclosures 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 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 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 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 formal, written complaint with our office or with the Department of Health and 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.
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