Privacy Statement

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Privacy Statement

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. PLEASE REVIEW THIS CAREFULLY.

This notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations (TPO) 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” 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 and related health care services.
Uses and Disclosures of Protected Health Information.
Your PHI may be used and disclosed by your physician, our office staff, and others outside of our office that are involved in your case and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice and any other use required by law.

We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your PHI, as necessary, to a home health agency that provides care to you. For example, your PHI may be provided to a physician to whom you have referred to ensure that the physician has the necessary information to diagnose or treat you.

Your PHI will be used, as needed to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.

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 of assessment activities, employee review activities, training of medical students, licensing, and conducting or arranging for other business activities. For example, we may disclose your PHI to medical students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk were you will be asked to sing your name and indicate your physician. We may also call you by your name in the waiting room when your physician is ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment.

We may use or disclose your PHI in the following situations without your authorization. These include: as Required by Law, Public Health issues as required by law, Communicable Diseases: Health Oversight: Abuse or Neglect: food and Drug Administration requirements: Legal Proceedings: Law Enforcement; Coroners, Funeral Directors, and Organ Donation: Research: Criminal Activity, Military Activity and National Security; Workers Compensation; Inmates Required Uses or Discloses: Under the law, we must make disclosure to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500

Other Permitted and Required Uses and Disclosures
Will be made Only with Your Consent, Authorization, Or Opportunity to Object unless 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.

Your Rights
Following is a statement of your rights with respect to your PHI.

Your have the right to inspect and copy your PHI
Under federal law, however, you may not inspect or copy the following record; psychotherapy notes; information complied in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and PHI that is subject to law that prohibits access to PHI.

Your have the right to request a restriction of your PHI
This means you may ask us not to use or disclose any part of your PHI 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 family members or friends who may be involved in your care of 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 believes it is in your best interest to permit use and disclose of your PHI, your PHI will not be restricted. You then have the right to use another Healthcare Professional.

You have the right to request to receive confidential communications from us by alternative means or at an alternative location
You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively, ie. Electronically.

Your have the right to have your physician amend your PHI
If we deny your request for amendment, you have the right to file a statement or disagreement with us and we may prepare to rebuttal to your statement and will provide you with a copy of any such rebuttal.

You have the right to receive an accounting of certain disclosers we have made, if any, of your PHI
We reserve the right to change the terms of this notice and will inform you by mail of those changes. You then have the right to object or withdraw as provided in this notice.

You may complaint o us or to the Secretary of Health and Human Services, if you believe your privacy rights have been violated by us. We may file a complaint with us by notifying our privacy contact by your complaint. We will not retaliate against you for filing a complaint.

This notice was published and becomes effective on/or before June 25, 2010.

We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information. If you have any objections to this form, please ask to speak with our HIPAA Compliance Office in person or by phone at our main phone number.