Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective April 14, 2003
The privacy of your medical information is important to us. You may be aware that U.S. government regulators established a privacy rule (“HIPAA”) governing protected health information. This notice tells you about how it may be used, and about certain rights that you have.
Use and disclosure of protected information:
Federal law provides that we may use your medical information (protected health information) for treatment of you, without further specific notice to you, or written authorization by you.
Federal law provides that we may use your medical information to obtain payment for our services without further specific notice to you, or written authorization by you.
Federal law provides that we may use your medical information for health care operations without further specific notice to you, or written authorization by you.
We may use or disclose your medical information, without further notice to you, or specific authorization by you, where:
1. required by law;
2. required for public health purposes;
3. required by law to report child abuse;
4. required by a health oversight agency for oversight activities authorized by law;
5. required by law in judicial or administrative proceedings;
6. required for law enforcement purposes by a law enforcement official;
7. required by a coroner or medical examiner;
8. permitted by law to a funeral director;
9. permitted by law for organ donation purposes;
10. permitted by law to avert a serious threat to health or safety;
11. permitted by law and required by military authorities if you are a member of the U.S. armed forces.
Rights that you have:
You have the right to request restrictions on certain of the uses for disclosures described above.
You have the right to inspect and obtain copies of your medical information (a reasonable fee will be charged).
You have the right to request amendments to your medical information.
You have the right to request an accounting of any disclosures we make of your medical information,
You have the right to obtain a paper copy of this notice from our office.
Obligations that we have:
We are required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices.
If you want to complain to our office about violations of your privacy rights, Complaints should be directed to our privacy officer, who is the office manager.