Notice of Privacy Practices for Protective Health Information
This notice is to describe how medical information about you may be used and disclosed and how you can get access for this information.
We reserve the right to change our privacy practices and terms of this notice at any time providing such changes are permitted by law. This is effective for all health information we maintain, including health information we created or received before we made changes. Before significant changes in our privacy practices we will change this notice and make a new notice available upon request.
With your consent, the practice is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment and health care operations. Protected health information is information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, treatment and applying for future care and treatment. It also includes billing documents for those services. Said information is stored in a chart, computer and electronic health/personal health record.
Uses and disclosures of health information
- Treatment. We use medical information about you to provide your medical care. We disclose medical information to our employees and others who are involved in providing the care needed. This includes other physicians, labs and pharmacists. We may also disclose information to members of your family.
- Payment. We use and disclose medical information about you to obtain payment for the services we provide.
- Healthcare Operations. We may use and disclose your health information in connection with our health care operations. This includes assessment and improvement activities.
- Your Authorization. In addition to our use of your information for treatment, payment and healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us written authorization, you may revoke it in writing at any time. Unless you give us a written authorization we cannot use or disclose your health information for any reason except those described in this notice.
- Notification and communication with family. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition. Unless you have instructed otherwise.
- Marketing. We will not use or disclose your health information for marketing communications without your written authorization.
- Required by law. As required by law, we will use and disclose your health information, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities. We may, and are sometimes required by law, to disclose information to law enforcement officials for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with the court order, warrant, grand jury subpoena and other law enforcement purposes.
- Public Safety. We may, and are sometimes required by law, to disclose your health information to appropriate persons in order to prevent or lessen a serious an imminent threat to the health or safety of a particular person or the general public.
- Change of ownership. In the event that this medical practice is sold or merged with another, your health information/record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another physician or medical group.
- Breach Notification. In the case of a breach of unsecured protected health information, we will notify you as required by law.
- Appointment reminders. We may use information to provide appointment reminders. (such as voicemail, messages, postcard, e-mail or letters)
- Right to request special privacy protections. You have the right to request restrictions on certain uses and disclosures of your health information by a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed.
- Right to request/restrict confidential communications. You have the right to request that you receive your health information in a specific way or at a specific location. Examples are a particular e-mail address or physical address. We will comply with all reasonable requests in writing which specify how or where you wish to receive information.
- Right to inspect and copy. You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit written request detailing what information you want access to, whether you want to inspect or copy it, if you want a copy, your preferred format. We will also send a copy to any other person you designate in writing. We will charge a reasonable fee which covers our cost for labor, supplies and postage.
- Right to a paper of electronic copy of this notice. You have a right to this notice of our legal duties and privacy practices with respect to your health information, including a right to a paper copy of this notice of privacy practices, even if you have previously requested its receipt by e-mail.3
- Right to an accounting of disclosure. You have a right to receive an accounting of disclosures of your health information made by this practice.
- Right to amend or supplement. you have the right to request that we amend your health information that you believe is incorrect or incomplete. You must make request in writing and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information, and will provide you with information about this medical practice’s denial and how you can disagree with the denial.
We support your right to the privacy of your health information.