SUMMARY

NOTICE OF PRIVACY PRACTICES

 

As required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Our complete Notice of Privacy Practices will be provided to you in our office.

At our practice, we are required to protect the privacy of your medical/health information about you and that can be identified with you. This is called “protected health information” or “PHI” for short. We respect the privacy and confidentiality of your protected health information. Our Notice of Privacy Practices describes the ways in which we may use and disclose your medical/protected health information and how you can get access to this information. Your health information is contained in your medical and billing records maintained by our practice. It includes demographic information and information that relates to your present, past or future physical or mental health and related healthcare services. The Notice of Privacy Practices applies to uses and disclosures we may make of all your protected health information whether created by us in our practice or received by us from another healthcare provider.

Uses and Disclosures of Health Information.

 

We will use and disclose your health information in order to treat you or to assist other health care providers in treating you. We will also use and disclose your health information in order to obtain payment for our services or to allow insurance companies to process insurance claims for services rendered to you by us or other health care providers. Finally, we may disclose your health information for certain limited operational activities such as quality assessment, licensing, accreditation and training of students.

Uses and Disclosures Based on Your Authorization

Except as stated in more detail in the Notice of Privacy Practices, we will not use or disclose your health information without your written permission.

Uses and Disclosures Not Requiring Your Authorization

In the following circumstances, we may disclose your health information without your written authorization:

 • Unless you object, to family members or close friends who are involved in your health

    care 

• For certain limited research purposes

• For purposes of public health and safety

• To Government agencies for purposes of their audits, investigations and other oversight

   activities

• To government authorities to prevent child abuse or domestic violence

• To the FDA to report product defects of incidents

• To law enforcement authorities to protect public safety or to assist in apprehending

    criminal offenders

• When required by court orders, search warrants, subpoenas and otherwise required

    by law

Patient Rights

As our patient, you have the following rights:

• To have access to and/or a copy of your health information

• To request an accounting of certain disclosures we have made of your health information

• To request restrictions as to how your health information is used or disclosed

• To request that we communicate with you in confidence

• To request that we amend your health information

• To receive notice of our privacy practices

If you have a question, concern or complaint regarding our privacy practices, please refer to the detailed Notice of Privacy Practices provided to you by our practice and contact our Privacy Officer.