This notice describes how health information about you, as a patient of
this practice, may be used and disclosed, and how you can get access to your
health information. This is required by the Privacy Regulations created as a
result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Our practice is dedicated to maintaining the privacy of your health information.
We are required by law to maintain the confidentiality of your health
information.
We realize that these laws are complicated, but we must provide you
with the following important information:
1.
The following circumstances may
require us to use or disclose your health information:
2.
We will use patient information for treatment, payment, and operations
of this medical practice.
3.
To public health authorities
and health oversight agencies that are authorized by law to collect
information.
4.
Lawsuits and similar
proceedings in response to a court or administrative order.
5. When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. We will only make disclosures to a person or organization able to help prevent the threat.
6.
If you are a member of
7.
To federal officials for
intelligence and national security activities authorized by law.
8.
To correctional institutions
or law enforcement officials if you are an inmate or
under the custody of a law enforcement official or if required to do so by a
law enforcement official.
9.
For Workers Compensation and
similar programs.
1.
Communications. You can
request that our practice communicate with you about your health and related
issues in a particular manner or at a certain location. For instance, you may
ask that we contact you at home, rather than work. We will accommodate
reasonable requests.
2.
You can request a
restriction in our use or disclosure of your health information for treatment,
payment, or health care operations. Additionally, you have the right to request
that we restrict our disclosure of your health information to only certain
individuals involved in your care or the payment for your care, such as family
members and friends. We are not required to agree to your request; however, if
we do agree, we are bound by our agreement except when otherwise required by
law, in emergencies, or when the information is necessary to treat you.
3.
You have the right to
inspect and obtain a copy of the health information that may be used to make
decisions about you, including patient medical records and billing records, but
not including psychotherapy notes. You must submit your request in writing to
our privacy officer.
4.
You may ask us to amend your
health information if you believe it is incorrect or incomplete, and as long as
the information is kept by or for our practice. To request an amendment, your
request must be made in writing and submitted to our privacy officer. You must provide us with a reason that
supports your request for amendment.
5.
Right to a copy of this
notice. You are entitled to receive a copy of this Notice of Privacy Practices.
You may ask us to give you a copy of this Notice at any time. To obtain a copy
of this notice, contact our receptionist or privacy officer.
6.
Right to file a complaint.
If you believe your privacy rights have been violated, you may file a complaint
with our practice or with the Secretary of the Department of Health and Human
Services. To file a complaint with our practice, contact our privacy
officer. All complaints must be
submitted in writing. You will not be penalized for filing a complaint.
7.
Right to provide an
authorization for other uses and disclosures. Our practice will obtain your
written authorization for uses and disclosures that are not identified by this
notice or permitted by applicable law.
If you have any questions regarding this notice or our health
information privacy policies, please contact our privacy officer, Randall
Light, M.D. at 979-776-4791.
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