HIPAA Notice Of Privacy Practices

Your Knowledge. Rights you have. Responsibilities we have. This notice outlines your rights to access and controls your medical information as well as how it may be used and disseminated. Please carefully read it.

Your Rights

You have some rights regarding the information about your health. Your rights and some of our obligations to assist you are explained in this section.

Get A Copy Of Your Medical Record In Paper Or Electronic Form.

  • Your medical file and any other health information we may have about you are available upon request, whether in electronic or physical form. For assistance, please ask.
  • Within 30 days of your request, we will typically send you a copy or a summary of your medical records. A reasonable, cost-based fee might be assessed by us.

Ask Us To Correct Your Medical Record

  • If you believe that any health information about you is inaccurate or lacking, you can request that we change it. For assistance, please ask.
  • We might decline your request, but we’ll provide a written explanation of why within 60 days.

Request Us To Limit Our Use Of Or Sharing

  • You have the right to request that we not use or disclose specific health information for operations, payment, or treatment.
  • We are not obligated to grant your request, and we have the right to decline if it might jeopardize your care.
  • You have the option to request that we not disclose information with your health insurance for the purpose of payment or our business operations if you pay in full for a service or item of health care out of pocket.
  • Unless a law mandates us to reveal that information, we will respond “yes.”

Get A Copy Of This Privacy Notice

  • Even though you have consented to receive this notice electronically, you can request a printed copy at any time. We’ll send you a paper copy right away.

Choose Someone To Act For You

  • Someone can exercise your rights and make decisions regarding your health information if you have granted them medical power of attorney or if they are your legal guardian.
  • Before we do anything, we’ll make sure the person has this power and is capable of acting on your behalf.

File A Complaint, In The Event That You Feel Your Rights Have Been Violated

  • If you believe we have violated your rights, you may file a complaint by contacting us using the details on the back page.
  • By writing a letter to 200 Independence Avenue, SW, Washington, D.C. 20201, calling 1-877-696-6775, or visiting the Privacy Complaints Article, you can lodge a complaint with the U.S. Health and Human Services Department’s Office for Civil Rights
  • We won’t punish you in any way for making a complaint.

Your Choices

You can let us know how you feel about sharing certain health information. Talk to us if you have a strong preference for how we share your information in the scenarios listed below. We shall do what you direct as long as you tell us what to do.

 In Certain Situations, You Have The Freedom To Direct Us To:

  • Share information with your loved ones, close friends, or anyone caring for you.
  • When providing information for disaster aid
  • Add your details to a hospital directory

We may share your information if we think it is in your best interest even if you are unable to express your preference, such as if you are unconscious. When a serious and immediate threat to health or safety exists, we might also release your information.

In These Situations, We Will Never Share Your Information Without Your Prior Written Consent.

  • Marketing objectives
  • Sale of your information
  • Most exchanges of psychotherapy notes

In The Case Of Fundraising:

  • We may contact you about fundraising. You can request not to contact you again.

Our Uses And Disclosures

What typical uses or disclosures do we make of your health information? The following are typical uses or disclosures we make of your health information.

Treat You

  • We can utilize your health information and pass it along to other medical personnel who are attending to you in order to treat you.

Example: A doctor treating you for an injury asks another doctor for an assessment of your general health.

Manage Our Company

  • Your health information may be used by us to bill insurance companies or other organizations and collect payment from them.

Example: We provide your health insurance plan with information about you so that it will cover the cost of your services.

Bill For Your Services

  • We can use and share your health information to manage our practice, enhance your treatment, and get in touch with you when necessary.

Example: We make use of health data about you to manage your treatment and services.

What Other Ways Can We Use Or Disclose Your Health Information?

We are permitted or obligated to share your information in other contexts, typically for purposes that benefit society as a whole, such as public health and research. Before we can share your information for these purposes, we must adhere to a number of legal requirements. For more details: Go to the HIPAA Article.

Help With Public Health And Safety Issues

Example: We manage your treatment and services using health information about you.

  • Preventing disease
  • Supporting product recalls
  • Reporting of medication side effects
  • Reporting any allegations of spousal abuse, violence, or neglect
  • Removing or preventing a major threat to the health or safety of anyone

Do Research

  • Your information may be shared or used for health research.

Comply With The Law

  • If state or federal laws require it, we will share information about you, including with the Department of Health and Human Services if it needs to verify that we are abiding by federal privacy legislation.

Respond To Organ And Tissue Donation Requests

  • Organ procurement organizations may receive information about your health from us.

Work With A Medical Examiner Or Funeral Director

  • Organ procurement organizations may receive information about your health from us.

Law Enforcement, Workers’ Compensation, And Other Government Requests Should Be Addressed.

We may make use of or divulge health data about you if:

  • Regarding claims for workers’ compensation
  • For the aim of law enforcement, or in conjunction with a law enforcement official.
  • With health oversight organizations for legal operations, 
  • Some of the special government functions such as national security, military, and presidential protective services.

Respond To Lawsuits And Legal Actions

  • In response to a subpoena, a court order, or an administrative directive, we may disclose health data about you.

Our Responsibilities

  • We must uphold the confidentiality and security of your protected health information in accordance with the law.
  • If there is a breach that would have compromised your information’s security or privacy, we’ll notify you right away.
  • We are required to send you a copy of this notice and to abide by the obligations and privacy policies it outlines.
  • Unless you specifically authorize us in writing, we won’t use or disclose your information in any way other than what is stated here. If you say we can, you can afterward decide not to if you prefer. If you decide to change your mind, let us know in writing. For additional details: Visit the article on privacy practices.

Changes To The Terms Of This Notice

We reserve the right to modify this notice at any time, and any updated terms will be applicable to all of your personal data. The updated notification will be accessible online, in our office, and upon request.

All the organizations on this site are subject to the terms of this Notice of Privacy Practices. Please refer to the relevant page for contact details.

HIPAA Office Contact Information

HIPAA Entity:

Civil Rights Coordinator:

Civil Rights Coordinator Title:

Address:

Phone:

Email:

Fax:

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