
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.
If you have any questions about this notice, please contact our Privacy Officer.
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by accessing our website, or calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
Uses and Disclosures of Protected Health
Information Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of your physician’s practice. Following are examples of the types of uses and disclosures of your protected health information that your physician’s office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office:
- Treatment
- Payment
- Healthcare
- Operations
- Medications
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree or Object
We may use or disclose your protected health information in the following situations without your authorization or providing you the opportunity to agree or object. These situations include:
• Required By Law
• Public Health • Communicable Diseases • Health Oversight • Abuse or Neglect • Food and Drug Administration • Legal Proceedings
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• Law Enforcement
• Coroners, Funeral Directors, and Organ Donation • Research • Criminal Activity • Military Activity and National Security • Workers’ Compensation • Inmates
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Other Permitted and Required Uses and Disclosures That Require Providing You the Opportunity to Agree or Object
We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest.
- Facility Directories Others
- Involved in Your Health Care or Payment for your Care
Rights That You Have
Following is a statement of your rights with respect to your protected health information:
• Access to Your PHI
• Amendments to Your PHI • Accounting for Disclosures of Your PHI • Restrictions on Use and Disclosure of Your PHI |
• Restrictions on Disclosures to Health Plans
• Confidential Communications • Breach Notification • Paper Copy of Notice |
Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint.
Nick Gentile
Privacy Officer
P: 407-249-1234