Notice of Privacy Practices
Introduction
This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Your health information privacy is important to us.
Fundraising
We may contact you for fundraising efforts, but you can inform us if you do not wish to be contacted again.
Our Uses and Disclosures
How We Typically Use or Share Your Health Information
Treat You: We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run Our Organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for Your Services: We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
Other Ways We Can Use or Share Your Health Information
We are allowed or required to share your information in other ways—usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes.
Help with Public Health and Safety Issues: We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone's health or safety
Do Research: We can use or share your information for health research.
Comply with the Law: We will share information about you if state or federal laws require it, including with the Department of Health and Human Services to ensure we comply with federal privacy laws.
Respond to Organ and Tissue Donation Requests: We can share health information about you with organ procurement organizations.
Work with a Medical Examiner or Funeral Director: We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address Workers' Compensation, Law Enforcement, and Other Government Requests: We can use or share health information about you:
- For workers' compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to Lawsuits and Legal Actions: We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and provide you with a copy of it.
- We will not use or share your information other than as described here unless you provide written consent. You can change your mind at any time by letting us know in writing.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Patient Rights
Access
You have the right to look at or get copies of your health information, with limited exceptions. If you request copies, we will charge a reasonable fee to locate and copy your information and for postage if you want the copies mailed to you.
Amendment
You have the right to request that we amend your health information.
Questions and Complaints
If you want more information about our privacy practices or have questions or concerns, please contact us. If you believe we may have violated your privacy rights or disagree with a decision we made about access to your health information, you may file a complaint with us using the contact information listed at the end of this notice. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint upon request.
We support your right to the privacy of your health information. We will not retaliate if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
A Privacy/Contact Officer has been designated for this office. The Privacy Officer can be contacted by simply contacting the office and asking to speak to the Office Manager who serves as the Privacy Officer.
