AND HIPAA INFORMATION
It is our responsibility to safeguard the privacy of all patients and to protect the confidentiality of their health information. We are committed to protecting the privacy of your medical and personal information. Personal and health information includes both medical information and individually identifiable information, such as your name, address, telephone number or social security number. In accordance with Federal and State laws, our privacy practices are shown below. These practices are already in place and will remain in effect unless otherwise replaced or modified. We may modify or change our privacy practices from time to time, particularly as new laws and regulations become effective. Any changes will be effective for all the personal and health information we maintain, even information in existence before the change. If we materially modify our privacy practices, we will provide you with a new notice advising you of the changes.
In order to provide you with the best medical care, we share your medical records with the health care providers involved in your care. We share your information only to the extent necessary to collect payment for the services we provide, to conduct our business operations, and to comply with the laws that govern health care. We will not use or disclose your information for any other purpose without your permission.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU:
- RIGHT TO INSPECT AND OBTAIN A COPY OF YOUR MEDICAL RECORDS
- RIGHT TO REQUEST AN AMENDMENT TO YOUR MEDICAL RECORD
- RIGHT TO AN ACCOUNTING OF DISCLOSURES OF YOUR MEDICAL RECORDS
- RIGHT TO REQUEST RESTRICTIONS
- RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS
COMMENTS OR COMPLAINTS
We welcome your comments about our privacy practices. If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the Department of Health and Human Services.
Secretary of the Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
PLEASE BE ASSURED THAT NO ONE WILL RETALIATE OR TAKE ACTION AGAINST YOU FOR FILING A COMPLAINT.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you provide us with written authorization to use or disclose medical or personal information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical or personal information about you for the activities covered by the authorization, except if we have already acted in reliance on your permission. We are unable to undo any disclosures we have already made, and we are required to retain our records of the care that we have provided. If you have any questions regarding this Notice please ask our staff.