Privacy Notice

NOTICE OF PRIVACY PRACTICES AND PROTECTED HEALTH INFORMATION (HIPAA)

This notice describes how medical information about you may be used and disclosed and how you may get access to this information. Please review it carefully.

We safeguard information about your health and person: We collect information from you and store it in a medical record as well as on a computer. Charts are stored in a secure area and available only to designated staff and only for designated reasons. Housekeeping, maintenance and other non-office personnel have no access to the chart areas. Service technicians may have access to the computer, but only for the service of computer operations.

Typical uses and disclosures of medical information: We collect medical information from you. Within our office, we restrict the disclosure of this information to doctors, nurses, therapists, technicians, and insurance and billing personnel. We may use your medical information for treatment and care, payment to insurers and for healthcare operations. Outside our office, we restrict the disclosure to those people, entities, and agencies for which you authorize disclosure such as other healthcare providers (doctors, nurses), insurance companies, billing agencies, or other agencies and entities for whom legal and administrative requirements demand disclosure of such as:

When required by law
Public health activities (deaths, abuse, neglect, domestic violence, problems with products, reactions to medications, product recall, disease/infection exposure, disease/injury/disability control and prevention)
Health oversight activities (audits, investigations, inspections)
Judicial and administrative proceedings (court order)
Appropriate law enforcement requests (to identify or locate a suspect, fugitive, material witness or missing person)
Deceased person information to coroners, medical examiners, funeral directors
Organ and tissue donation
Research, provided authorizations is IRB-approved or privacy board approved
Emergencies or to avert serious threat to health or safety
Specialized government functions (military, inmates)
Workman’s compensation
Disaster relief

We will not use or disclose your medical information for any purpose not listed without your specific written authorization. Any specific written authorization you provide may be revoked at any time by writing us.

Patient Privacy Rights:

You have the right to:

Inspect and copy medical information from your chart. You may submit a written request to our office and pay the copy fee and receive a copy of your record. We must respond within 30 days if the record is readily available and within 60 days if it is not readily available. You may also get an electronic copy if one is available.
Amend medical information in your chart. You may identify inaccurate or incomplete information in your chart. You can do this with a written request directed to our office. We must respond within 60 days.
Receive an accounting of any disclosures made from you record over the last six years, starting July 13, 2013. You can get this with a written request directed to our office. We must respond within 60 days.
Request restrictions as the amount of medical information we disclose. This is limited as noted above, and your request may not supersede the typical disclosures noted above. You may revoke or restrict the consent.
Restrict certain disclosures of PHI to a health plan when you pay out of pocket in full for the healthcare item or service.
Request confidential communications. All communications in our office are confidential. You may specifically request that all communications be confidential with a written request directed to our office.
Not to have your protected health information sold for marketing purposes.
Opt out of receiving fund raising communications.
Be notified following a breach of your unsecured protected health information.
Receive a copy of this notice with a written request directed to this office, and a copy of this notice will be given with all new patient packets.

We may contact you for appointment reminders and we may provide you with information about health-related or product benefits and services. Each person is given a copy of the Privacy Notice and an opportunity to review and understand it.

Our Responsibility under HIPAA:

We are required by Law to maintain the privacy of your personal health information and to provide you notice of our legal duties and privacy practices and adhere to this notice. We reserve the right to make changes to this notice. We will post a notice that the notice has changed and the effective date of the change. Copies will be made available.

You can submit a complaint about our privacy policy or its execution whether verbally or in writing to our Privacy Officer, Donna Pearcy.

If you get no resolution to your complaint, you can send a written statement to the Office of the Secretary of Health and Human Services.