NOTICE OF PRIVACY PRACTICES (Effective April 14, 2003)
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
The federal law called the Health Insurance Portability and Accountability Act of 1993 (“HIPAA”) creates certain rights for our patients. One of those is a right to information regarding our privacy practices. Under federal regulations, we must provide you with a copy of this Notice of Privacy Practices and ask that you sign an acknowledgement that we gave the notice to you. You may review the Notice of Privacy Practices immediately or later. At some point, you should read it carefully because it explains:
- Generally how we use health information about you;
- That we, like other health care providers, may use and disclose health information about you as part of your treatment, to arrange for payment for services provided and for our internal operations. We are not required to have separate permission for these uses and disclosures;
- Other circumstances where we may use or disclose information about your health where we are not required to get your permission first;
- The rights you have with respect to health information we have about you, including:
- Your right to have a copy of this privacy notice;
- Your right to review and copy health information that we may have about you;
- Your right to an accounting of how we use and disclose your health information, other than for treatment, payment or health care operations;
- Your right to request that we communicate with you at alternative locations, mailing addresses or telephone numbers;
- Your right to request restrictions on how we use your health care information;
- Your right to request an amendment to information in our records that you think is in error;
- Your right to file a complaint if you think your privacy rights have been violated.