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| HIPAA Privacy Policy |
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| Effective Date April 14th, 2003 |
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This notice describes how medical
information about you may be used and disclosed and how you can get
access to this information. Please review and if you have
any questions about this notice, please contact us. This is effective until further notice. |
| We are
required by law to: |
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Maintain the privacy of protected
health information |
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Give you this notice of our legal duties and
privacy practices regarding your health information |
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Follow the terms of the notice currently in
effect. |
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| How we may use
and disclose your health information: |
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Described below are the ways we may use and
disclose your health information. Except for the following purposes,
we will use and disclose your health information only with your
written permission. You may revoke such permission at any time by
a written request. |
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Treatment |
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We may use and disclose your health information
for your treatment and to provide you with treatment-related health
care services. For example, we may disclose your health information
to doctors, nurses, technicians, or other personnel, including
people outside our office, who are involved in your medical care and
need the information to provide you with medical care. |
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Payment |
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We may use and disclose your health information
for the purposes of billing and obtaining payment from you, your
insurance company, or any other third party for services rendered
during a visit. |
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Health Care Operations |
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We may use and disclose your health information
to evaluate and improve our medical care and to operate and manage
our office. For example, we may use and disclose information to a
peer review organization or a health plan that is evaluating our
care. We may also share information with others that have a
relationship with you for their health care operation activities. |
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Appointment Reminders, Treatment Alternatives, and
Health-Related Benefits and Services. |
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We may use and disclose your health
information to contact you and remind you of your appointment, to
tell you about treatment alternatives or health-related benefits and
services you could use. |
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Individuals Involved in Your Care or Payment for
Your Care. |
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When appropriate, we may share your health
information with a person involved in, or paying for, your care
(such as your family or a close friend). We may notify your family
about your location or condition or disclose such information to an
entity assisting in disaster relief. |
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Research |
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We may use and disclose your health
information for research. For example, a research project may
involve comparing the health of patients who received one treatment
to those who received another for the same condition. Before we do
so, the project needs to go through a special approval process. Even
without special approval, we may permit researchers to look at
records to help identify patients who may be included in their
research, as long as they do not remove or copy any of your health
information. |
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As Required by Law |
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We will disclose your health information when
required to do so by international, federal, state or local law. |
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To Avert a Serious Threat to Health or Safety. |
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We may use and disclose your health information
when necessary to prevent a serious threat to the health and safety
of you, another person, or the public. Disclosures will be made only
to someone who can prevent the threat. |
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Business Associates |
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We may disclose your health information to our
business associates that perform functions on our behalf or provide
us with services if necessary. For example, we may use another
company to perform billing services on our behalf. All of our
business associates are obligated to protect the privacy of your
information and are not allowed to use or disclose the information
for any other purpose than appears in their contract with us. |
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Military and Veterans |
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If you are a member of the armed forces, we
may release your health information as required by military command
authorities. If you are a member of a foreign military we may
release your health information to the foreign military command
authority. |
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Worker's Compensation |
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We may release your health information for
worker's compensation or similar programs that provide benefits for
work-related injuries or illness. |
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Public Health Risks |
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We may disclose your health information for
public health activities to prevent or control disease, injury or
disability. We may use your health information in reporting births
or deaths, suspected child abuse or neglect, medication reactions or
product malfunctions or injuries, and product recall notifications.
We may use your health information to notify someone who may have
been exposed to a disease or may be at risk for contracting or
spreading a disease or condition. If we are concerned that a patient
may have been a victim of abuse, neglect, or domestic violence we
may ask your permission to make a disclosure to an appropriate
government authority. We will make that disclosure only when you
agree or when required or authorized to do so by law. |
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Health Oversight Activities |
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We may disclose your health information to a
health oversight agency for activities authorized by law. These may
include audits, investigations, inspections, and licensure. These
activities are necessary for the government to monitor the health
care system, government programs, and compliance with civil rights
laws. |
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Lawsuits and Disputes |
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If you are involved in a lawsuit or dispute, we
may disclose your health information in response to a court or
administrative order. We may disclose your health information in
response to a subpoena, discovery request, or other lawful process
by someone else involved in the dispute, but only if efforts have
been made to tell you about the request or to obtain an order
protecting the information requested. |
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Law Enforcement |
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We may release your health information request by
law enforcement official if :
There is a court order, subpoena, warrant, summons or similar
process
If the request is limited to information needed to identify or
locate a suspect, fugitive, material witness, or missing person
The information is about the victim of a crime - even if, under
certain very limited circumstances, we are unable to obtain your
agreement.
The information is about a death that may be the result of criminal
conduct;
The information is relevant to criminal conduct on our premises
It is needed in an emergency to report a crime, the location of a
crime or victims, or the identity, description, or location of the
person who may have committed the crime. |
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Coroners, Medical Examiners, and Funeral Directors |
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We may release your health information to a
coroner, medical examiner, or funeral director to identify a
deceased person or cause of death, or other similar circumstance.
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National Security and Intelligence Activities |
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We may disclose your health information to
authorized federal officials for intelligence and other national
security activities authorized by law |
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Inmates or Individuals in Custody |
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If you are an inmate of a correctional
institution or in custody we may disclose your information:
For the institution to provide you with health care
To protect your health and safety or that of others
For the safety and security of the institution. |
| YOUR RIGHTS
REGARDING YOUR HEALTH INFORMATION |
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Right to Inspect and Copy by written request |
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You have the right to inspect and copy your
medical and billing records by written request |
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Right to Amend by written request |
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You have the right to request an amendment to
your records by written request |
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Right to an Accounting Of Disclosures by written
request |
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You have a right to an accounting of certain
disclosures by written request |
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Right to Request Restrictions by written request |
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You have the right to request restriction or
limitation on your health information |
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Right to Request Confidential Communication by
written request |
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You have the right to request that we communicate
with you about medical matters in a certain way or at a certain
location. You can ask, for example, that we contact you only by mail
or at work. Your written request must specify how or where you wish
to be contacted. We will accommodate reasonable requests. |
| CHANGES TO
THIS NOTICE |
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We may change this notice and make it effective
for medical information we already have about you as well as new
information. The current notice will be posted and available at all
times. You have a right to request a paper copy of the current
notice at any visit or by written request. |
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