Privacy Policy
NOTICE OF
PRIVACY PRACTICES
This
notice describes how health information about you may be used and disclosed and
how you can get access to this information. PLEASE REVIEW THIS INFORMATION CAREFULLY
LEGAL
DUTY
We are
required by federal and state law to maintain the privacy of your health
information. We are also required
to give you this Notice about our privacy practices, our legal duties and your
rights concerning your health information. We must follow the privacy practices that are described in
this Notice while it is in effect. This Notice takes effect April 14, 2003 and will remain in effect until
we replace it. You may request a
copy of our Privacy Practice Notice at any time. For more information or additional copies of this Notice,
please contact us at the telephone number listed in the Company Information
section at the top of this Notice. If and when permitted by applicable, we have the right to change our
privacy practices; if we do so, we will notify you in writing of these changes.
USE
AND DISCLOSURES OF HEALTH INFORMATION
We are
permitted, by law, to use and disclose health information about you for reasons
concerning treatment, payment and healthcare operations. Examples:
Treatment: We may disclose your health information to a physician or other
healthcare provider that
Payment: We may use and disclose your health
information to obtain payment for services that we provide you.
Operations: We may use and disclose your health information in connection with our
healthcare operations, which include administration and planning and other
tasks that help us improve that quality
Family
and Friends: We may disclose your health information
to a family member, relative or a friend
Requirements
of the Law: We may use or disclose your health
information when we are required to do so by Law.
Victim
of Abuse or Neglect: We may disclose your health information
to authorities if reasonable belief is that you are a possible victim of abuse, neglect or
domestic violence. We may disclose
information to the extent necessary to avert additional serious threat to your
health or safety or the health or safety of others.
Public
Health Activities: We may disclose your health information
to public health authorities for the purpose of preventing or controlling disease or preventing injury; to alert a person
who may have been the U.S. Food and Drug Administration;
to report information to a health oversight agency that is responsible for ensuring compliance with
governmental rules and regulations, such as Medicare and Medicaid.
National
Security: We may disclose to military authorities
the health information of Armed Forces personnel under certain
circumstances. We may disclose to
authorized federal officials health information
required for lawful intelligence, counter intelligence and other national
security activities.
Appointment
Reminders: We may contact you to provide you with
appointment reminders, such as voice messages; including essential information
such as time, location and the name of the company/provider.
Worker’s
Compensation: We may use or disclose your health
information to the extent necessary to comply with state laws relating to
workers’ compensation.
Disclosures
requiring your Authorization: For any reasons other than those listed
in this notice, we may only use or disclose your health information with your
written authorization. Your
authorization must also be obtained prior to using your health information for any
marketing activity.
YOUR
RIGHTS TO YOUR PERSONAL HEALTH INFORMATION
Access
to Record: You may have access to your health
information, with limited exceptions. Request
Revocation
of your Authorization: You may revoke your authorization to
disclose your health information at any time. Request must be made in writing, using our Authorization Revocation
form.
Disclosure
Accounting: You may request a list of instances in
which we (or our business associates)
Alternative
Communication: You may request that we communicate
with you about your health
Amendment: You have the right to request that we amend your health information. You must make
Right to Receive Paper Copy of this Notice: upon request, you may obtain a paper copy of this notice.
