We
use medical information about you to provide your medical care.
We disclose medical information to our employees and others who
are involved in providing the care you need. For example, we
may share your medical information with other physicians or
other health care providers who will provide services, which we
do not provide. Or we may share this information with a
pharmacist who needs it to dispense a prescription to you, or a
laboratory that performs a test. We may also disclose medical
information to members of your family or others who can help you
when you are sick or injured.
We
use and disclose medical information about you to obtain payment
for the services we provide. For example, we give your health
plan the information it requires before it will pay us. We may
also disclose information to other health care providers to
assist them in obtaining payment for services they have provided
to you.
| 3. HEALTH CARE
OPERATIONS |
We
may use and disclose medical information about you to operate
this medical practice. For example, we may use and disclose
this information to review and improve the quality of care we
provide, or the competence and qualifications of
our
professional staff. Or we may use and disclose this information
to get your health plan to authorize services or referrals. We
may also use and disclose this information as necessary for
medical reviews, legal services and audits, including fraud and
abuse detection and compliance programs and business planning
and management. We may also share your medical information with
our “business associates”, such as our billing service, that
perform administrative services for us. We have a written
contract with each of these business associates that contains
terms requiring them to protect the confidentiality of your
medical information. Although federal law does not protect
health information which is disclosed to someone other than
another healthcare provider, health plan or healthcare
clearinghouse, under California law all recipients of health
care information are prohibited from re-disclosing it except as
specifically required or permitted by law. We may also share
your information with other health care providers, health care
clearinghouses or health plans that have a relationship with
you, when they request this information to help them with their
quality assessment and improvement activities, their efforts to
improve health or reduce health care costs, their review of
competence, qualifications and performance of health care
professionals, their training programs, their accreditation,
certification or licensing activities, or their health care
fraud and abuse detection and compliance efforts.
BACK TO TOP
|
CONTACT US
We
may use and disclose medical information to contact and remind
you about appointments. If you are not home, we may leave this
information on your answering machine or in a message left with
the person answering the phone.
We
may use and disclose medical information about you by having you
sign in when you arrive at our office. We may also call out
your name when we are ready to see you.
| 6. NOTIFICATION AND
COMMUNICATION WITH FAMILY |
We
may disclose your health information to notify or assist in
notifying a family member, your personal representative or
another person responsible for your care about your location,
your general condition or in the event of your death. In the
event of a disaster, we my disclose information to a relief
organization so that they may coordinate these notification
efforts. We may also disclose information to someone who is
involved with your care or helps pay for your care. If you are
able and available to agree or object, we will give you the
opportunity to object prior to making these disclosures,
although we may disclose this information in a disaster even
over your objection if we believe it is necessary to respond to
the emergency circumstances. If you are unable or unavailable
to agree or object, our health professionals will us their best
judgment in communication with your family and others.
We
may contact you to give you information about products or
services related to your treatment, case management or care
coordination, or to direct or recommend other treatments or
health-related benefits and services that may be of interest to
you, or to provide you with small gifts. We may also encourage
you to purchase a product or service when we see you. We will
not otherwise use or disclose your medical information for
marketing purposes without your written authorization.
As
required by law, we will use and disclose your health
information, but we will limit our use or disclosure to the
relevant requirements of the law. When the law requires us to
report abuse, neglect or domestic violence, or respond to
judicial or administrative proceedings, or to law enforcement
officials, we will further comply with the requirement set forth
below concerning those activities.
BACK TO TOP
|
CONTACT US
We may,
and are sometimes required by law to disclose your health
information to public authorities for purposes related to:
preventing or controlling disease, injury or disability; reporting
child, elder or dependent adult abuse or neglect; reporting domestic
violence; reporting to the Food and Drug Administration problems
with products and reactions to medications; and reporting disease or
infection exposure. When we report suspected elder or dependent
adult abuse or domestic violence, we will inform you or your
personal representative promptly unless in our best professional
judgment, we believe the notification would place you at risk of
serious harm or would require informing a personal representative we
believe is responsible for the abuse or harm.
| 10. HEALTH OVERSIGHT
ACTIVITIES |
We
may, and are sometimes required by law to disclose your health
information to health oversight agencies during the course of
audits, investigations, inspections, licensure and other
proceedings, subject to the limitations imposed by federal and
California law.
| 11. JUDICIAL AND
ADMINISTRATIVE PROCEEDINGS |
We
may, and are sometimes required by law to disclose your health
information in the course of any administrative or judicial
proceeding to the extent expressly authorized by a court or
administrative order. We may also disclose information about
you in response to a subpoena, discovery request or other lawful
process if reasonable efforts have been made to notify you of
the request and you have not objected, or if your objections
have been resolved by a court or administrative order.
We
may, and are sometimes required by law, to disclose your health
information to a law enforcement official for purposes such as
identifying or locating a suspect, fugitive, material witness or
missing person, complying with a court order, warrant, grand
jury subpoena and other law enforcement purposes.
We
may, and are often required by law, to disclose your health
information to coroners in connection with their investigations
of deaths.
| 14. ORGAN OR TISSUE
DONATION |
We
may disclose your health information to organizations involved
in procuring, banking or transplanting organs and tissues.
BACK TO TOP
|
CONTACT US
We
may, and are sometimes required by law, to disclose your health
information to appropriate persons in order to prevent or lessen
a serious and imminent threat to the health or safety of a
particular person or the general public.
| 16. SPECIALIZED
GOVERNMENT FUNCTIONS |
We
may disclose your health information for military or national
security purposes or to correctional institutions or law
enforcement officers that have you in their lawful custody.
| 17. WORKER'S
COMPENSATION |
We
may disclose your health information as necessary to comply with
worker’s compensation laws. For example, to the extent your
care is covered by workers’ compensation, we will make periodic
reports to your employer about your condition. We are also
required by law to report cases of occupational injury or
occupational illness to the employer or workers’ compensation
insurer.
In
the event that this medical practice is sold or merged with
another organization, your health information/record will become
the property of the new owner, although you will maintain the
right to request that copies of your health information be
transferred t another physician or medical group.
B. WHEN THIS MEDICAL
PRACTICE MAY NOT USE OR DISCLOSE
YOUR HEALTH INFORMATION |
Except
as described in this Notice of Privacy Practices, this medical
practice will not use or disclose health information which
identifies you without your written authorization. If you do
authorize this medical practice to use or disclose your health
information for another purpose, you may revoke your authorization
in writing at any time.
|
C. YOUR HEALTH
INFORMATION RIGHTS |
| 1. RIGHT TO REQUEST
SPECIAL PRIVACY PROTECTIONS |
You
have the right to request restrictions on certain uses and
disclosures of your health information, by a written request
specifying what information you want to limit and what
limitations on our use or disclosure of that information you
wish to have imposed. We reserve the right to accept or reject
your request, and will notify you of our decision.
BACK TO TOP
|
CONTACT US
| 2. RIGHT TO REQUEST
CONFIDENTIAL COMMUNICATIONS |
You
have the right to request that you receive your health
information either mailed to a specific location or you or
someone you have authorized in writing may pick up the
information in person.
| 3. RIGHT TO INSPECT AND
COPY |
You
have the right to inspect and copy your health information, with
limited exceptions. To access your medical information, you
must submit a written request detailing what information you
want access to and whether you want to inspect it or get a copy
of it. We will charge a reasonable fee, as allowed by
California and federal law. We may deny your request under
limited circumstances. If we deny your request to access your
child’s records or the records of an incapacitated adult you are
representing because we believe allowing access would be
reasonably likely to cause substantial harm to the patient, you
will have a right to appeal our decision. If we deny your
request to access your psychotherapy notes, you will have the
right to have them transferred to another mental health
professional.
| 4. RIGHT TO AMEND OR
SUPPLEMENT |
You
have a right to request that we amend your health information
that you believe is incorrect or incomplete. You must make a
request to amend in writing and include the reasons you believe
the information is inaccurate or incomplete. We are not required
to change your health information, and will provide you with
information about this medical practice’s denial and how you can
disagree with the denial. We may deny your request if we do not
have the information, if we did not create the information
(unless the person or entity that created the information is no
longer available to make the amendment), if you would not be
permitted to inspect or copy the information at issue, or if the
information is accurate and complete as is. You also have the
right to request that we add to your record a statement of up to
250 words concerning any statement or item you believe to be
incomplete or incorrect.
| 5. RIGHT TO ACCOUNT OF
DISCLOSURES. |
You
have a right to receive an accounting of disclosures of your
health information made by this medical practice, except that
this medical practice does not have to account for the
disclosures provide to you or pursuant to your written
authorization, or as described in paragraphs 1(treatment), 2
(payment), 3 (health care operations), 6 (notification and
communication with family) and 16 (specialized government
functions) of Section A of this Notice of Privacy Practices or
disclosures for purposes of research or public health which
exclude direct patient identifiers, or which are incident to a
use or disclosure otherwise permitted or authorized by law, or
the disclosures to a health oversight agency or law enforcement
official to the extent this medical practice has received notice
from that agency or official that providing this accounting
would be reasonably likely to impede their activities.
BACK TO TOP
|
CONTACT US
6. YOU HAVE A RIGHT TO
A PAPER COPY OF THIS NOTICE OF PRIVACY PRACTICES,
EVEN IF
YOU PREVIOUSLY HAVE REQUESTED IT'S RECEIPT |
If
you would like to have a more detailed explanation of these
rights or if you would like to exercise one or more of these
rights, contact our Privacy Officer listed at the top of this
Notice of Privacy Practices.
|
D. CHANGES TO THIS
NOTICE OF PRIVACY PRACTICES |
We
reserve the right to amend this Notice of Privacy Practices at any
time in the future. Until such amendment is made, we are required
by law to comply with this Notice. After an amendment is made, the
revised Notice of Privacy Protections will apply to all protected
health information that we maintain, regardless of when it was
created or received. We will keep a copy of the current notice
posted in our reception area, and will offer you a copy. We will
also post the current notice on our website.
If you
believe your privacy right have been violated, you may file a
complaint with our office or with the Secretary of the Department of
Health and Human Services. To file a complaint with
our office,
contact Nicole (540) 667-3223. You will not be penalized for
filing a complaint.
|
