This notice provides you information about how your health information may be used and disclosed. It also provides you with information on obtaining your own copies of your health information.
DISCLOSURE OF HEALTH INFORMATION
Use of your health information is for the coordination of your treatment, to bill and collect payment for the services you receive, to obtain prior approval for the treatment that you are scheduled to receive, and to evaluate the quality of care that you receive. We may also disclose your health information when we are required by law for such instances as public health issues or abuse, neglect, or domestic violence; health oversight activities such as audits, investigations, inspections, and licensure; judicial proceedings such as court orders, warrants, or criminal investigations; or due to serious threats to health and safety as dictated by law enforcement authorities. We may also share your health information with family members or other relatives or to someone who assists in paying for your health care. Utilizing your health information for research purposes is subject to a special approval process. Information may be shared by verbal communication, paper transmission, facsimile transmission, electronic mail, or by other means. As stated above, we may release information without your consent for specific reasons required by law. In other circumstances, we will obtain your authorization for release of your health information.
PATIENT RIGHTS
In most circumstances, you have the right to request to look at and/or obtain a copy of your health information. You may be charged a fee when requesting copies. You also have the right to review what requests have been made in terms of your health information, the right to request confidential communications regarding your health information, and the right to restrict or limit disclosure of your health information. In emergency situations, we are not required to agree to your request if you are requiring treatment. You also have the right to request that your health information be amended with provision of a reason that supports your request. Amendments to your health information may be denied if we did not create the information, the information is not part of the information that you would be permitted to inspect, or the information is accurate and complete. All of the above requests must be received in writing. You may at any time in the future revoke the authorization to release information, which also must be submitted in writing. We are unable to reverse any previous disclosures that you have already agreed to if you revoke future authorization.
LEGAL DUTY
The law protects the privacy of your health information. We are required to provide this notice to you and follow the practices listed in this letter. You have the right to request a paper copy of this notice at any time. If changes in this policy are warranted, we will provide notice to you of those policy changes and you may request a copy of those notices.
PRIVACY COMPLAINTS
If you have concerns regarding violation of the privacy of your health information, you may request the address and send a written complaint to the US Department of Health and Human Services.
