HIPPA Policy
NOTICE OF PRIVACY PRACTICES (MEDICAL)
This notice describes how medical information about you may be used and disclosed and how you can
get access to this information. Please review the information carefully.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires
that all medical records and other individually identifiable health information used or disclosed by us in
any form, whether electronically, on paper, or orally, are kept properly confidential. This Act give you,
the patient, significant new rights to understand and control how your health information is used.
HIPAA provides penalties for covered entities that misuse personal information. As required by HIPAA,
we have prepared this explanation of how we are required to maintain the privacy of your health
information and how we may use and disclose your health information.
We may use and disclose your medical records only for each of the following purposes: treatment,
payment, and health care operations.
- Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include a physical examination.
- Payment means such activities as obtaining reimbursement for services, confirming coverage, billing, or collection activities, and utilizing review. An example of this would be sending a bill for your visit to your insurance company for payment.
- Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost management analysis, and customer service. An example of this would be an internal quality assessment.
We may also create and distribute de-identified health information by removing all references to
individually identifiable information.
We may contact you to provide appointment reminders or information about treatment alternatives or
other health related benefits and services that may be of interest to you.
NOTICE OF PRIVACY PRACTICES (MEDICAL)
Any other uses and disclosures will be made only with your written authorization. You may revoke such
authorization in writing, and we are required to honor and abide by that written request, except to the
extent that we have already taken actions relying on your authorization.
You have the rights with respect to your protected health information, which you can exercise by
presenting a written request to the Privacy Officer:
- The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
- The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.
- The right to inspect and copy your protected health information.
- The right to amend your protected health information.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of this notice from us upon request.
We are required to maintain by law to maintain the privacy of your protected health information and to
provide you with notice of our legal duties and privacy practices with respect to protected health
information.
The notice is effective as of September 01, 2024, and we are required to abide by the terms of the Notice
of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy
Practices and to make the new notice provisions effective for all protected health information that we
maintain. We will post and you may request a written copy of a revised Notice of Privacy Practices from
this office.
You have recourse if you feel that your privacy protections have been violated. You have the right to file
a written complaint with our office, or with the Department of Health & Human Services, Office of Civil
Rights, about violations of the provisions of this notice or the policies and procedures of our office. We
will not retaliate against you for filing a complaint.
