This notice describes how health information may be used and disclosed and how you can get access to this information. Please review it carefully.
I. My Pledge Regarding Health Information
- I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements.
- This notice applies to all of the records of your care generated by this practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.
- I am required by law to:
- Make sure that protected health information (“PHI”) that identifies you is kept private.
- Give you this notice of my legal duties and privacy practices with respect to health information. Follow the terms of the notice that is currently in effect.
- I can change the terms of this notice, and such changes will apply to all information I have about you. The new notice will be available upon request, in my office, and on my website.
II. How I May Use and Disclose Health Information About You
- For Treatment, Payment, or Health Care Operations: I may use or disclose your health information for treatment purposes, to obtain payment, or for healthcare operations. For example, I may share your information with other healthcare providers involved in your care.
- Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information in response to subpoenas or lawful processes related to disputes.
III. Certain Uses and Disclosures Require Your Authorization
- Any use or disclosure of medical records requires your authorization unless the use or disclosure is:
- For my use in treating you.
- For my use in training or supervising associates to help them improve their clinical skills.
- For my use in defending myself in legal proceedings instituted by you.
- For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
- Required by law and the use or disclosure is limited to the requirements of such law.
- Required by law for certain health oversight activities.
- Required by a coroner performing duties authorized by law.
- Required to avert a serious threat to health and safety.
- Marketing Purposes: I will not use or disclose your PHI for marketing purposes.
- Sale of PHI: I will not sell your PHI in the regular course of my business.