This notice describes how your medical information may be used and disclosed and how you can gain access to this information. This notice applies to all your records of care.
The Health Insurance Portability & Accountability Act (H.I.P.A.A.) of 1996 is a federal program that requires that all medical records and health information about you are kept confidential. This notice is a requirement of this legislation and is used for information purposes only.
How we may use and disclose medical information about you:
Treatment: this includes providing information about you to other health care providers, family members and/or other representatives authorized by you. An example would be a discussion of a planned surgical treatment with your dentist or family physician.
Payment: we may disclose information about you as needed for billing, collections or other third parties. For example, a request for determination of insurance coverage.
Health Care Operatons: to allow a more efficient treatment course and provide increased quality of care. An example would be an annual quality assessment review.
We may also contact you to provide appointment reminders via phone, answering machine or mail. Also, a “Sign-in” list is requested to facilitate patient access.
Additional areas of disclosure may include emergency situations, requirements of law, workman’s compensation, public health risks and investigations and for purposes of settlement of disputes.
You have the following rights and may be exercised by written request to our office:
The right to inspect, copy and amend your protected health information.
The right to receive an accounting of disclosures of protected health information.
The right to request restrictions on certain uses of limitations on the medical information we use to disclose about you for treatment, payment or health care operations. We are, however, not required to comply with your request.
The right to request confidential communications and a copy of this notice.
We are, not only required by law, but are personally committed to safeguard your protected health information and will do so to the best of our abilities and abide by the terms of this notice.
We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of this notice currently in effect. You may contact the Department of Health and Human Services with any concerns or complaints and form more information about H.I.P.A.A.