Notice of Privacy Practices

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and related services. For example, we may share information with other healthcare providers involved in your care, such as your primary care physician or specialists.

Payment

We may use and disclose your PHI to obtain payment for services we provide to you. For example, we may send your health insurance plan information about services you received so they will pay us or reimburse you.

Health Care Operations

We may use and disclose your PHI for our health care operations. These uses and disclosures are necessary to run our practice and ensure quality care. For example, we may use PHI to review our treatment and services and evaluate the performance of our staff.

Other Uses and Disclosures

We may also use or disclose your PHI without your authorization in the following situations:

• As Required By Law: When required by federal, state, or local law
• Public Health: To report public health activities, such as disease prevention or reporting abuse
• Health Oversight: To health oversight agencies for audits, investigations, and inspections
• Judicial Proceedings: In response to a court order or subpoena
• Law Enforcement: To law enforcement officials as required by law or court order
• Serious Threat to Health or Safety: To prevent a serious threat to your health or safety or the health or safety of others
• Workers' Compensation: As authorized by workers' compensation laws
• Military and Veterans: To military authorities if you are a member of the armed forces

Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request, but if we do, we will comply with your restrictions except in emergency situations.

Right to Request Confidential Communications

You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may request that we contact you only at work or by mail.

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your PHI that we maintain in your designated record set. We may charge a reasonable fee for copying and postage.

Right to Request Amendment

You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances.

Right to an Accounting of Disclosures

You have the right to receive an accounting of certain disclosures of your PHI made by us in the six years prior to your request. This does not include disclosures for treatment, payment, or health care operations.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this notice at any time, even if you have agreed to receive it electronically.