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This notice describes our office’s policy for how health information about you may be used and disclosed, how you can get access to this information, and how your privacy is being protected. Please review it carefully.
Federal privacy requirements (the HIPAA privacy regulations) obligate most practices to provide notice about privacy rights and detailed policies designed to protect your privacy. These requirements were put in place because so much patient information is now being shared in digital format over computer networks. This clinic is committed to protecting patient confidentiality.
We reserve the right to change our privacy practices and the terms in this notice at any time, provided such changes are permitted by applicable law. We reserve the right to make changes in our privacy policy and the new terms of our notice effective for all health information that we maintain, including health information we created or received before we made changes. Before we make a significant change in our privacy practices, we will change this notice and make the new notice available upon request. You may request a copy of our notice at any time. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this Notice.
We use and disclose health information about you for treatment. For example:
Treatment: We may use or disclose your health information to a physician or other health care provider providing treatment to you.
Payment: We may use and disclose your health information to obtain payment for services we provide to you.
Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner performance, conducting training programs, accreditation, certification, licensing or credentialing activities.
Your Authorization: In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this notice.
To Your Family and Friends: We must disclose your health information to you, and may disclose your health information to a family member, friend or other person involved in your treatment to the extent necessary to help with your healthcare, but only if you agree that we may do so.
Persons Involved In Care: We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location or general condition. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of health information, to the extent applicable.
Marketing Health-Related Services: We will not use your health information for marketing communications without your written authorization.
Required by Law: We may use or disclose your health information when we are required to do so by law.
Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.
National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody of protected health information of inmate or patient under certain circumstances.
Appointment Reminders: Appointment Reminders: We may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters).
Access: On your written request, we will provide you with copies of your health care records. We may impose a reasonable charge, not to exceed $.75 per paper copy. A request to release records may not be denied for inability to pay.
Disclosure Accounting: You may have the right to receive a list of instances in which your health information was disclosed for purposes other than treatment or certain other activities for the last 6 years.
Alternative Communication: You may request that we communicate with you about your health information by alternative means or to alternative locations. We may agree to reasonable requests.
Amendment: You may request that we amend your health information. (Your request must be in writing, and it must explain why the information should be amended.) We may deny your request under certain circumstances.
Required by Law: We may use or disclose your health information when we are required to do so by law.
Required by Law: We may use or disclose your health information when we are required to do so by law.
If you want more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this Notice. You also may submit a written complaint to the New York State Department of Public Health. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the State.
We will, on request, provide you the following: (a) information related to your health care professional’s educational background, experience, training, specialty, and board certification, if applicable; (b) affiliation with any licensed hospital, home care service, HMO, or specified mental health care facilities; (c) information regarding the health care professional’s participation in continuing education programs and compliance with any licensure, certification or registration requirements, if applicable; and (d) information regarding the health care professional’s participation in clinical performance reviews conducted by the department where applicable and where available. Such disclosure need not be in writing.
