NOTICE OF PRIVACY PRACTICES
This notice tells how medical information about you may be used and released and how you can get access to this information.
Please review it carefully.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires confidential care of medical information (written, verbal or electronic). This law gives you, the patient, several rights to control how your health information is used. HIPAA protects your privacy with penalties for misuses.
We have prepared this explanation, according to the law, of how we are required to maintain the privacy of your health information and how we may use and disclose your health information. We have the right to change the terms of this notice; if so, we will post a new notice.
We may use and disclose your medical records only for the following purposes:
Treatment means providing, coordinating or managing health care and related services by one or more health care providers. (Examples: referrals, prescriptions, lab orders, etc.)
Payment means activities to obtain reimbursement for services, confirming coverage, billing and collections, utilization review. (Examples: billing your insurance carrier and/or workers’ compensation and sending them copies of a chart note if requested by them.)
Health care operations include the business aspects of running the medical practice, such as evaluation and improvement of quality of care, patient satisfaction, and costs analysis. (Example: medical quality assessment review.)
We are sometimes required by federal, state or local law to disclose your health information to public health and/or law enforcement agencies. Any other disclosures will be made only with your written authorization.
We will not release any information about you to family members or friends unless requested by you in writing. We will contact you about appointments, reminders and test results only at the address and phone number you approve.
You may revoke your authorization for release of information in writing at any time and we will abide by that written request, from the time at which we receive your request.
You have the following rights regarding your protected health information, which you can exercise by giving a written request to the Office Manager, Yvonne Coren:
The right to request restrictions on certain uses and disclosures of protected health information.
The right to inspect and receive a copy of your protected health information. The request must be submitted in writing (forms available in the office). We may charge a fee for the cost of copying your records.
The right to receive an accounting of disclosures of protected health information.
The right to obtain a paper copy of this notice upon request.
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 and Human Services, Office of Civil Rights, about violations or the policies and procedures at our office. We welcome your comments and will not, under any circumstances, retaliate against you for filing a complaint. If you have any questions please contact our Office Manager, Yvonne Coren.
For more information about HIPAA, or to file a complaint
U.S. Department of Health and Human Services,
Office of Civil Rights
200 Independence Avenue, S.W.,
Washington, D.C. 20201
202-619-0257 or 877-696-6775 (toll free)
NOTICE TO MEDICARE BENEFICIARIES
MEDICARE CARE MANAGEMENT PROGRAM
We are proud to announce that our medical office is taking part in a study that rewards doctors for giving high quality health care. The study is being conducted by the Centers for Medicare & Medicaid Services, the federal agency that runs the Medicare program.
Dr. Coren and Christine Ramsay, P.A.-C will work with you and your other doctors and nurses to coorindate and improve the care you receive. You will continue to get your regular Medicare-covered services, and you can still see Dr. Coren and any other doctor you choose.
During the study, Medicare may need to share your personal medical information with us. This will allow us to make sure that you are getting quality health care and that you are getting the services you need. By law, Medicare is required to protect the privacy of your personal medical information. Your personal medical information is important so Medicare takes every step to make sure your information is kept private.
If you need more information about this study, please ask Dr. Coren or the office manager, Yvonne.
June 5, 2007
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