NOTICE OF ALLERGY
& ASTHMA CONSULTANTS, LTD. PRIVACY PRACTICES
THIS NOTICE
DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED AND DISCLOSED
BY ALLERGY & ASTHMA CONSULTANTS,
LTD AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION.
PLEASE REVIEW IT CAREFULLY.
The Health Insurance Portability &
Accountability Act of 1996 ("HIPAA") is a federal program that
requires that all medical records and other individually
identifiable health information used or disclosed by us in any
form, whether electronically, on paper, or orally, are kept
properly confidential. This Act gives you, the patient,
significant new rights to understand and control how your
health information is used. HIPAA provides penalties for
covered entities that misuse personal health information.
As requires by HIPAA, we have prepared this
explanation of how we are required to maintain the privacy of
your health information and how we may use and disclose your
health information.
Allergy & Asthma Consultants, Ltd. may use
and disclose your medical records only for each of the
following purposes: treatment, payment and health care
operations.
-
Treatment means providing, coordinating, or
managing health care and related services by one or
more health care providers. An example of
this would include a physical examination.
-
Payment means such activities as obtaining
reimbursement for services, confirming coverage,
billing or collection activities, and utilization
review. An example of this would be sending a
bill for your visit to your insurance company for
payment.
-
Health care operations include the business aspects
of running our practice, such as conducting quality
assessment and improvement activities, auditing
functions, cost-management analysis, and customer
service. An example would be internal quality
assessment review.
We may also create and distribute de-identified
health information by removing all references to individually
identifiable information.
We may contact you to provide appointment
reminders or information about treatment alternatives or other
health-related benefits and services that may be of interest to
you.
Any other uses and disclosures will be made
with your written authorization. You may revoke such
authorization in writing and we are required to honor and abide
by that written request, except to the extent that we have
already taken actions relying on your authorization.
You have the following rights with respect to
your protected health information, which you can exercise by
presenting a written request to the Privacy Officer:
-
The right to request restrictions on certain uses
and disclosures of protected health information,
including those related to disclosures to family
members, other relatives, close personal friends,
or any other person identified by you. We
are, however, not required to agree to a requested
restriction. If we do agree to a restriction,
we must abide by it unless you agree in writing to
remove it.
-
The right to reasonable requests to receive
confidential communications of protected health
information from us by alternative means or at
alternative locations.
-
The right to inspect and copy your protected health
information.
-
The right to amend your protected health
information.
-
The right to receive an accounting of disclosures
of protected health information.
-
The right to obtain a paper copy of this notice
from us upon request.
We are required by law to maintain the privacy
of your protected health information and to provide you with
notice of our legal duties and privacy practices with respect
to protected health information.
This notice is effective as of June 10, 2002,
and we are required to abide by the terms of the Notice of
Privacy Practices currently in effect. We reserve the
right to change the terms of our Notice of Privacy Practices
and to make the new notice provisions effective for all
protected health information that we maintain. We will
post and you may request a written copy of a revised Notice of
Privacy from this office.
You have recourse if you feel that your privacy
protections have been violated. You have the right to
file a formal, written complaint with our office or with the
Department of Health & Human Services, Office of Civil
Rights, about violations of the provisions of this notice or
the policies and procedures of our office. We will not
retaliate against you for filing a complaint.
Please contact us for more information, by
asking to speak with our Privacy Officer or for written
inquiries, note "Attention Privacy Officer."
For more information about HIPAA or to file a
complaint:
The U.S. Department of Health & Human
Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775
Privacy Notice Printable Version
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