In
the course of your care as a patient at our office we may use or disclose
personal and health related information about you in the following ways:
*Your personal health
information, including all of your clinical records, may be disclosed to
another health care provider or hospital if it is necessary to refer you for
further diagnosis, assessment or treatment.
*Your health care records
as well as your billing records may be disclosed to another party, such as an
insurance carrier, an HMO, a PPO, or your employer, if they are or may be
responsible for the payment of your services.
*Your
name, address, phone number, and your health care records may be used to
contact you regarding appointment reminders, information about alternatives
to your present care, or other health related information that may be of
interest to you.
If
you are not at home to receive an appointment reminder, a message may be left
on your answering machine. Further, you have the right to
inspect or obtain a copy of the information we will use for these purposes.
You also have the right to refuse to provide authorization for this office to
contact you regarding these matters. If you do not provide us with this
authorization it will not affect the care provide to you or the reimbursement
avenues associated with your care.
Under
federal law, we are also permitted or required to use or disclose your health
information without your consent or authorization in these following
circumstances:
*If we are providing
health care services to you based on the orders of another health care
provider.
*If we provide health care
services to you in an emergency.
*If we are required by law
to provide care to you and we are unable to obtain your consent after
attempting to do so.
*If
there are substantial barriers to communicating with you, but in our
professional judgment we believe that you intend for us to provide care.
*If we are ordered by the
courts or another appropriate agency.
Any
use or disclosure of your protected health information, other than as outlined
above, will only be made upon your written authorization.
We
normally provide information about your health to you in person at the time
you receive chiropractic care from us. We may also mail information to you
regarding your health care or about the status of your account. If you would
like to receive this information at an address other than your home or, if you
would like the information in a different form please advise us in writing as
to your preferences.
You have the right to inspect and/or copy your health
information for seven years from the date that the record was created or as
long as the information remains in our files. In addition you have the right
to request an amendment to your health information. Requests to inspect, copy
or amend your health related information should be provided to us in writing.
We
are required by state and federal law to maintain the privacy of your patient
file and the health protected health information therein. We are also required
to provide you with this notice of our privacy practices with respect to your
health information.
We
are further required by law to abide by the terms of this notice while it is
in effect. We reserve the right to alter or amend the terms of this privacy
notice. If changes are made to our privacy notice we will notify you in
writing as soon as possible following the changes. Any change in our privacy
notice will apply for all of your health information in our files.
Information that we use or disclose based on this privacy notice may be
subject to re-disclosure by the person to whom we provide the information and
may no longer be protected by the federal privacy rules.
If
you have a complaint regarding our privacy notice, our privacy practices or
any aspect of our privacy activities you should direct your complaint to:
If
you would like further information about our privacy policies and practices
please contact: Susan Shockey, Office Manager, Mary K. Brittain, D.C.