This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.

Uses and Disclosures of Your Protected Health Information: Your protected health information may be used and disclosed by our organization, our office staff, and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the organization, and any other use required by law.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes coordinating or managing your health care with a third party. For example, we may disclose your protected health information, as necessary, to a home health agency that provides care to you. We may also provide your protected health information to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

Payment: We will use your protected health information, as needed, to obtain payment for your health care services. For example, obtaining approval for equipment or supplies coverage may require that your relevant protected health information be disclosed to the health plan to obtain approval for coverage.

Healthcare Operations: We may use or disclose your protected health information, as needed, in order to support the business activities of our organization. These activities include, but are not limited to, quality assessment activities, employee review activities, accreditation activities, and conducting or arranging for other business activities. For example, we may disclose your protected health information to accrediting agencies as part of an accreditation survey. We may also call you by name while you are at our facility. We may use or disclose your protected health information, as necessary, to contact you to check the status of your equipment.

Your Rights: Following is a statement of your rights with respect to your protected health information.

• You have the right to request restrictions on the use or disclosure of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment, or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.

• You have the right to request to receive confidential communications from us by alternative means or at an alternative location.

• You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively, e.g., electronically.

Complaints: You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact with your complaint. We will not retaliate against you for filing a complaint.

We are required by law to maintain the privacy of your protected health information and to provide you with this notice of our legal duties and privacy practices.

We welcome your comments: Please feel free to call us if you have any questions about how we protect your privacy. Our goal is always to provide you with the highest quality services.

Our Uses and Disclosures of Your Health Information

How do we typically use or share your health information?

We typically use or share your health information in the following ways:

• Treat you: We can use your health information and share it with other professionals who are treating you.

  • Example: A doctor treating you for an injury asks another doctor about your overall health condition.

• Run our organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.

  • Example: We use health information about you to manage your treatment and services.

• Bill for your services: We can use and share your health information to bill and get payment from health plans or other entities.

  • Example: We give information about you to your health insurance plan so it will pay for your services.

How else may we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes.

For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

• Help with public health and safety issues: We can share health information about you for certain situations, such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

• Do research: We can use or share your information for health research.

• Comply with the law: We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

• Respond to lawsuits and legal actions: We can share health information about you in response to a court or administrative order, or in response to a subpoena.