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Notice Of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
East Side Ortho (ESO) and Stuart D. Katchis, M.D., P.C.
respect you and your privacy. We are committed to keeping all
information received or created confidential.
We want you to have a clear understanding of how we use and
safeguard information about you. This Notice of Privacy Practices
describes how we may use and disclose your protected health
information in order to carry out services, voucher for payment and
for other purposes permitted or required by law. It also describes
your rights to access and control your information.
We are required by law to maintain the privacy of your protected
health information and to provide you with notice of the legal
duties and privacy practices with respect to your protected health
information.
Health information means any information, whether oral or recorded
in any form, that is created or received by (ESO) and/or Stuart D.
Katchis, M.D., P.C., relates to the past, present or future
physical, mental health or condition of an individual, the provision
of health care to an individual, or the past, present or future
payment for the provision of health care to an individual.
How Your Protected Health Information May Be Used or Disclosed
(ESO) and/or Stuart D. Katchis, M.D., P.C., use protected health
information about you for services, payment and regular health care
operation purposes. We do not require authorization to use your
protected health information for these purposes.
Payment
Information needed for billing, insurance, or compensation for
services, if necessary. We may provide necessary portions of your
protected health information to our billing department and to your
health plan to get paid/reimbursed for the services we provide to
you.
Regular Health Care Operations
Activities that may include quality assessment, program
evaluation and auditing.
Emergency Care
To help you obtain treatment in a medical emergency. An
authorization is required as soon as reasonably possible after the
emergency and the provider should document the reasons as to why the
authorization could not be received.
When Legally Necessary
If required by federal, state or local law. We may make
disclosures when a law requires that we report information to
government agencies or law enforcement personnel about victims of
abuse, neglect, domestic violence or to avoid serious threat to
health or safety of a person or the public.
We may provide protected health information to a family member,
friend or other person that you indicate is involved in your
services or the payment for your services unless you object, in
whole or in part. The opportunity to consent may be obtained
retroactively in emergency situations.
ALL OTHER USES AND DISCLOSURES REQUIRE YOUR PRIOR WRITTEN
AUTHORIZATION.
IN ADDITION, ANY ALCOHOL OR SUBSTANCE ABUSE RECORDS ARE PROTECTED
UNDER FEDERAL REGULATIONS GOVERNING CONFIDENTIALITY. (42CFR Part II)
ANY HIV RECORDS ARE PROTECTED UNDER PUBLIC HEALTH LAW GOVERNING
CONFIDENTIALITY. (Article 27-F)
When (ESO) and/or Stuart D. Katchis, M.D., P.C., May Not Use or
Disclose Your Health Information
Except as described in this Notice of Privacy Practices, we will
not use or disclose your health information without your written
authorization. If you do authorize us to use or disclose your health
information for another purpose, you may revoke your authorization
in writing at any time.
Your Health Information Rights
You have the right to inspect and obtain a copy of your health
information. You have the right to request restrictions on certain
uses and disclosures of your health information. We are not required
to agree to the requested restriction. You have a right to request
that we amend your health information. An amendment can only be
granted if the information requested to be amended is created by (ESO)
and/or Stuart D. Katchis, M.D., P.C. You have a right to receive an
accounting of disclosures of your health information. This will not
include any dates before April 13, 2003 and cannot be longer than
six years from this date. You have a right to receive confidential
communications of protected health information and the manner in
which it is sent to you. Within reason, you have the right to ask
that we send information to you at an alternate address (such as
requesting that we send information to your work address rather than
your home address) or by alternate means (such as by regular mail
versus e-mail, if such methods are reasonably available). You have a
right to a paper copy of this Notice of Privacy Practices. You will
be asked to sign an Acknowledgement of Receipt of this Notice. You
have a right to complain if you believe your privacy rights have
been violated or if you are dissatisfied with the services you are
receiving. You will not be punished in any way for filing a
complaint.
Changes to This Notice of Privacy Practices
We are bound by the terms of this notice currently in effect and
reserve the right to amend this Notice of Privacy Practices at any
time in the future. If such amendment is made, all individuals
currently active in our programs will be provided a revised Notice
of Privacy Practices by mail or at their next scheduled meeting.
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