In order to fulfill the Health Information and Patient Privacy Act (HIPPA) requirements, your information and treatment records in this office meet federal privacy guidelines. Among other things, this means my computer files are protected while, at the same time, the files are easily accessible upon your request.
A. Uses and Disclosures
B. Appointment Reminders
C. Marketing
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Here are some examples of how we might have to use or disclose your health care information:
1. Your acupuncturist or staff member may have to disclose your health information including all of your clinical records to another health care provider or hospital if it is necessary to refer you to them for diagnosis, assessment, or treatment.
2. Our insurance and billing staff may have to disclose your examination and treatment records and your billing records to another party, such as an insurance carrier, an attorney, an HMO, a PPO, or your employer, if they are potentially responsible for the payment of your services.
3. Your acupuncturist or staff members may need to use your health information, examination and treatment records and your billing records for quality control purposes or for other administrative purposes to effectively run our practice.
4. Your acupuncturist or staff members may need to use your name, address, phone number, and your clinical records to contact you to provide appointment reminders, information about treatment alternatives, or other health related information that may be of interest to you. If you are not home to receive an appointment reminder, a message will be left on your answering machine.
You have the right to refuse to give us authorization to contact you to provide appointment reminders, information about treatment alternatives, or other health related information. If you do not give us authorization, it will not affect the treatment we provide to you or the methods we use to obtain reimbursement for your care.
You may inspect or copy the information that we use to contact you to provide appointment reminders, information about treatment alternatives, or other health related information at any time.
Your acupuncturist and members of the practice staff may need to use your name, address, phone number, and your clinical records to contact you with appointment reminders, information about treatment alternatives, or other health related information that may be of interest to you. If this contact is made by phone and you are not at home or work, a message will be left on your answering machine. By signing this form, you are giving us authorization to contact you with these reminders and information.
From time to time our practice works with marketing organizations to make you aware of products or services that you may have an interest in purchasing. We may need to use your health information including your name, address, phone number, and your clinical records for the purpose of marketing products and services to you. The authorization form you sign for this purpose contains the name of the organization and/or products and services we are marketing.
You have the right to refuse to give us authorization to contact you for marketing purposes. If you do not give us authorization it will not affect the treatment we provide to you or the methods we use to obtain reimbursement for your care.
You may inspect or copy the information that we use to market products and/or services to you at any time. Our practice and staff will receive direct or indirect remuneration from our marketing activities.
We have, and always will, respect your privacy. Other than the uses and disclosures we describe above, we will not sell or provide any of your health information to any outside marketing organization.
Under federal law, we are permitted or required to use or disclosure your health information without your consent or authorization in these following circumstances:
1. We are permitted to use or disclose your health information if we are providing health care services to you based on the orders of another health care provider.
2. We are permitted to use or disclose your health information if we provide health care services to you as an inmate.
3. We are permitted to use or disclose your health information if we provide health care services to you in an emergency.
4. We are permitted to use or disclose your health information if we are required by law to treat you and we are unable to obtain consent after attempting to do so.
5. We are permitted to use or disclosure your health information if there are substantial barriers to communicating with you, but in our professional judgment we believe that you intend for us to provide care.