This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices that are described in the Notice while it is in effect. This Notice take effect 03/01/2018 and will remain in effect until we replace it.

We reserve the right to change our policy practices and the term of this Notice at any time, provided such changes are permitted by applicable law, and to make new Notice provisions effective for all protected health information that we maintain. When we make a significant change in our privacy practices, we will change this Notice and post the new Notice clearly and prominently at our practice location, and we will provide copies of the new Notice upon request.

You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice. 

HOW WE MAY USE AND DISClOSE HEALTH INFORMATION ABOUT YOU

We may use and disclose your health information for different purposes, including treatment, payment, and health care operations. For each of these categories, we have provided a description and an example. Some information, such as HIV-related information, genetic information, alcohol, and/or substance abuse records , and mental health records may be entitled to special confidentiality protection under applicable state or federal law. We will abide by these special protections as they pertain to applicable cases involving these types of records.

TREATMENT

We may use and disclose your health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.

PAYMENT

We may use and disclose your health information to obtain reimbursement for the treatment and services you receive from us or another entity involved with your care. Payment activities including billing, collections, claims management, and determinations of eligibility and coverage to obtain payment from you, an insurance company, or another third party. For example, we may send claims to your dental health plan containing certain health information.

HEALTHCARE OPTIONS

We may use and disclose your health information in connection with our healthcare operations. For example, healthcare operations include quality assessment and improvement activities, conducting training programs, and licensing activities.

INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE

We may disclose your health information to your family or friends when any other individual identified by you when they are involved in  your care or in the payment for your care. Additionally, we may disclose information about you to a patient representative. If a person has the authority by law to make a health care decision for you, we will treat that patient representative the same way we would treat you with respect to your health information.

DISASTER RELIEF

We may use or disclose your health information to assist in disaster relief efforts.

REQUIRED BY LAW

We may use or disclose your health information when we are required to do so by law.

PUBLIC HEALTH ACTIVITIES

We may disclose your health information for public health activities, including disclosure to:

- Prevent or control disease, injury, or disability

- Report neglect

- Report reactions to medications or problems with products or devices

- Notify a person of a recall, repair, or replacement of products or devices

- Notify a person who may have been exposed to a disease or condition

- Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence

NATIONAL SECURITY

We may disclose to military authorities the health information of Armed Forces personnel under circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody the protected health information of an inmate or patient.

SECRETARY OF HHS

We will disclose your health information to the Secretary of the U.S. Department of Health and Human Services when required to investigate or determine compliance with HIPAA.

WORKER'S COMPENSATION

We may disclose your PHI to the extent necessary to comply with laws relating to worker's compensation or other similar programs established by law.

LAW ENFORCEMENT

We may disclose your PHI for law enforcement purposes as permitted by HIPAA, as a required by law, or in response to a subpoena or court order.

HEALTH OVERSIGHT ACTIVITIES

We may disclose your PHI to an oversight agency for activities authorized by law. These oversight activities include audits investigations, inspections, and credentialing, as necessary for licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.

JUDICIAL AND ADMINISTRATIVE PROCEEDINGS

If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to tell you about the request or to obtain an order protecting the information requested.

RESEARCH

We may disclose your PHI to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

CORONERS, MEDICAL EXAMINERS, AND FUNERAL DIRECTORS

We may release your PHI to a coroner or medical examiner. This may be necessary, for example , to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to enable them to carry out their duties.

FUNDRAISING

We may contact you to provide you with information about our sponsored activities, including fundraising programs, as permitted by applicable law. If you do not wish to receive such information from us, you may opt out of receiving the communications.

OTHER USES AND DISCLOSURES OF PHI

Your authorization is required, with a few exceptions, for disclosure of psychotherapy notes, use or disclosure of PHI for marketing, and for the sale of PHI. We will also obtain your written authorization before using or disclosing your PHI for purposes other than those provided for this Notice (or as otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the authorization.

YOUR HEALTH INFORMATION RIGHTS

ACCESS

You have the right to look at or get copies of your health information, with limited expectations. You must make the request in writing. You may obtain a form