The Health Insurance Portability And Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper or orally, are kept properly confidential. This Act gives YOU, the patient significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information.

As required by HIPAA, we have prepared this explanation of how we are required to maintain and protect the privacy of your health information and how we may use and disclose your health information.

We may use and disclose your medical records only for each of the following purposes: Treatment, payment, and health care operations .

Treatment: providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would be a physical exam.

Payment: Activities as obtaining reimbursement for services, confirming coverage, billing or collecting activities and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.

Health care operations: the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost management analysis and customer service. An example of this would be an internal quality assessment review.

We may also create and distribute de-identified health information by removing references to individually identifiable information.

We may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing, and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the privacy officer of our practice.

The right to request restrictions on certain uses and disclosures of protected health information, including those related to: Disclosures to family members, other relatives, close personal friends or other people identified by you. We are, however, not required to agree to the requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it

The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations

The right to inspect and copy your protected health information. If you request a copy of you health information for you own personal reason, there is a monetary charge of $1.00 per page for the administrative costs

The right to amend your protected health information

The right to receive an accounting of disclosures of protected health information

The right to obtain a paper copy of this notice from us upon request

To sum up your rights under “HIPAA”, you understand that your protected health information can and will be used to: To sum up your rights under “HIPAA”, you understand that your protected health information can and will be used to:

Conduct, plan and direct your treatment and follow up if necessary with other healthcare providers who may be involved in your treatment either directly or indirectly

To obtain payment from third party payers

To conduct normal healthcare operations such as quality assessment and physician certifications.