Effective: June 3, 2020
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. If you have any questions, please contact our office.
We are required by law to:
- Maintain the privacy of your protected health information;
- Give you this notice of our duties and privacy practices regarding health information about you;
- Follow the terms of our notice that are currently in effect.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION:
Described as follows are the ways we may use and disclose health information that identifies you (Health Information, or PHI). Except for the following purposes, we will collect, use, or disclose your Health Information only with your written consent. You may revoke such consent at any time by writing to us and stating that you wish to revoke the consent you previously gave us.
Treatment. We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.
Payment. We may use and disclose Health Information so that we may bill and receive payment from you, an insurance company, or a third party for the treatment and services you received. For example, we may give your health plan information so that they will pay for your treatment. However, if you pay for your services yourself (e.g. out-of-pocket and without any third-party contribution or billing), we will not disclose Health Information to a health plan if you instruct us not to do so.
Health Care Operations. We may use and disclose Health Information for health care operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and to operate and manage our office. For example, we may use and disclose information to make sure the care you receive is of the highest quality. Subject to the exception above, if you pay for your care yourself, we also may share information with other entities that have a relationship with you (for example, your health plan) for their health care operations.
Privacy Contact Officer: Dr. Jeremy Sewell