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Notice of Privacy Practices




 The Health Insurance Portability & Accountability Act of 1996 (“HIPAA”) is a federal program that requires that medical records and health information in any form, whether electronic, 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.  As required by “HIPAA”, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

 We may use and disclose your medical records for the following purposes:  treatment, payment, and health care operations. 

  • Treatment means providing, coordinating, or managing health care and related services by one or more providers. Examples of this include sending records to your surgeon or giving the hospital lab your diagnosis for a blood test.
  • Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review.  An example of this would be sending a bill to Medicare for payment, or sending your records to your insurance company to verify why a certain test was required.
  • Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, customer service, or computer and software maintenance.  An example would be reviewing our charts to see who needs flu shots or reviewing charts for proper billing.

 The “HIPAA” laws are complex.  The following is a partial list of our policies regarding your medical information. 

  • We may send you test results or appointment reminders in the mail.
  • We may leave a message on your answering machine requesting that you call our office about a test result or appointment.
  • We will discuss your private health information with relatives only if you give us permission to do so, if a relative is closely involved in your treatment, or if you are unable to make your own decisions due to a serious illness.
  • Records containing information about mental illness, depression, psychiatric illness, AIDS, HIV infection, sexually transmitted diseases, drug abuse or alcohol abuse will be disclosed in the same manner as your other medical information as allowed by law, unless you ask us to handle these records separately.
  • We are required by law to release information in certain cases such as a judge’s order, suspected child abuse, certain contagious diseases, medical liability cases, criminal activity, and death certificates. 
  • We are required to release records regarding Workman’s Compensation to both the insurance company and the involved employer, and we may discuss these cases with the employer to protect your health in the workplace.
  • We periodically have students here, who are bound to protect your confidentiality just as our employees are. 

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 that 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.

  • The right to request restrictions on certain uses and disclosures of protected health information.  For example, you could request we do not release information about your cholesterol problem to your spouse, or send information about depression to your insurance company.  However, if we think your request is unworkable, unethical, or not in your best interests, we will let you know this and will try to come to an agreement with you.  We are not required by law to agree to these restrictions if we let you know of our disagreement.
  • The right to reasonable requests to receive confidential medical information from us by alternative means or at alternative locations.
  • The right to inspect and copy your health information.
  • The right to amend your protected health information if you believe there is an error in the record.
  • The right to know who has received a copy of your protected health information.
  • The right to obtain a paper copy of this notice from us upon request. 

We agree to follow these policies as of April 14, 2003.  We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain.  We will post these revisions, and you may also request a written copy of a revised Notice of Privacy Practices from this office.  If you believe that your privacy has been violated, please let us know right away.  Our privacy officer is our practice manager, Connie Ellison (551-0083).  You also have the right to file a written complaint with our office or with the Department of Health & Human Services about violations of the provisions of this notice.  We will not retaliate against you for filing a complaint.  For more information about HIPAA or to file a complaint, contact:


                             The U.S. Department of Health & Human Services

                                                      Office of Civil Rights

                                          200 Independence Avenue, S.W.

                                                  Washington, D.C. 20201




Effective Date:  March 1, 2018

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