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NOTICE OF PRIVACY PRACTICES
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.
The Health Insurance Portability & 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 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 healthcare operations.
- Treatment means providing, coordinating,
or managing health care and related services by one or more health care
providers. An example of this would include a complete eye health exam.
- 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 for your visit to your insurance company for payment.
- Health care operations include 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 would be an internal quality
assessment review.
We may also create and distribute de-identified health information by
removing all 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:
- 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 any other person identified by you. We are, however,
not required to agree to a 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.
- 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.
We are required by law to maintain the privacy of your protected health
information and to provide you with notice of our legal duties and privacy
practices with respect to protected health information.
This notice is effective as of December 19, 2002 and we are required to
abide by the terms of the Notice of Privacy Practices currently in effect.
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 and you may request a written
copy of a revised Notice of Privacy Practices from this office.
You have recourse if you feel that your privacy protections have been
violated. You have the right to file written complaint with our office, or
with the Department of Health and Human Services, Office of Civil Rights,
about violations of the provisions of this notice or the policies and
procedures of our office. We will no retaliate against you for filing a
complaint.
Please contact us for more information: For more information about HIPAA
Or to file a complaint:
The U.S. Department of Health &
Human Services, Office of Civil Rights
200 Independence Avenue, SW
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775
East Oregon Surgery Center 1050 Southgate, Suite B, Pendleton, OR 97801
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