Privacy Policy

In accordance with the Health Insurance Portability and Accountability Act of 1996, as of May 6, 2006 all health care providers are required to provide their with a “Notice of Privacy Practice” statement. 

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 care provider named above is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information.

Disclosure of your Health Care Information

Treatment

1. We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operation.

2. On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associate with the healthcare provider named above. 

Payment

We may disclose your healthcare information to your insurance company. If you pay for healthcare services personally, we will, as a courtesy, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you. The billing statement contains medical information, including diagnosis, date of injury or condition, and codes which the health care services received.

Workers’ Compensation

We may disclose your healthcare information as necessary to comply with State workers compensation laws.

Emergencies

We disclose your health care information to notify or assist in notifying a family member or another person responsible for your care about your medical condition or in the event of an emergency or you death.

Public Health

As required by law, we may disclose your healthcare information to public health authorities for the purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the food and drug admiration problems with product and reactions to medications, reporting disease or infection exposure.

Judicial and Administration Proceedings

We disclose your health care information in the course of any administrative or judicial proceeding.

Law Enforcement

We disclose your health care information to law enforcement official for purpose such as identifying or location a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purpose.

Deceased person

We disclose your health care information to coroners or medical examiners.

Organ Donation

We disclose your health care information to organization involved in procuring, banking, or transplanting organs and tissues.

Research

We disclose your health care information to researchers conducting research that has been approved by an Institutional Review Board.

Public Safety

It may be necessary to disclose your health care information to appropriate persons in order to prevent or lessen a serious and imminent threat to health or safety of particular person or to general public.

Specialized Government Agencies

We disclose your health care information for military, national security, prisoner and government benefits purposes.

Courtesy calls

As a courtesy to our patients, it is our policy to call your home or cell number(text asked verbally) on the day prior to your schedules appointment to remind you of your appointment time. If you are not available, we will leave reminder message on your answering machine or with the person answering the phone. No personal health information will be disclosed during this recording or message with other than the date and time of your scheduled appointment along with a request to call the office if you need to cancel or reschedule your appointment.

Change of Ownership

In the event that the health care provider named above is sold or merged with another organization, your health information/record will become the property of the new owner.

Your Health Information Rights

1. You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised however, that the healthcare provider named above is not required to agree to the restriction(s) that you requested.

2. You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.

3. You have the right to inspect and copy your health information.

4. You have the right to request that the healthcare provider named above amend your protected health information. Please be advised, however, the healthcare provider named is not required to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial. 

5. You have the right to receive an accounting of disclosures of your health information made by the healthcare provider named above.

6. You have the right to paper copy of this Notice of Privacy Practices at any time upon request.

Changes to this Notice of Privacy Practices

1. The healthcare provider named above reserves the right to amend this notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains, Until such amendments is made, the healthcare provider named above is required by law to comply with this Notice. 

2. The healthcare provider named above is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this notice of if you want more information about your privacy rights, please call the office number listed at the top of this page. 

Complaints

Complaints about your Privacy rights or how the healthcare provider named above has handled your health information should be directed to Practice Privacy Officer by calling this office at the number above this page. If you are not satisfied with manner in which this office handles your complaint, you may submit a formal complaint to: DHHS, Office of Civils Rights, U.S. Department of Health and Human Services
Sam Nunn Atlanta Federal Center, Suite 16T70; 61 Forsyth Street, S.W.; Atlanta, GA 30303-8909