This notice describes how health information about you, if you decide to become a patient of this practice may be used and disclosed, and how you can get access to your health information. This is required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Our commitment to your privacy
Our practice is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information. We realize that these laws are complicated, but we must provide you with the following information:
Use and disclosure of your health information in certain special circumstances.
The following circumstances may require us to use or disclose your health information:
- To public health authorities and health oversight agencies that are authorized by law to collect information.
- Lawsuits and similar proceeding in response to a court order.
- If required to do so by a law enforcement official.
- When necessary to reduce or prevent a serious threat to your health and safety or of another individual of the public. We will only make disclosures to a person or organization able to help prevent the threat.
- If you are a member of U.S. Military forces and if required by the appropriate authorities.
- To federal officials for intelligence and national security activities authorized by law.
- For Workers Compensation and similar programs.
Your rights regarding your health information
- Communications. You can request that our practice communicate with you about your health in a particular manner. We will accommodate reasonable requests.
- You can request a restriction in our use or disclosure of our health information for treatment, payment of health care operations.
- You have the right to inspect and obtain a copy of your health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to your physician’s name, 1441 Avocado Avenue Suite 801, Newport Beach CA, 92660, we will respond within 30 days.
- You may ask to amend your health information if you believe it is incorrect or incomplete, as long as the information is kept by of for our practice. To request an amendment, your request must be made in writing and submitted to this office. You must provide us with a reason that supports your request for amendment.
- Right to a copy of this notice.
- Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
- Right to provide an authorization for other uses and disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.
If you have any questions regarding this notice or our health information privacy policies, please contact our office at (949) 759-5539.