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.
We are required by law to provide you with this notice that explains our privacy practices with regard to yourmedical information and how we may use and disclose your protected health information for treatment, payment, and for health care operations, as well as for other purposes that are permitted or required by law. You have certain rights regarding the privacy of your protected health information and we also describe those rights in this notice.
Ways in Which We May Use and Disclose Your Protected Health Information:
The following paragraphs describe different ways that we use and disclose your protected health information. We have provided an example for each category, but these examples are not meant to be exhaustive. All of the ways we are permitted to use and disclose your health information fall within one of these categories.
Treatment. We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. We will also disclose your health information to other physicians who may be treating you. Additionally we may from time to time disclose your health information to another physician whom we have requested to be involved in your care. For example – we would disclose your health information to a specialist to whom we have referred you for a diagnosis to help in your treatment.
Payment. We will use and disclose your protected health information to obtain payment for the health care services we provide you. For example — we may include information with a bill to a third-party payer that identifies you, your diagnosis, procedures performed, and supplies used in rendering the service.
Health Care Operations. We will use and disclose your protected health information to support the business activities of our practice. For example -– we may use medical information about you to review and evaluate our treatment and services or to evaluate our staff’s performance while caring for you. In addition, we may disclose your health information to third party business associates who perform billing, consulting, or transcription, or other services for our practice.
Other Ways We May Use and Disclose Your Protected Health Information:
Appointment Reminders. We will use and disclose your protected health information to contact you as a reminder about scheduled appointments or treatment.
Treatment Alternatives. We will use and disclose your protected health information to tell you about or recommend possible alternative treatments or options that may be of interest to you.
Others Involved in Your Care. We will use and disclose your protected health information to a family member, a relative, a close friend, or any other person you identify that is involved in your medical care or payment for care.
Research. We will use and disclose your protected health information to researchers, provided the research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
As Required by Law. We will use and disclose your protected health information when required to by federal, state, or local law.
To Avert a Serious Threat to Public Health or Safety. We will use and disclose your protected health information to public health authorities permitted to collect or receive the information for the purpose of controlling disease, injury, or disability. If directed by that health authority, we will also disclose your health information to a foreign government agency that is collaborating with the public health authority.
Worker’s Compensation. We will use and disclose your protected health information for worker’s compensation or similar programs that provide benefits for work-related injuries or illness.
Your Health Information Rights
Although your health record is the physical property of the practitioner or facility that compiled it, the information belongs to you. You have the right to:
A Paper Copy of This Notice. You have the right to receive a paper copy of this notice upon request.
You may obtain a copy by asking our receptionist at your next visit or by calling and asking us to mail you a copy.
Inspect and Copy. You have the right to inspect and copy the protected health information that we maintain about you in our designated record set for as long as we maintain that information. This designated record set includes your medical and billing records, as well as any other records we use for making decisions about you. Any psychotherapy notes that may have been included in records we received about you are not available for your inspection or copying, by law. We may charge you a fee for the costs of copying, mailing, or other supplies used in fulfilling your request.
If you wish to inspect or copy your medical information, you must submit your request in writing to our Privacy Officer:
Attention: Privacy Officer
3003 South Loop West Suite 475
Houston Texas 77054
You may mail your request, or bring it to our office. We will have 30 days to respond to your request for information that we maintain at our practice site. If theinformation is stored off-site, we are allowed up to 60 days to respond but must inform you of this delay.