Right to request how we contact youIt is our normal practice to communicate
with you at your home address and daytime phone number you gave us
when you scheduled your appointment, about health matters, such as
appointment reminders, etc. Sometimes we may leave messages on your
voicemail. You have the right to request that our office communicate
with you in a different way. Right to release your medical records.
You may consent in writing to release your records to others. You
have the right to revoke this authorization, in writing, at any time.
However, a revocation is not valid to the extent that we acted in
reliance on such authorization.Right to inspect and copy your medical
and billing records.
You have the right to inspect and obtain a copy of your information
contained in our medical records. Under limited circumstance way may
deny your request to inspect and copy. If you ask for a copy of any
information, we may charge a reasonable fee for the costs of copying,
mailing and supplies. Right to add information and amend your medical
records.
If you feel that information contained in your medical record is incorrect
or incomplete, you may ask us to add information to amend the record.
We will make a decision on your request within 60 days, or some cases
within 90 days. Under certain circumstances, we may deny your request
to add or amend information. If we deny your request, you have a right
to file a statement that you disagree. Your statement and our response
will be added to your record. We will require you to submit your request
in writing and to provide and explanation concerning the reason for
your request. Right to an accounting disclosure.
You may request an accounting of any disclosures , if any, we have
made related to your medical information, except for information we
used for treatment, payment, or health care operational purposes or
that we shared with you or your family, or information that you gave
us specific consent to release. It also excludes information we were
required to release. To receive information regarding disclosure made
for a specific time period no longer than six years please submit
your request in writing. We will notify you of the cost involved in
preparing this list. Right to request restrictions on uses and disclosures
of your health information.
You have the right to ask for restrictions on certain uses and disclosures
of your health information. This request must be in writing and submitted
to this office. However, we are not required to agree to such a request.
Right to complain.
If you believe your privacy rights have been violated, please contact
us personally, and discuss your concerns. If you are not satisfied
with the outcome, you may file a written complaint with the US Department
of Health and Human Services. An individual will not be retaliated
against for filing such a complaint. Right to receive changes in policy.
You have the right to receive any future policy changes secondary
to changes in state and federal laws. |
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