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.
Dr. Duncan Brown Hair
Transplantation Center respects your privacy. We understand
that your personal information is very sensitive. We will not
disclose your information to others unless you tell us to do so,
or unless the law authorizes or requires us to do so.
The law protects the
privacy of the health information we create and obtain in
providing our care and services to you. For example, your
protected health information includes the health history you
give us, your treatment here and your payment of fees relating
to these services. Federal and state law allows us to use and
disclose your protected health information for purposes of
treatment and health care operations.
Examples of use and
disclosures of Protected Health Information for Treatment,
Payment, and Health Operations:
Treatment:
-
Information obtained by
a nurse, physician, or other member of our health care team
will be recorded in your medical record and used to help
decide what care may be right for you.
For Payment:
-
The only persons exposed to your
payment information are Dr. Brown and Sandy Brown and our
accountant.
For health care operations:
-
We use your medical records to
assess quality and improve services.
-
We may use and disclose medical
records for quality assurance review and performance of our
staff and to train our staff.
-
We may contact you to confirm
appointments for consultations or procedures, or for reminders.
-
We may use payment information for
accounting services.
YOUR HEALTH INFORMATION RIGHTS
The health and accounting records
that we create and store are the property of the practice. The
protected health information in it, however, generally belongs
to you.
You have a right to:
-
Receive, read, and ask
questions about this notice;
-
Ask us to restrict certain
uses and disclosures. You must deliver this request
in writing to us. We are not required to
grant the request. But we will comply with any request granted;
-
Request and receive from us a paper
copy of the most current Notice of Privacy Practices for
Protected Health Information;
-
Request that you be allowed
to see and get a copy of your protected information. You may
make this request in writing. We have a form available for this
type of request.
-
Have us review a denial of access
to your health information-except in certain
circumstances;
-
Ask us to change your health
information. You may give us this request in writing. You
may write a statement of disagreement if your request is
denied. It will be stored in your medical record, and included
with any release of your records.
-
When you request, we will
give you a list of disclosures of your health information. You
may receive this information without charge once every 12
months.
-
Ask that your health
information be given to you by another means or at another
location. Please sign, date, and give us your request in
writing.
-
Cancel prior authorizations
to use or disclose health information by giving us a written
revocation. Your revocation does not affect information already
released. It does not affect any action taken before we have
it.
For help with these rights during
normal business hours, please contact:
Privacy Officer: Sandy Brown (509)-838-0213
Our
Responsibilities
We are required to:
- Keep your health information
private
- Give you this notice
- Follow the terms of this
notice.
We have the right to change our practices
regarding the protected health information we maintain. If
we make changes, we will update this Notice. You may
receive the most recent copy of this Notice by calling and
asking for it or by visiting our office to pick one up.
To
Ask for Help or Complain
If you have Questions, want more
information or want to report a problem about the handling of
your protected health information, you may contact:
Privacy Officer: Sandy Brown
(509)-838-0213
If you believe your privacy rights have been
violated, you may discuss your concerns with any staff member.
You may also deliver a written complaint to the above named
Privacy officer. You may also file a complaint with the U.S.
Secretary of Health and Human Services.
We respect your right to file a complaint with
us or with the U.S. Secretary of Health and Human Services. If
you complain we will not retaliate against you.
Other Disclosures and Uses of
Protected Health Information
Notification of Family and Others
Unless you abject, we may
release health information about you to a friend or family
member who is involved in your medical care. We may also give
information to someone who helps pay for your care.
We may use and disclose your protected
health information without your authorization as follows:
-
For Public Health and
Safety Purposes as Allowed or Required by Law:
-
To prevent or reduce a
serious, immediate threat to the health or safety of a person or
the public.
-
To public health or legal
authorities
-
In the course of
Judicial/Administrative Proceedings at your request, or as
directed by a subpoena or court order.
-
To Comply with workers
Compensation Laws- if you make a workers’ compensation claim.
Other Uses and Disclosures of
Protected Health Information
Uses and disclosures not in
this Notice will be made only as allowed or required by law or
with your written authorization.
WEB SITE
We have a web site that
provides information about us. For your benefit, this Notice is on the Web site at this address:
www.duncanbrownmd.com
Effective date: April 14, 2003
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