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
If you have any questions about this Notice, please contact our Privacy Officer at the number listed at the end of this Notice. Eachtime you visit a healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This Notice applies to all of the records of your care generated by your health care provider. Our Responsibilities
Dr. Steven A. Fischman Orthodontics, LLC is required by law to maintain the privacy of your health information and to provideyouwitha description of our legal duties and privacy practices regarding your health information. The current Notice will be posted in the mainreception areaand on our website at centerortho.com The notice will include the effective date. In addition, we will make our best effort to provide you with a copy of this notice that we request you acknowledge with your signature.
We are required by law to abide by the terms of this Notice and notify you if we make changes to this Notice, which may be at any time. Changes to the Notice will apply to your medical information that we already maintain as well as new information receivedafterthechange occurs. If we change our Notice, it will be posted in the main reception area and on our website at centerortho.com You may also request that will a revised Notice be sent to you in the mail or you may ask for one at your next appointment or appropriate visit. This Noticealsoserveto advise you as to your rights with regard to your medical information.
How We May Use and Disclose Medical Information About You The following categories describe examples of the way we use and disclose medical information
ForWe may use medical information about you to provide, coordinate and manage your treatment or services. We may disclose Treatment medicalinformation about you to other doctors, nurses, technicians (e.g. clinical laboratories or imaging companies), medical students, or other personnel who are involved in your care. We may communicate your information either orally or in writing by mail or facsimile.
We mayalso provide a subsequent healthcare provider with copies of various reports that should assist him or her in treating you. For example, your medical information may be provided to a care provider to whom you have been referred so as to ensure that the doctor has appropriate information regarding your previous treatment and diagnosis.
ForPayment We may use and disclose medical information about your treatment and services to bill and collect payment from you, your insurancecompany or a third party payer. For example, we may need to give your insurance company information before it approves or pays for the health care services we recommend for you.
ForHealth Care Operations We may use or disclose, as needed, your health information in order to support our business activities. These activities mayinclude, but are not limited to quality assessment activities, employee review activities, licensing, legal advice, accounting support, information systems support and conducting or arranging for other business activities. In addition, we may also call you by name in the waiting room when your care provider is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment by telephone or reminder card.
BusinessAssociates There are some services provided in our organization through contracts with business associates. Examples include software support. If these services are contracted, we may disclose your health information to our business associate so that they canperform the job that we have asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information through a written contract.
Object Other Permitted and Required Uses and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to
We also may use and disclose your health information as set forth below. You have the opportunity to agree or object to the use or disclosure of all orpartof your health information in these instances. If you are not present or able to agree or object to the use or disclosure of the health information (such as in an emergency situation), then your clinician may, using professional judgment, determine whether the disclosure isin your best interest. In this case, only the information that is relevant to your health care will be disclosed.
IndividualsInvolved in Your Care or Payment for Your Care Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care or who helps to pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
FutureCommunications We may communicate to you via newsletters, mailings or other means regarding treatment options, information on health-related benefits or services; to remind you that you have an appointment for medical care; or other community based initiatives or activities in which our facility is participating. If you are not interested in receiving these materials, please contact our PrivacyOfficer.
Otherand Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object We Permitted useor disclose your health information in the following situations without your authorization or without providing you with an may opportunity to object. These situations include:
As required by law We may use and disclose health information to the following types of entities, including but not limited to: Food and Drug Administration Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability Correctional Institutions