Notice of Privacy Practices
Effective Date: 09/23/2013 | Publication Date: 09/23/2013
This notice describes how medical information about you may be used and disclosed, and how you can gain access to this information. Please review it carefully.
Protected health information (PHI), about you, is maintained as a written and/or electronic record of your contacts or visits for healthcare services with our practice. Specifically, PHI is information about you, including demographic information (i.e., name, address, phone, etc.), that may identify you and relates to your past, present or future physical or mental health condition and related healthcare services.
Our practice is required to follow specific rules on maintaining the confidentiality of your PHI, using your information, and disclosing or sharing this information with other healthcare professionals involved in your care and treatment. This Notice describes your rights to access and control your PHI. It also describes how we follow applicable rules and use and disclose your PHI to provide your treatment, obtain payment for services you receive, manage our healthcare operations and for other purposes that are permitted or required by law.
Your Rights Under The Privacy Rule
Following is a statement of your rights, under the Privacy Rule, in reference to your PHI. Please feel free to discuss any questions with our staff.
Right to Receive Notice of Privacy Practices
You have the right to receive, and we are required to provide you with, a copy of this Notice of Privacy Practices. We are required to follow the terms of this notice. We reserve the right to change the terms of our notice, at any time. Upon your request, we will provide you with a revised Notice of Privacy Practices.
Right to Authorize Other Use and Disclosure
This means you have the right to authorize any use or disclosure of PHI that is not specified within this notice. For example, we would need your written authorization to use or disclose your PHI for marketing purposes, for most uses or disclosures of psychotherapy notes, or if we intended to sell your PHI. You may revoke an authorization, at any time, in writing.
Right to Request Alternative Means of Communication
This means you have the right to ask us to contact you about medical matters using an alternative method (i.e., email, telephone), and to a destination designated by you. You must inform us in writing how you wish to be contacted. We will follow all reasonable requests.
Right to Inspect and Copy Your PHI
This means you may inspect, and obtain a copy of your complete health record. If your health record is maintained electronically, you will also have the right to request a copy in electronic format. We have the right to charge a reasonable fee for copies.
Right to Request Restriction of PHI
This means you may ask us, in writing, not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. If we agree to the requested restriction, we will abide by it, except in emergency circumstances when the information is needed for your treatment.
Right to Request Amendment
This means you may request an amendment of your PHI for as long as we maintain this information. In certain cases, we may deny your request.
Right to Request Disclosure Accountability
This means that you may request a listing of disclosures that we have made, of your PHI, to entities or persons outside of our office.
Right to Receive Privacy Breach Notice
You have the right to receive written notification if the practice discovers a breach of your unsecured PHI.
How We May Use or Disclose Protected Health Information
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. This includes the coordination or management of your healthcare with a third party that is involved in your care and treatment.
Payment
Your PHI will be used, as needed, to obtain payment for your healthcare services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we recommend for you.
Healthcare Operations
We may use or disclose, as needed, your PHI in order to support the business activities of our practice. This includes, but is not limited to business planning and development, quality assessment and improvement, medical review, legal services, auditing functions and patient safety activities.
Privacy Complaints
You have the right to complain to us, or directly to the Secretary of the Department of Health and Human Services if you believe your privacy rights have been violated by us. We will not retaliate against you for filing a complaint.
Contact Information
7270 NW 12 STNo. 345
Office 380
Miami, FL 33126