|
|
Urology Consultants, P.A.
|
||
|
|
|||
|
|
|||
|
|
|||
|
|
|
|
|
|
Notice
of Privacy Practices
To
our patients:
This notice describes how health information about you (as a
patient of this practice) may be used and disclosed, and how you can get
access to your health information. This
is required by the Privacy Regulations created as a result of the Health
Insurance Portability and Accountability Act of 1996 (HIPAA). Our
commitment to your privacy Our
practice is dedicated to maintaining the privacy of your health
information. We are required
by law to maintain the confidentiality of your health information. We
realize that these laws are complicated, but we must provide you with the
following important information: Use
and disclosure of your health information in certain special circumstances The
following circumstances may require us to use or disclose your health
information: 1. To public health authorities and health oversight agencies that
are authorized by law to collect information. 2. Lawsuits and
similar proceedings in response to a court or administrative order. 3. If required to
do so by a law enforcement official. 4. When necessary
to reduce or prevent a serious threat to your health and safety or the
health of another individual or the public.
We will only make disclosures to a person or organization able to
help prevent the threat. 5. If you are a
member of U.S. or foreign military forces (including veterans) and if
required by the appropriate authorities. 6. To federal
officials for intelligence and national security activities authorized by
law. 7. To correctional
institutions or law enforcement officials if you are an inmate or under
the custody of a law enforcement official. 8. For Workers
Compensation and similar programs. Your
rights regarding your health information 1. Communications:
You can request that our practice communicate with you about your
health and related issues in a particular manner or at a certain location.
For instance, you may ask that we contact you at home, rather than
work. We will accommodate
reasonable requests. 2. You can request
a restriction in our use or disclosure of your health information for
treatment, payment, or health care operations.
Additionally, you have the right to request that we restrict our
disclosure of your health information to only certain individuals involved
in your care or the payment for your care, such as family members and
friends. We are not required to agree to your request; however, if we
do agree, we are bound by our agreement except when otherwise required by
law, in emergencies, or when the information is necessary to treat you. 3. You have the
right to inspect and obtain a copy of the health information that may be
used to make decisions about you, including patient medical records and
billing records, but not including psychotherapy notes.
You must submit your request in writing to Urology Consultants,
P.A., 8038 Wurzbach, Suite 430, San Antonio, TX 78229 (210) 616-0410. 4. You may ask us
to amend your health information if you believe it is incorrect or
incomplete, and as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing
and submitted to Urology Consultants, P.A. 8038 Wurzbach, Suite 430, San
Antonio, TX 78229 (210) 616-0410. You
must provide us with a reason that supports your request for amendment. 5. Right to a copy
of this notice. You are
entitled to receive a copy of this Notice of Privacy Practices.
You may ask us to give you a copy of this Notice at any time.
To obtain a copy of this notice, contact our front desk
receptionist. 6. Right to file a
complaint. If you believe
your privacy rights have been violated, you may file a complaint with our
practice or with the Secretary of the Department of Health and Human
Services. To file a complaint
with our practice, contact Urology Consultants, P.A., 8038 Wurzbach, Suite
430, San Antonio, TX 78229 (210)616-0410.
All complaints must be submitted in writing.
You will not be penalized for filing a complaint. 7. Right to
provide an authorization for other uses and disclosures.
Our practice will obtain your written authorization for uses and
disclosures that are not identified by this notice or permitted by
applicable law. If you have any questions regarding this notice or our health information privacy policies, please contact Urology Consultants, P.A., 8038 Wurzbach, Suite 430, San Antonio, TX 78229, (210) 616-0410).
|
|