This notice describes my office policy for how medical information about you may be used and disclosed, how you can get access to this information, and how your privacy is being protected.
In order to maintain the level of service that you expect, I may need to share limited personal, medical, and financial information with your insurance company or with other medical practitioners that you authorize. You have the right to request a restriction as to how your identifiable health information is used or disclosed to carry out treatment, payment or health care operations of the practice. This clinic will not use your health information for marketing purposes without your written authorization. We may, with your permission, send you birthday cards, newsletters and appointment reminders, by telephone, mail, or email.
Safeguards in place at my office include:
- Limited access to facilities where information is stored.
- Policies and procedures for handling information.
- Requirements for third parties to contractually comply with privacy laws.
- All medical files and records (including email, regular mail, telephone, and faxes sent) are kept on permanent file.
Types of information that we gather and use:
In administering your health care, I gather and maintain information that may include non-public personal information:
- About your financial transactions with us (billing transactions).
- From your medical history, treatment notes, all test results, and any letters, faxes, emails or telephone conversations to or from other health care practitioners.
- From health care providers, insurance companies, and other third party administrators (e.g. requests for medical records, claim payment information).
- Upon written request you have the right to access, review or receive copies of your healthcare records. There is a copy fee (minimum of $5 or legal amount) and 10 working days for us to process this request.
- Upon written request, you have the right to receive a list of items this office disclosed about your healthcare information.
- You have the right to request that this office place additional restrictions on disclosure of your protected health information.
- You have the right to request in writing that we amend your protected health information.
- You have a right to receive all notices in writing.
When required by law, this office may use or disclose your protected health information.
I value our relationship, and respect your right to privacy.
Destin Radder L.Ac., Dipl. Ac.