Notice of Privacy Practices
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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 and safety 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
Alan Hamilton MD PC, attention: HIPAA Officer, 5425 E. Bell Road, #145, Scottsdale,
AZ 85254 (602) 354-3172.
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: Alan Hamilton M.D., P.C., 5425 E. Bell Road, #145, Scottsdale, AZ 85254 (602)
354-3172. You must provide us
with a reason that supports your request for the 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, or
click
here.
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 Alan Hamilton
M.D., P.C., (602) 354-3172, Attn: HIPAA Officer, 5425 E. Bell Road, #145,
Scottsdale, AZ 85254. 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
Alan Hamilton M.D. P.C., 5425 E. Bell Road, #145, Scottsdale, AZ 85254 (602)
354-3172.
Click here
for a printer friendly (Adobe .pdf) version.
