NOTICE OF PRIVACY PRACTICES
I. 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.
The terms of this Notice of Privacy Practices apply to Aloupis Dermatology. Aloupis Dermatology is a covered entity that includes our general physician office. Aloupis Dermatology, its employees, volunteers, students, independent contractors, Medical Staff, and other professionals will share personal health information of patients with other Aloupis Dermatology entities as necessary to carry out treatment, payment, and health care operations as permitted by law.
II. We Have a Legal Duty to Protect Your Health Information
We are required by law to protect the privacy of your health information. We are also required to provide you with this notice about our privacy practices. We are required to comply with all the terms described in the current version of our Notice of Privacy Practices.
You can request a copy of this notice from our office listed in Section VI below at any time.
III. How We May Use and Disclose Your Health Information
A. Use and Disclosure That Does Not Require Your Authorization
Aloupis Dermatology collects health information from you and stores it on a computer. The collected information may be used for the following purposes.
1. For treatment. We may give information about you to physicians, nurses, medical students, and other health care personnel who are involved in your care.
2. To obtain payment for treatment. We may give portions of your information to our billing department and to your health plan to get paid for the services we provided to you. We may give your information to our business associates, such as billing companies, claims processing companies, law firms, collection agencies, and others that process our health care claims. We may also give your information to another health care provider that has treated you for their payment purposes.
3. For regular health care operations. We may disclose information about you to operate this business. For example, we may use information about you to look at the quality of health care services that you received or to look at the performance of the professionals who provided health care services to you. We may provide information about you to our accountants, attorneys, consultants, and others in order to make sure we are complying with the laws that affect us. We may also give your information to other health care providers and health plans for their business operations if they have or had a patient relationship with you.
4. When required by federal, state, or local law, judicial or administrative proceedings, or law enforcement. For example, we give out your information when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with gunshot and other wounds; either by subpoena or when ordered by the court.
5. For public health activities. For example, we report information about births, deaths, and various diseases, to government officials in charge of collecting that information, and we give coroners, medical examiners, and funeral directors necessary information relating to a death.
6. For health oversight activities. For example, we will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.
7. For purposes of organ donation. We may notify organ procurement organizations to assist them in organ, eye, or tissue donation and transplants.
8. For workers’ compensation purposes. We may release your information to your employer when we have provided health care to you at the request of your employer to determine workplace-related illness or injury.
9. Appointments and services. We may contact you to remind you of an appointment or give you a test result. You have the right to request that messages not be left on voice mail or sent to a particular address. We may also contact you to give you information about treatment alternatives, or other health care services and benefits we offer.
B. You Have the Opportunity to Object to These Disclosures
1. Disclosures to family, friends, or others. We may provide your information to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object and fill out the appropriate form.
2. Health Information Exchanges. We may share your information through secure electronic means both to and from health care providers who are treating you.
IV. Your Health Information Rights
A. The Right to Request Limits on How We Use and Disclose Your Health Information.
You have the right to ask that we limit how we use and give out your information. We will carefully consider your request, but we are not required to accept it, except for certain disclosures when you have paid for service out-of-pocket in full.
If we accept your request, we will put it in writing and abide by it except in emergency situations. To request limits, complete the appropriate form at the facility where you are receiving care.
B. The Right to Choose How We Send Your Information to You.
You have the right to ask that we send information to you to an alternate address. For example, you may ask us to send information to your work address rather than your home address. You can also ask that it be sent by alternate means. For example, you can ask that we send information by fax instead of regular mail. We will agree to your request if we can easily provide it in the format you request.
C. The Right to See and Get Copies of Your Health Information.
Most of the time, you have the right to look at or get copies / summary of your health information that we have. Your request must be signed by you or your legally authorized representative. If we keep your health information in an Electronic Health Record, it will be given to you (or your designee) electronically upon your request.
D. The Right to Correct or Update Your Health Information.
If you believe that there is a mistake in your information or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information.
Each request will be carefully considered. If we approve your request, we will make the change to your information, tell you that we have done it, and tell others that need to know about the change.
E. The Right to Get This Notice.
You have the right to request a paper copy of this notice. You also have a right to get a copy of this notice by e mail. F. The Right to Privacy Notification.
You have the right to be notified after a breach of your protected health information.
V. Changes to the Policy
VI. Complaints and Contact Information
If you think that we may have violated your privacy rights, or you disagree with a decision we made about your health information, you may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to
200 Independence Avenue, S.W., Washington, D.C. 20201; calling 1-877-696-6775, or visiting
www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.
If you have any questions about this notice or any complaints about our privacy practices, please contact Aloupis Dermatology at (561) 313-1230.