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NOTICE
OF PRIVACY PRACTICES (NPP) -- Brief
Version
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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.
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OUR
COMMITMENT TO YOUR PRIVACY
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Our practice is
dedicated to maintaining the privacy of your
personal health information as part of providing
professional care. We also are required by law to
keep your information private. These laws are
complicated, but we must give you this important
information. This is a shorter version of the full,
legally required NPP so refer to it for more
information. However, we can't cover all possible
situations, so please talk to our Privacy Officer
(see the bottom of this notice) about any questions
or problems.
We will use the
information about your health that we get from you
or from others mainly to provide you with
treatment, to arrange payment for our services, and
for some other business activities that are called,
in the law, health care operations. After you have
read this NPP we will ask you to sign a Consent
Form to let us use and share your information. If
you do not consent and sign this form, we cannot
treat you.
If you or we want to use or disclose (send, share,
release) your information for any other purposes we
will discuss this with you and ask you to sign an
Authorization Form to allow this.
Of course we will keep your health information
private, but there are some times when the laws
require us to use or share it. For
example:
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1.
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When there is a
serious threat to your health and safety or the
health and safety of another individual or the
public. We will only share information with a
person or organization, that is able to help
prevent or reduce the threat.
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2.
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Some lawsuits and
legal or court proceedings
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3.
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If a law
enforcement official requires us to do so.
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4.
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For Workers'
Compensation and similar benefit programs
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There are some
other situations like these but which don't happen
very often. They are described in the longer
version of the NPP.
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Your
rights regarding your health
information
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1.
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You can ask us to
communicate with you about your health and related
issues in a particular way or at a certain place,
that is more private for you. For example, you can
ask us to call you at home, and not at work to
schedule or cancel an appointment. We will try our
best to do as your ask.
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2.
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You have the right
to ask us to limit what we tell people involved in
your care or the payment for your care, such as
family members and friends. Upon signing a Release
of Information Form, we will keep our agreement
except if it is against the law, or in an
emergency, or when the information is necessary to
treat you.
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3.
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You have the right
to look at the health information we have about you
such as your medical and billing records. You can
even get a copy of these records but we may charge
you. Contact our Privacy Officer to arrange a way
to see your records. See below.
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4.
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If you believe the
information in your records is incorrect or missing
important information, you can ask us to make some
kinds of changes (called amendments) to your health
information. You have to make this request in
writing and send it to our Privacy Officer.
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5.
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You have a right
to a copy of this notice. If we change this NPP we
will post the new version in our waiting area and
you can always get a copy of the NPP from the
Privacy Officer.
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6.
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You have the right
to file a complaint if you believe your privacy
rights have been violated. You can file a complaint
with our Privacy Officer, and with the Secretary of
the Department of Health and Human Services. All
complaints must be in writing. Filing a complaint
will not change the health care we provide to you
in any way.
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If you have any
questions regarding this notice or our health
information privacy policies, please contact our
Privacy Officer who is Dr. Joan McGillicuddy, and
who can be reached by telephone at 520-836-1029, or
by e-mail at
jmcgillicuddy@helpingassociates.com.
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The
effective date of this notice is April 14,
2003.
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