PRIVACY

NOTICE OF PRIVACY PRACTICES

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 Health Insurance Portability and Accountability Act of 1996 (called "HIPAA") is the law requiring health care providers to make sure your personal medical information is kept private. I am also required to give you this notice, so that if I have any of your personal information, you will know how I may use it, or whether and how I may give your information to anyone else.

I have the right to use and give out your personal medical information to bill for the cost of your health care.I may also use your personal medical information when I need this information to make sure that you get quality health care, to provide customer services to you, or to resolve any complaints you may have.I may use or give out your personal medical information, but only for these reasons:

  • If state and federal agencies that have the legal right to see your medical information ask for it.
  • If the information is needed for public health activities (such as reporting outbreaks of serious diseases)
  • If a court or another agency orders me to release the information
  • If the information is needed by law enforcement (such as when the information is needed to help locate a missing person)
  • For research studies that meet all privacy law requirements (such as research related to the prevention of disease or disability)
  • If the information will help to avoid a serious and immediate threat to health or safety

Federal law says that I must use and give out your personal medical information:

  • If you or someone who has the legal right to act for you asks for the information
  • If the federal government asks for it
  • If some other law requires that your medical information be disclosed.

The law requires me to get your permission, in writing, before I can use or give out your personal medical information for any purpose that is not listed in this notice. You may take back your written permission at any time. However, taking back your permission will not affect disclosures I have already made based on your earlier permission to use or give out your information.

By law, you have the right to:

  • See and get a copy of your personal medical information.
  • Have your personal medical information changed if you believe that it is wrong or if information is missing, and if I agree. If I disagree, you may have a statement of your disagreement added to your personal medical information.
  • Get a list of those with whom I have shared your personal medical information. (The list will not cover your personal health information that was given to you or your personal representative, information that was given out to pay for your health care, or for operations, or information that was given out for law enforcement purposes.)
  • Ask me to communicate with you in a particular method or location. (For example, by sending information to a person's P.O. Box instead of their home address).
  • Ask me to limit how your personal medical information is used and given out. Please note that I may not be able to agree to your request.

If you have questions or would like more information about this Notice, please ask me.

You have the right to file a complaint if you believe that I have given out or used your personal medical information improperly. You may file a complaint with the Secretary of the U.S. Department of Health and Human Services within 180 days of your discovery of the incident causing your complaint.

Serving the Bay Area including: Oakland, Berkeley, Albany, El Cerrito, Walnut Creek, Lafayette, Orinda, Alameda, San Leandro, San Francisco, Alameda Co., Contra Costa Co., Marin Co.