HIPAA Statement:
Your Rights
1. You have the
right to request restrictions on our uses and
disclosures of protected health information for
treatment, payment and health care operations. However,
we are not required to agree to your request.
2. You have the right to reasonably
request to receive communications of protected health
information by alternative means or at alternative
locations.
3. Subject to payment of a reasonable
copying charge as provided by state law, you have the
right to inspect or obtain a copy of the protected
health information contained in your medical and billing
records and in any other practice records used by us to
make decisions about you, except for:
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psychotherapy notes, which are notes
recorded by a mental health professional documenting
or analyzing the contents of a conversation during a
private counseling session or a group, joint or
family counseling session and that have been
separated from the rest of your medical record
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information compiled in reasonable
anticipation of, or for use in, a civil, criminal,
or administrative action proceeding
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protected health information
involving laboratory tests when your access is
required by law
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if you are a prison inmate and
obtaining such information would jeopardize your
health, safety, security, custody, or rehabilitation
or that of other inmates, or the safety of any
officer, employee, or other person at the
correctional institution or person responsible for
transporting you
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if we obtained or created protected
health information as part of a research study for
as long as the research is in progress, provided
that you agreed to the temporary denial of access
when consenting to participate in the research
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your protected health information is
contained in records kept by a federal agency or
contractor when your access is required by law
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if the protected health information
was obtained from someone other than us under a
promise of confidentiality and the access requested
would reasonably likely to reveal the source of the
information
We may also deny a request for
access to protected health information if:
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a licensed health care professional
has determined, in the exercise of professional
judgment, that the access requested is reasonably
likely to endanger your life or physical safety or
that of another person
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the protected health information
makes reference to another person (unless such other
person is a health care provider) and a licensed
health care professional has determined, in the
exercise of professional judgment, that the access
requested is reasonably likely to cause substantial
harm to such other person
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the request for access is made by the
individual's personal representative and a licensed
health care professional has determined, in the
exercise of professional judgment, that the
provision of access to such a personal
representative is reasonably likely to cause
substantial harm to you or another person
If we deny a request
for access for any of the three reasons described above,
then you have the right to have our denial reviewed in
accordance with the requirements of applicable law.
4. You have the right to request a
correction to your protected health information, but we
may deny your request for correction, if we determine
that the protected health information or record that is
the subject of the request:
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was not created by us, unless you
provide a reasonable basis to believe that the
originator of protected health information is no
longer available to act on the requested amendment
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is not part of your medical or
billing record
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is not available for inspection as
set forth above
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is accurate and complete
In
any event, any agreed upon correction will be included
as an addition to, and not a replacement of, already
existing records.
5. You have the right to receive an
accounting of disclosures of protected health
information made by us to individuals or entities other
than to you for the period provided by law, except for
disclosures:
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to carryout treatment, payment and
health care operations as provided above
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to persons involved in your care or
for other notification purposes as provided by law
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for national security or intelligence
purposes as provided by law
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to correctional institutions or law
enforcement officials as provided by law
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that occurred prior to April 14, 2003
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that are otherwise not required by
law to be included in the accounting
6. You have the right to request and
receive a paper copy of this notice from us.
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