Notice of Privacy Practices (HIPAA)

 

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.

I can share the details of your protected health information for treatment and payment. This means that I can discuss the information about you and discuss it with your other healthcare providers. I can share the information with any specialists you may be referred to, or your health insurance company.

When it comes to your health information, you have certain rights.

  • Get an electronic or paper copy of your medical record

  • Ask us to correct your medical record

  • Request confidential communications

  • Ask us to limit what we use or share

  • Get a list of those with whom we’ve shared information

  • Get a copy of this privacy notice

  • Choose someone to act for you

  • File a complaint if you feel your rights are violated

Our Responsibilities:

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

I am the Privacy Officer for this one person company. If you believe your privacy rights have been violated, you can contact me, Melissa Mancini at (408)883-5478. I will work with you to try to resolve the situation. I will not retaliate against you for filing a complaint, if you choose to do so. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rightsby 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/