» Patient's Rights Under HIPAA

Under HIPAA, individuals have the following rights:

• Right to inspect and copy PHI. This includes your medical and billing records, but does not include psychotherapy notes. To inspect and/or copy your medical record, you must submit your request in writing. If you request a copy of the information, we may charge a fee for the costs of copying and mailing your information. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by the practice will review your request and denial. The person conducting the review will not be the person who denied your request. The practice will comply with the outcome and recommendations from that review.
• Right to amend. If you feel that the medical information about you in your record is incorrect or incomplete, then you may ask us to amend the information. Your request must be submitted in writing, along with your amendment and a reason that supports your request to amend. The amendment must be dated and signed by you. The practice may deny your request for an amendment if it is not in writing or does not include a reason to support the request. Our request may also be denied if you ask for information to be amended that:
  • Is not part of the medical information kept by or for the practice.
  • Is not part of the information which you would be permitted to inspect and copy.
  • The information is accurate and complete.
  • The information was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
• The right to request restrictions on the use and disclosure of PHI. This right may not necessarily be granted.
• The right to an accounting of certain disclosures of PHI. This request must be submitted in writing and must state a time period. The time period cannot go back further than six years and may not include dates before April 14, 2003. You will be notified of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with you written permission, unless those uses can be reasonably inferred from the intended uses above. If you have provided us with your permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

The patient has the right to copy of this notice. You may ask for a copy of this notice at any time.

Changes to This Notice
The practice reserves the right to change this notice. The revised or changed notice will become effective immediately upon the completion of the revision. We will post a copy of the current notice in the office. The notice will contain the effective date. Each time you register at or are seen at the office for treatment, we will offer you a copy of the current notice.

Complaints
If you believe your privacy rights have been violated, you may file a complaint with the office or with the Secretary of the Department of Health and Human Services. To file a complaint with the office, contact the Privacy Office/Office Manager. All complaints must be submitted in writing. You will not be penalized for filing a complaint.