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SUMMARY OF OUR NOTICE OF PRIVACY
PRACTICES
Southeastern Orthopedics Sports Medicine and
Shoulder Center
Effective Date: April 14, 2003
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
CAN GET ACCESS TO THIS INFORMATION
Please review the full Notice of Privacy Practices (NPP) which is attached.
If you have any
questions about this notice, please contact Carol LaRegina, Office Manager at
(919) 256-1511.
OUR PLEDGE REGARDING HEALTH INFORMATION:
We understand that health information about you and your health care is
personal. We are
committed to protecting health information about you. We create a record of
the care and
services you receive from us. We need this record to provide you with quality
care and to
comply with certain legal requirements. This notice applies to all of the
records of your care
generated by this health care practice, whether made by your personal doctor
or others working in this office. This notice will tell you about the ways in
which we may use and disclose health information about you. We also describe
your rights to the health information we keep about you, and describe certain
obligations we have regarding the use and disclosure of your health
information.
We are required by law to:
· make sure that health information that identifies you is kept private;
· give you this notice of our legal duties and privacy practices with respect
to health
information about you; and
· follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.
The following categories describe different ways that we use and disclose
health information. By coming for care, you give us the right to use your
information for treatment, to get reimbursed for your care, and to operate
our organization.
There are also various other ways in which we may use or disclose your
information:
· Appointment Reminders
· To Allow Oversight of the Quality of the Healthcare We Provide
· To Allow Workers' Compensation Claims
· As Required by Subpoena in Lawsuits and Disputes
· Various Uses as Required by Law or to Avert a Serious Threat to Health or
Safety
The full details for all these uses are contained in the full NPP.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU.
You have the following rights regarding health information we maintain about
you:
· Right to Inspect and Copy
· Right to Amend
· Right to an Accounting of Disclosures
· Right to Request Restrictions
· Right to Request Confidential Communications
· Right to a Paper Copy of This Notice
Information on how to exercise these rights can be seen in the NPP or can be
obtained from Carol LaRegina, Office Manager at (919) 256-1511.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the
revised or changed notice effective for health information we already have
about you as well as any information we receive in the future. We will post a
copy of the current notice in our facility. The notice will contain on the
first page, in the top right-hand corner, the effective date. In addition,
each time you register for treatment or health care services, we will offer
you a copy of the current notice in effect.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a
complaint with us or with the Secretary of the Department of Health and Human
Services. To file a complaint with us, contact Carol LaRegina, Office
Manager. All complaints must be submitted in writing. You will not be
penalized for filing a complaint.
OTHER USES OF HEALTH INFORMATION.
Other uses and disclosures of health information not covered by this notice
or the laws that
apply to us will be made only with your written permission. If you provide us
permission to use or disclose health 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 health information about 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.
© 2001-2002
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