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| Privacy Policy |
OUR COMMITMENT TO YOU
REGARDING MEDICAL INFORMATION
This practice is determined to protect the privacy of
your medical information. In order to provide you with
quality care and service, as well as comply with the
law, we must create a medical record for you and
document the care and services you receive at this
practice. Federal law requires us to ensure the
confidentiality of your medical record. This notice will
explain to you which circumstances require us to use or
disclose your medical information. We also describe your
rights, as well as our obligations, regarding the use
and disclosure of medical information.
WHAT THE LAW REQUIRES US
TO DO
I.
The Federal Law requires us to:
- Keep your medical information private.
- Give you this notice describing our legal duties,
privacy practices, and your rights regarding your
medical information.
- Follow the terms of the notice that is now in effect.
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II.
We have the right to:
- Change our privacy practices and the terms of this
notice at any time, provided that the law permits the
changes.
- Make the changes in our privacy practices and the new
terms of our notice effective for all medical
information that we keep, including information
previously created or received before the changes.
Notice of Change to Privacy Practices:
Before we make an important change in our privacy
practices, we will change this notice and make the new
notice available upon request.
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USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION
Following is a description of the different
circumstances that may require this practice to use or
disclose your medical information. For any of these
circumstances, you can submit a written request
restricting our use or disclosure of your medical
information for treatment, payment, or healthcare
operations. You may also request (in writing) that we
only disclose your medical information to certain
individuals responsible for your care or the payment of
your care. Legally we are not required to agree to your
request. If we do not agree to honor the written
request, then we must abide by our agreement unless in
those situations by law, in emergencies, or when
information is necessary to treat you. If you wish to
revoke any previously written request, you may do so in
writing.
FOR TREATMENT:
We may use your health information to provide you with
medical treatment or services, such as sharing medical
data with another provider, making referrals, and
placing lab and prescription orders. We may disclose
your health information to those people who are
responsible for your care, for instance, your doctors,
nurses, technicians, medical students, or any other
people who are taking care of you. We may also share
medical information about you to other health care
providers to assist them in treating you.
FOR PAYMENT:
We may use and disclose your health information for
payment purposes. For instance, we may need to give your
health insurance plan information about a treatment you
received at our practice when filing a claim, so that
your health plan may either pay us or reimburse you for
your payment. We may also tell your health plan about a
treatment you are going to receive to get approval or
determine if your plan will pay for the treatment.
FOR HEALTH CARE OPERATIONS:
We may use and disclose your health information for our
healthcare operations. This includes quality assurance,
employee performance evaluations, conducting training
programs, and getting the accreditation, licensure, and
credentialing.
ADDITIONAL USES AND DISCLOSURES:
In addition to using and disclosing your medical
information for treatment, payment, and health care
operations, we may use and disclose medical information
for the following purposes:
- Medical information to notify or help
notify:
- a family member
- your personal representative
- another person responsible for your care
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We will share information about your location, general
condition, or death. If you are present, we will get
your permission if possible before we share, or give you
the opportunity to refuse permission. In case of
emergency, and if you are not able to refuse permission,
we will share only the health information that is
directly necessary for your health care, according to
our professional judgment. We will also use our
professional judgment to make decisions in your best
interest about allowing someone to pick up medicine
medical supplies, x-ray or medical information about
you.
- Disaster Relief:
We may share medical information with a public or
private organization or person who can legally assist in
disaster relief efforts. - Fund Raising:
We may provide medical information to one of our
affiliated fundraising foundations to contact you for
fund raising purposes. We will limit our use and sharing
to information that describes you in general, not
personal, terms and the dates of your health care. In
any fundraising materials, we will provide you a
description of how you may choose not to receive future
fundraising communications. - Research and limited
circumstances:
Medical information for research purposes in limited
circumstances where the research has been approved by a
review board that has reviewed the research proposal and
established protocols to ensure the privacy of medical
information.
- Funeral Director, Coroner, Medical Examiner
To help them carry out their duties, we may share the
medical information of a person who has died with a
coroner, medical examiner, funeral director, or an organ
procurement organization.
- Specialized Military Personnel Functions:
Your medical information may be disclosed if you are
military personnel, either active status or a veteran,
and if required by the appropriate authorities. - Public Health Activities:
Your medical information may be disclosed if required to
do so by a public health or law enforcement official
whose job is to prevent or control disease, injury or
disability. Your medical information may also be
disclosed to a person from the Food and Drug
Administration for the purposes of reporting adverse
effects stemming from products defects or problems, to
enable product recalls, repairs or replacements, or to
conduct activities required by the Food and Drug
Administration. - Personal Health and Safety:
Your medical information may be disclosed when necessary
to prevent a serious threat to your health and safety of
another individual or the public. The information will
be disclosed only to a person or organization able to
prevent the threat. - Workers Compensation
Your medical information may be disclosed when necessary
to comply with the laws for the Workers Compensation
Program. - Public Health Oversight Activities:
Your medical information may be disclosed to public
health authorities and health oversight agencies that
are authorized by law to gather health information (e.g.
audits, licensure, disciplinary actions, administrative
and criminal investigations, etc.) - Law Enforcement:
Your health information may be disclosed in response to
a court or administrative order in a lawsuit or similar
proceeding.
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YOUR INDIVIDUAL RIGHTS
I. You have the right to:
- Look at or get copies of
your medical records on file.
- You have the right to receive a copy of the Privacy
Notice. To receive a copy, please notify the
receptionist.
- Receive a list of all the
times we or our business
associates shared your medical
information for purposes other
than treatment, payment, and
health care operations and other
specified exceptions.
- Request that
we place additional restrictions on our use or
disclosure of your medical information.
We are not required to agree to these restrictions, but
if we do, we will abide by our agreement (except in the
case of an emergency).
- Request that we communicate with you about your medical
information by different means or a different location
must be made in writing to the contact person listed at
the end of this notice.
- Ask to change your health information if you think it is
incomplete or inaccurate. The request must be made in
writing to the contact person listed at the end of this
notice. If, however, the physician or audiologist finds
that the patient’s health information is complete and
accurate, he/she can refuse to make the requested
changes.
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If you have received this notice electronically, and
wish to receive a paper copy, you have the right to
obtain a paper copy by making a request in writing to
the contact person listed at the end of this notice.
QUESTIONS AND COMPLAINTS
If you have any questions about this notice please
contact:
Gene K. Erickson
Desert Hearing Care
4448 E. Main Street, Suite #6
Mesa, AZ 85205
(480) 985-2544
If you think that we may have violated your privacy
rights, contact the person named above. You may also
submit a written complaint to the U.S. Department of
Health and Human Services. We will provide you with the
address to file your complaint with the U.S. Department
of Health and Human Services. We will not retaliate in
any way if you choose to file a complaint.
The Privacy Rule portion of the HIPAA regulations
requires our practice to submit a copy of the Privacy
Notice to each patient, both existing and new. If the
patient refuses to sign the notice, this practice is not
obligated to treat the patient.
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Dramatic Hearing
Results - No Regrets!
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Hearing Aids Mesa, Hearing Aids Phoenix, Hearing Aids Scottsdale, Hearing Aids Tempe Hearing Aids Chandler, Hearing Aids Gilbert– Desert Hearing Care
Call (480) 985-2544 now for an appointment or
CLICK HERE to schedule an
appointment online.
(click on location name for directions)
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MESA OFFICE
4448 East Main St.
East of Fry's Marketplace |
SUN LAKES OFFICE
9670 E. Riggs Rd.
Dobson & Riggs |
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Hearing Aids Mesa, Hearing Aids Phoenix, Hearing Aids Scottsdale, Hearing Aids Tempe Hearing Aids Chandler, Hearing Aids Gilbert– Desert Hearing Care
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