Your Rights Regarding Your Medical Information. You have several rights with regard to your health information. If you wish to exercise any of these rights, please contact our Medical Records Department in our office. Specifically, you have the following rights: • Right to Request Restrictions - You have the right to ask that we limit how we use or disclose your medical information. We require that any requests for use or disclosure of medical information be made in writing. Written notice must be sent to the attention of the Office Manager at the practice and address indicated in the header of this Notice. We will consider your request, but in some cases, we are not legally required to agree to these requests. However, if we do agree to them, we will abide by these restrictions. We will always notify you of our decisions regarding restriction requests in writing. We will not ask you the reason for your request. For example, for services you request no insurance claim be filed and for which you pay privately, you have the right to restrict disclosures for these services for which you paid out of pocket. You have the right to ask that we send you information at an alternative address or by alternative means. Your request must specify how or where you wish to be contacted. You have the right to opt out of communications for fundraising purposes.
Your Rights Regarding Your Medical Information. You have the following rights regarding the protected health information we maintain about you.
A. The Right to Request Restrictions – You have the right to request restrictions on uses and disclosures of your protected health information for treatment, payment and health care operations. We are not required to agree to your request unless you request restriction on disclosures to a health plan for purposes of payment or healthcare operations, and the protected health information relates to an item or service for which you, or another person on your behalf, have assumed full financial responsibility. If we do agree to your request for restrictions, we are bound by the restrictions, except in limited circumstances, such as if there is an emergency. In
B. The Right to Request to Receive Confidential Communication – We will accommodate reasonable requests to communicate protected health information to you at a certain location or in a certain way. For example, you may ask us to contact you at work, or at a location other than your home address. If possible, please make alternative location requests at your first contact or at the time of registration. However, you may make such requests anytime thereafter. Requests for alternative means of communication made after the first contact or registration must be made in writing to our Privacy Officers at the address listed above.
Your Rights Regarding Your Medical Information. You have the following rights regarding the protected health information we maintain about you.
