660 COOPER RD. SUITE 300 WESTERVILLE, OH 43081

(614)389-3536

HIPAA                         Notice of Privacy Practices

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

Uses and Disclosures
Treatment. Your health information may be used by staff members or dis­closed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For exam­ple, results of laboratory tests and procedures will be available in your medi­cal record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment.Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For exam­ple, your health plan may request and receive information on dates of ser­vice, the services provided, and the medical condition being treated.
Health care operations.Your health information may be used as necessary to support the day-to-day activities and management of the practice.  For example, information on the services you received may be used to sup­port budgeting and financial reporting, and activities to evaluate and pro­mote quality.
Law enforcement.Your health information may be disclosed to law enforce­ment agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.
Public health reporting.Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
Other uses and disclosures require your authorization. Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a writ­ten revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.

Additional Uses of Information
Appointment reminders. Your health information will be used by our staff to call or send you appointment reminders.
Test results: We may contact you by phone or mail regarding test results and other health information.
Information about treatments. Your health information may be used to send you information that you may find interesting on the treatment and management of your medical condition.. We may also send you infor­mation describing other health-related products and services that we believe may interest you.

Individual Rights
You have certain rights under the federal privacy standards. These include:
the right to request restrictions on the use and disclosure of your protected health information
the right to receive confidential communications concerning your medical condition and treatment
the right to inspect and copy your protected health information
the right to amend or submit corrections to your protected health information
the right to receive an accounting of how and to whom your protected health information has been disclosed
the right to receive a printed copy of this notice
Our Responsibilities
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.
We also are required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all pro­tected health information we maintain.
Requests to Inspect Protected Health Information
You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing.