Signed in as:
filler@godaddy.com
Signed in as:
filler@godaddy.com
When we provide medical care to you, we may collect the following personal information about you:
This information may constitute Protected Health Information ("PHI") under HIPAA and the California Confidentiality of Medical Information Act (“CMIA”).
We will use your health information for the following purposes:
Patients have the right to inspect and obtain a copy of their health and billing records that are used to make decisions about their care. We will provide a copy in the form and format that is requested, if readily producible. We may charge a reasonable, cost-based fee as permitted by HIPAA and applicable state law. We will provide a copy or summary within thirty (30) days.
If the patient believes that information we have about them is incorrect or incomplete, the patient may request that we amend it. This request must be in writing and must explain why the information should be amended. We may deny the request under limited circumstances permitted by law.
Patients have the right to request an accounting of certain disclosures of PHI we made for purposes other than treatment, payment, or health care operations, or that were not made pursuant to written authorization. The request must state a time period of up to six (6) years prior to the date of the request. We will provide one (1) accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within twelve (12) months.
Patients have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment, or healthcare operations, or to a person who is involved in a patient’s care or the payment for that care. If you pay for a service out-of-pocket in full, you can ask us not to share that information with your health insurer. We will say “yes” unless a law requires us to share that information.
Patients have the right to request that we communicate with them about health matters in a specific way or at a specific location- for example, only by mail at a particular address. We will say “yes” to reasonable requests submitted in writing.
Patients have the right to a paper copy of this Notice at any time, even if they have agreed to receive it electronically. Patients may also request an electronic copy.
Patients have the right to be notified if there is a breach of unsecured PHI, in compliance with the HIPAA breach-notification rules.
If you believe privacy rights have been violated, you may file a complaint with the Company by contacting the Privacy Officer at the email address below. You may also file a complaint with the Department of Health and Human Services. You will not be retaliated against or penalized for filing a complaint.
DHHS, Office of Civil Rights
200 Independence Avenue SW
Washington, DC 2020
877-696-6775
https://www.hhs.gov/ocr/ (for online filing)
These technologies on our website and mobile applications allow us to track your browsing behavior, such as links clicked, pages viewed, and items purchased. These technologies also automatically collect date to measure website performance and improve our systems, including metadata, log files, page load time, server response time, network routing, and server configurations. You have the option to opt out of these technologies by not accepting cookies.
We may revise the Privacy Policy from time to time. The changes will apply to all information we already have about you as well as any information we receive in the future. The current Privacy Policy will be posted on our website and/or our office and will include the effective date. You may also request a current copy by contacting us.
If you have questions about our Privacy Policy, wish to exercise any of the rights described above, or want to file a privacy complaint, you may contact our Privacy Officer. We will respond to all requests and inquiries within thirty (30) days.
Susan Taylor, Esq.
562-755-9734