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.

If you have any questions about this notice, please contact us.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION

Described as follows are the ways we may use and disclose health information
that identifies you ("Health Information"). Except for the following
purposes, we will use and disclose Health information only with your written
permission. You may revoke such permission at any time by writing to our
practice's privacy officer.

Treatment. We may use and disclose Health Information for your treatment and
to provide you with treatment-related health care services. For example, we
may disclose Health Information to doctors, nurses, technicians, or other
personnel, including people outside our office, who are involved in your
medical care and need the information to provide you with medical care.

Payment: We may use and disclose Health Information so that we or others
may bill and receive payment from you, an insurance company, or a third party
for the treatment and services you received. For example, we may give your
health pIau information so that they will pay for your treatment.

Health Care Operations: We may use and disclose Health Information for
health care operation purposes. These uses and disclosures are necessary to
make sure that all of our patients receive quality care and to operate aud
manage our office. For example, we may use and disclose information to a
surgeon, anesthesiologist or medical facility such as a surgery center. We may
also share information with other entities that have a relationship with you (for
example, your health plan) for their health care operation activities.

YOUR RIGHTS

As Required by Law. We will disclose Health Information when required to do
so by international, federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use and disclose
Health Information when necessary to prevent a serious threat to your health
and safety or the health aud safety of the public or another person. Disclosures,
However, will be made only to someone who may be able to help prevent the
threat.

Business Associates. We may disclose Health Information to our business
associates that perform functions on our behalf or provide us with services if
the information is necessary for such functions or services. For example, we
may use another company to perform billing services on our behalf. All of our
business associates are obligated to protect the privacy of your information and
are not allowed to use or disclose any information other than as specified in our
contract.

Organ and Tissue Donation. If you are an organ donor, we may use or release
Health Information to organizations that handle organ procurement or other
entities engaged in procurement; banking or transportation of organs, eyes, or
tissues to facilitate organ, eye, or tissue donation; and transplantation.

Military and Veterans. If you are a member of the armed forces, we may
release Health Information as required by military command authorities. We
also may release Health Information to the appropriate foreign military
authority if you are a member of a foreign military.

 

 

Appointment Reminders, Treatment Alternatives, and Health-Related
Benefits and services.
We may use and disclose Health Information to contact
you and remind you that you have an appointment with us. We also may use
and disclose Health Information to tell you about treatment alternatives or
health-related benefits and services that may be of interest to you. Unless you
notify us you would like to decline such information.

Individuals Involved in Your Care or Payment for Your Care. When
appropriate, we may share Health Information with a person who is involved in
your medical care or payment for your care, such as your family or a close
friend. We also may notify your family about your location or general condition
or disclose such information to an entity assisting in a disaster reilief effort.

Research. Under certain circumstances, we may use and disclose Health
Information for research. For example, research may involve collecting data for
the Centers of Disease Control and other national quality organizations.

Workers' Compensation. We may release Health Information for workers'
compensation or similar programs. These programs provide benefits for work-
related injuries or illness.

Public Health Risks. We may disclose Health Information for public health
activities. These activities generally include disclosures to prevent or control
disease, injury, or disability; report births and deaths; report child abuse or
neglect; report reactions to medications or problems with products; notify
people of recalls of products they may be using; inform a person who may have
been exposed to a disease or may be at risk for contracting or spreading a
disease or condition; and report to the appropriate government authority if we
believe a patient has been the victim of abuse, neglect, or domestic violence.
We will only make this disclosure if you agree or when required or authorized
bylaw.

Health Oversight Activities. We may disclose Health Information to a health
oversight agency for activities authorized by law. These oversight activities
include, for example, audits, investigations, inspections, and licensure. These
activities are necessary for the government to monitor the health care system,
government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may
disclose Health Information in response to a court or administrative order. We
also may disclose Health Information in response to a subpoena, discovery
request, or other lawful process by someone else involved in the dispute, but
only if efforts have been made to tell you about the request or to obtain an order
protecting the information requested.

YOUR RIGHTS

You have the following rights regarding Health Information we have about
you:

Right to Inspect and Copy. You have a right to inspect and copy Health
Information that may be used to make decisions about your care or payment for
your care. This includes medical and billing records, other than psychotherapy
notes. To inspect and copy this Health Information, you must make your
request, in writing, to your physician.

Right to Amend. If you feel that Health Information we have is incorrect or
incomplete, you may ask us to amend the information. You have the right to
request an amendment for as long as the information is kept by or for our
office. To request an amendment, you must make your request, in writing, to
your physician.

Right to an Accounting of Disclosures. You have the right to request a list of
certain disclosures we made of Health Information for purposes other than
treatment, payment and health care operations or for which you provide written
authorization. To request an accounting of disclosures, you must make your
request, in writing to our administrator.

Right to Request Restrictions. You have the right to request a restriction or
limitation on the Health Information we use or disclose for treatment, payment,
or health care operations. You also have the right to request a limit on the
Health Information we disclose to someone involved in your care or the
payment for your care, like a family member or friend. For example, you could
ask that we not share information about a particular diagnosis or treatment with
your spouse. To request a restriction, you must make your request, in writing,
to your physician or our administrator. We are not required to agree to your
request.
If we agree, we will comply with your request unless the information
is needed to provide you with emergency treatment.

 

Right to Request Confidential Communication. You have the right to request
that we communicate with you about medical matters in a certain way or a
certain location. For example, you can ask that we contact you only by mail or
at work. To request confidential communication, you must make your request
in writing to your physician or our administrator. Your request must specify
how or where you which to be contacted. We will accommodate reasonable
requests.

Right to a Paper Copy of This Notice. You have the right to a paper copy of
this notice. You may ask us to give you a copy of this notice at any time. Even
if you have to agreed to receive this notice electronically, you are still entitled
to a paper copy of this notice. To obtain a paper copy of this notice contact
your physician or our administrator.

Changes To This Notice

We reserve the right to change this notice and make the new notice apply to
Health Information we already have as well as any information we receive in
the future. We will post a copy of our current notice at our office. The notice
will contain the effective date on the first page, in the lower right-hand comer.

Complaints

If you believe your privacy rights have been violated, you may file a complaint
with our office or with the Secretary of the Department of Health and Human
Services. To file a complaint with our office, contact our administrator. All
complaints must be made in writing. You will not be penalized for filing a
complaint.

 

 

 

NOTICE TO PATIENTS REGARDING THE DESTRUCTION OF HEALTH CARE RECORDS

Pursuant to the provisions of subsection 7 of NRS 629.05 I:

I .      The health care records of a person who is less than 23 years of age may not be destroyed; and

  1. The health care records of a person who has attained the age of 23 years may be destroyed for those records which have been retained for at least 5
    years or for any longer period provided by federal law; and
  2. Except as otherwise provided in section 7 of NRS 629.051 and unless a longer period of time is provided by federal law, the health care records of a
    patient who is 23 years of age or older may be destroyed after 5 years pursuant to subsection I of NRS 629.051.

 

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