Privacy Notice
PRIVACY- The information contained in your medical records will be kept strictly private except as noted in this information sheet.
TREATMENT- Information will be disclosed, as needed, to other health care providers who have a legitimate need for such information in the care of you as their patient. This may include other doctors, nurses, technicians, pharmacists, and other related health care providers who are caring for you.
PAYMENT- Information will be disclosed, as needed, for the purposes of determining insurance coverage, eligibility, billing, claims management, funding and reimbursement. This may include your insurance company, third party payor, insurance administrator, health plan or any other duly authorized representative involved in your claim.
REQUIRED BY LAW- Information will be disclosed, as needed, when responding to a court order or subpoena. Information will also be disclosed to government agencies as requred by law concerning victims of abuse, neglect, or domestic violence. Information will also be disclosed as required by law for workman's compensation claims. Information will only be released as legally required by law, and may include other government agencies.
RIGHT TO INSPECT AND COPY- Except as prohibited by law, you have the right to inspect and obtain copies of your records. There will be a charge associated the making copies to cover our time and costs.
QUESTIONS?- Please address any questions regarding this notce directly to the doctor.
TREATMENT- Information will be disclosed, as needed, to other health care providers who have a legitimate need for such information in the care of you as their patient. This may include other doctors, nurses, technicians, pharmacists, and other related health care providers who are caring for you.
PAYMENT- Information will be disclosed, as needed, for the purposes of determining insurance coverage, eligibility, billing, claims management, funding and reimbursement. This may include your insurance company, third party payor, insurance administrator, health plan or any other duly authorized representative involved in your claim.
REQUIRED BY LAW- Information will be disclosed, as needed, when responding to a court order or subpoena. Information will also be disclosed to government agencies as requred by law concerning victims of abuse, neglect, or domestic violence. Information will also be disclosed as required by law for workman's compensation claims. Information will only be released as legally required by law, and may include other government agencies.
RIGHT TO INSPECT AND COPY- Except as prohibited by law, you have the right to inspect and obtain copies of your records. There will be a charge associated the making copies to cover our time and costs.
QUESTIONS?- Please address any questions regarding this notce directly to the doctor.
