This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

 

We will use and communicate your health information only for the purposes of providing treatment, obtaining payment and we may use it while conducting clinical and clerical training or for ongoing care. Your health history will not be used for other purposes unless we have asked for and been voluntarily given your written permission.

 

To provide Treatment: We will use your health history within our office to provide you with the best chiropractic care possible. This may include administrative and clinical office procedures designed to optimize scheduling and the coordination of care when referral outside of the office is necessary. This will be extended to family, friends or other caregivers important in providing your care.

 

To Obtain Payment: We may include your health information with an invoice used to collect payment for services rendered to you. We may do this with insurance forms filed for you in the mail or sent electronically. It is possible that health history information will be disclosed during insurance company or governmental agency audits. We will be certain to only work with companies with a similar commitment to the security of your health information.

 

To Conduct Clinical and Clerical Training Sessions: Some of our best teaching opportunities use clinical and clerical situations experienced by patients receiving care at our office.

 

Ongoing Care: Because we believe regular care is very important to your general health, we will remind you of scheduled appointments and the need for follow-up care. These communications may be in the form of general mail, postcards, phone calls, fax transmissions or e-mail.

 

Required Reporting:  We are required to release health history information and cooperate with legal authorities with respect to Abuse and Neglect, Public Health, National Security, Law Enforcement Agencies, Coroners, Funeral Directors and Medical Examiners.

 

 

Patient Rights

 

The law is careful to describe that you have the following rights related to your health information.

 

Restrictions: You have the right to request restrictions on certain uses and disclosures of your health history. You have the right to request that we communicate with you in specific media. Our office will make every effort to honor reasonable restriction preference from our practice members.

 

Inspect, Amend and Copy Your Health Information: You have the right to inspect, amend and copy your health information. Please place your request in writing and be aware that to amend your record you must describe the reason for the proposed amendment. Your request to amend may be denied if the portion you of the record in question are accurate or was not created by this office. We may need to charge you a fee to compile copy or amend your record.

 

Documentation of Health History Use:  As of April 14, 2003 we began to track the use of your health history. This record indicates any activity beyond the uses stated in this notice. You may, in writing request a use review of that document. Such record will be maintained for up to six years.

 

Thank you very much for taking the time to review how carefully we are using your health information. If you have any questions we want to hear from you. As stated above for your protection, we ask that you communicate these requests in writing. Again, thank you for your confidence and friendship.