Summary of Notice of Privacy Practices
The Notice of Privacy Practices contains a detailed description of how our office will protect your health information, your rights as a patient, and our common practices in dealing with patient health information. The following material is a summary of that notice and is provided to asset you in understanding it’s contents. Please note that a complete copy is available at the reception deck.
Uses and Disclosures of Health Information.
We will use and disclose your health information in order to treat you or to assist other health care providers in treating you. We will also use and disclose our health information in order to obtain payment for our services or to allow insurance companies to process insurance claims for services rendered to your by us or other health care providers. Finally, we may disclose your health information for certain limited operation activities such as quality assessment, licensing, accreditation, and training of students.
Uses and Disclosures Based on Your Authorization.
With the exception of the following circumstances, we may not use or disclose your health information without your written authorization:
- For purposes of public health and safety
- For certain limited research purposes
- For government authorities to prevent child abuse or domestic violence
- For government agencies for purposes of their audits, investigations, and other oversight activities
- For law enforcement authorities to protect public safety or to assist in apprehending criminal offenders
- For the FDA to report product defects or incidents
- When required by court orders, search warrants, subpoenas, and as otherwise required by law
As a patient, you have the following rights:
- To have access to your health information
- To request restrictions as to how your health information is used or disclosed
- To receive notice of our privacy practices
Acknowledgement of Notice of Privacy Practices
I acknowledge that I have received Advanced Foot and Ankle Centers’ Notice of Privacy Practices. I have had full opportunity to read and considered the contents of the Notice of Privacy Practices.