Privacy practices

Acknowledgement of Notice of Health Information Practices

We have made available to you our Notice of Health Information Practices. PLEASE REVIEW THIS NOTICE CAREFULLY! You may have a personal copy of the Notice, or you may access the Notice under Forms.

The Notice explains when we might use/disclose your health information, and includes some of the following examples:

when you give us permission to disclose your health information• to aid in your treatment or to persons involved in your health care or the payment for such • to help us or other health care providers get paid for services provided to you
to improve our health care operations
to public health agencies, governmental agencies, or other entities or persons when required or authorized by law or when required or permitted to do so by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The Notice also explains some of your rights under HIPAA, including but not limited to your:

right to ask that information about you not be disclosed to certain persons
right to restrict disclosures of PHI to your health plan when you pay out of pocket in full for a healthcare item or procedure
right to ask that we communicate differently with you to ensure your privacy • right to look at and get a copy of most of your health information in our records
right to request that we correct health information in your record that is wrong or misleading
right to be notified when a breach of your health information has occurred
right to have us tell you to whom we have disclosed your health information
right to make a complaint with our Privacy Officer or the Secretary of the U.S. Department of Health and Human Services.