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HIPPA & Privacy



We understand the importance of your privacy. This notice describes how medical information about your minor child, or you as a patient, may be used and disclosed and how you can obtain access to this informaiton. We keep our patient's financial and health information private as required by law, by ethical standards, and our own polices. We obtain and use several types of financial information to carry out health insurance and billing activities. This includes information you give us on patient information forms or other forms, such as your name, address, employer, age and dependents: payment history, and information we may obtain from a consumer-reporting group pertinent with only with regard to your account with our medical practice.


We use physical, technical and procedural methods to protect your private information and share it only with our employees, affiliates, or others who need it to provide services to you, for insurance purposes, or for other legally allowed or required purposes. We may need to change the terms of this notice in the future and reserve the right to do so necessary to protect your privacy. 




For Payment


We use and disclose information about you to manage your account or benefits and to facilitate insurance payments for your claims for services. We may also give information to a doctor's office to confirm your benefits or we may ask a hosptial for details about your treatment for claims benefits, to review care and services you receive, to provide coordination of care management, or to coordinate services/


As allowed or required by law


Information about you may be shared for administrative or other legal proceedings; to public health authorities, or to law enforcement officers such as to comply with a court order or subpoena.




We will obtain your written permission before we use or share your protected health information for any other purpose unless otherwise allowed or required by law. You may withdraw permission at any time in writing. We will then stop using your information for that purpose. However, if we have already used your information based on your authorization, you cannot take back your agreement for those past situations.

Your Rights


Under privacy regulations effective April 14, 2003, you have the right to:


  • See or get a copy of the information that we have about you, or correct your personal information that you believe is mission or incorrect.

  • Ask us to communicate with you about health matters using reasonable alternative means or at a different address.

  • Receive a list of disclosures of your health information that we make on or after April 14, 2003, except when:

          a. You have authorized the disclosure;                 

          b. The disclosure is make for treatment, payment of benefits or                  health care operations. 

          c. The law otherwise restricts the accounting.



If you believe we have not protected your privacy, you can file a complaint with us. We will not take action against you for filing a complaint.

Copies & Changes


You have the right to receive another copy of this notice at any time.We reserve the right to change this notice. A revised notice will apply to information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever privacy notice is currently in effect.


Contact Information


If you want to exercise your rights under this notice or if you wish to talk with us about privacy issues or to file a complaint contact our Practice Manager.

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