OF PRIVACY PRIACTICES FOR RICHARD C. ANGRIST, M.D.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION
PLEASE REVIEW IT CAREFULLY
WHO WILL FOLLOW THIS NOTICE:
This notice describes our office’s practice and that of
any health care professional authorized to enter information into
your office or surgical chart.
All departments of the office.
All employees, staff and other personnel.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health
is personal. We are committed to protecting medical information
about you. We create a record of the care and services you receive
in the office. We need this record to provide you with quality
care and to comply with certain legal requirements. This notice
applies to all of the records of your care generated by the
office, made by your doctor. Your primary doctor may have different
policies or notices regarding the use of and disclosure of your
medical information created in his or her office or clinic.
This notice will tell you about the ways in which we may use
and disclose medical information about you. We also describe
your rights and certain obligations we have regarding the use
and disclosure of medical information.
We are required by law to:
- Make sure that medical information that identifies you is kept
- Give you this notice of our legal duties and privacy practices
with respect to medical information about you.
- Follow the terms of the notice that is currently in effect.
HOW MAY WE USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
The following categories describe different ways that we use and
disclose medical information. For each category of uses or disclosure
we will explain what we mean and try to give some examples. Not
every use or disclosure in a category will be listed. However,
all of the ways we are permitted to use and disclose information
will fall within one of the categories.
FOR TREATMENT: We may use medical information about you to provide
you with medical treatment or services. We may disclose medical
information about you to doctors, nurses, technicians, or other
office and/or surgery center personnel who are involved in taking
care of you at the office and/or surgery center. For example,
a doctor treating you for a broken leg may need to know if you
have diabetes because diabetes may slow the healing process. Different
departments within the office and/or surgery center may share
medical information about you in order to coordinate the different
things you may need, such as prescription and lab work. We also
may disclose medical information about you to people outside the
office and/or surgery center who may be involved with your medical
care after you leave the office and/or surgery center, such as
family members, clergy, or others we to provide services that
are part of your care.
FOR PAYMENT: We may use and disclose medical information about
you so that the treatment and services you receive at the office
and/or surgery center may be billed to and payment may be collected
from you, an insurance company, or third party. For example, we
may need to give your health plan information about surgery you
received at the surgery center so your health plan will pay us
or reimburse us you for the surgery. We may also tell you your
health plan about a treatment you are going to receive to obtain
approval or determine whether you plan will cover the treatment.