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Notice of Privacy Practice
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As Required by the Privacy
Regulations Created as a Result of the Health
Insurance Portability and Accountability Act of 1996
(HIPAA)
This notice describes how
health information about you (as a patient of this
practice) may be used and disclosed, and how you can
get access to your individually identifiable health
information. Please review this notice carefully.
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Our commitment to your
privacy
Our practice is dedicated to maintaining the
privacy of your individually identifiable health
information (IIHI). In conducting our business,
we will create records regarding you and the
treatment and services we provide to you. We are
required by law to maintain the confidentiality
of health information that identifies you. We
also are required by law to provide you with
this notice of our legal duties and the privacy
practices that we maintain in our practice
concerning your IIHI. By federal and state law,
we must follow the terms of the notice of
privacy practices that we have in effect at the
time.
We realize that these laws are complicated, but
we must provide you with the following important
information:
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How we may use and disclose your IIHI
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Your privacy rights in your IIHI
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Our obligations concerning the use and
disclosure of your IIHI
The terms of this notice
apply to all records containing your IIHI that
are created or retained by our practice. We
reserve the right to revise or amend this Notice
of Privacy Practices. Any revision or amendment
to this notice will be effective for all of your
records that our practice has created or
maintained in the past, and for any of your
records that we may create or maintain in the
future. Our practice will post a copy of our
current Notice in our offices in a visible
location at all times, and you may request a
copy of our most current Notice at any time.
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If you have questions
about this notice, please contact:
Privacy Officer,
The Reed Center 45 East 85th Street, NYC, 10028
1-212-772-8300
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We may use and disclose
your individually identifiable health.
information (IIHI) in the following ways
The
following categories describe the different ways
in which we may use and disclose your IIHI.
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Treatment.
Our practice may use your IIHI to treat you.
For example, we may ask you to have
laboratory tests (such as blood or urine
tests), and we may use the results to help
us reach a diagnosis. We might use your IIHI
in order to write a prescription for you, or
we might disclose your IIHI to a pharmacy
when we order a prescription for you. Many
of the people who work for our practice -
including, but not limited to, our doctors
and nurses - may use or disclose your IIHI
in order to treat you or to assist others in
your treatment. Additionally, we may
disclose your IIHI to others who may assist
in your care, such as your spouse, children
or parents. Finally, we may also disclose
your IIHI to other health care providers for
purposes related to your treatment.
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Payment.
Our practice may use and disclose
your IIHI in order to bill and collect
payment for the services and items you may
receive from us. For example, we may contact
your health insurer to certify that you are
eligible for benefits (and for what range-of
benefits), and we may provide your insurer
with details regarding your treatment to
determine if your insurer will cover, or pay
for, your treatment. We also may use and
disclose your IIHI to obtain payment from
third parties that may be responsible for
such costs, such as family members. Also, we
may use your IIHI to bill you directly for
services and items. We may disclose your
IIHI to other health care providers and
entities to assist in their billing and
collection efforts.
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Health Care
Operations. Our practice may use
and disclose your IIHI to operate our
business. As examples of the ways in which
we may use and disclose your information for
our operations, our practice may use your
IIHI to evaluate the quality of care you
received from us, or to conduct
cost-management and business planning
activities for our practice. We may disclose
your IIHI to other health care providers and
entities to assist in their health care
operations.
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Appointment
Reminders (Optional). Our
practice may use and disclose your IIHI to
contact you and remind you of an
appointment.
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Treatment Options
(Optional). Our practice may use and
disclose your IIHI to inform you of
potential treatment options or alternatives.
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Health-Related
Benefits and Services (Optional).
Our practice may use and disclose your IIHI
to inform you of health-related benefits or
services that may be of interest to you.
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Release of
Information to Family/Friends
(Optional). Our practice may release your
IIHI to a friend or family member that is
involved in your care, or who assists in
taking care of you. For example, a parent or
guardian may ask that a babysitter take
their child to the pediatrician's office for
treatment of a cold. In this example, the
babysitter may have access to this child's
medical information.
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Disclosures
Required By Law. Our practice
will use and disclose your IIHI when we are
required to do so by federal, state or
local.
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Use and disclosure of
your IIHI in certain special circumstances
The following categories describe unique
scenarios in which we may use or disclose your
identifiable health information:
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Public Health Risks.
Our practice may disclose your IIHI to
public health authorities that are
authorized by law to collect information for
the purpose of:
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maintaining vital records, such as births
and deaths
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reporting child abuse or neglect
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preventing or controlling disease, injury or
disability
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notifying a person regarding potential
exposure to a communicable disease notifying
a person regarding a potential risk for
spreading or contracting a disease or
condition
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reporting reactions to drugs or problems
with products or devices
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notifying individuals if a product or device
they may be using has been recalled
notifying appropriate government agency(ies)
and authority(ies) regarding the potential
abuse or neglect of an adult patient
(including domestic violence); however, we
will only disclose this information if the
patient agrees or we are required or
authorized by law to disclose this
information
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notifying your employer under limited
circumstances related primarily to workplace
injury or illness or medical surveillance.
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Health Oversight
Activities. Our practice may
disclose your IIHI to a health oversight
agency for activities authorized by law.
Oversight activities can include, for
example, investigations, inspections,
audits, surveys, licensure and disciplinary
actions; civil, administrative, and criminal
procedures or actions; or other activities
necessary for the government to monitor
government programs, compliance with civil
rights laws and the health care system in
general.
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Lawsuits and
Similar Proceedings. Our practice
may use and disclose your IIHI in response
to a court or administrative order, if you
are involved in a lawsuit or similar
proceeding. We also may disclose your IIHI
in response to a discovery request,
subpoena, or other lawful process by another
party involved in the dispute, but only if
we have made an effort to inform you of the
request or to obtain an order protecting the
information the party has requested.
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Law Enforcement.
We may release IIHI if asked to do so by a
law enforcement official:
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Regarding a crime victim in certain
situations, if we are unable to obtain
the person's agreement
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Concerning a death we believe has
resulted from criminal conduct
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Regarding criminal conduct at our
offices
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In response to a warrant, summons, court
order, subpoena or similar legal process
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To identify/locate a suspect, material
witness, fugitive or missing person
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In an emergency, to report a crime
(including the location or victim(s) of
the crime, or the description, identity
or location of the perpetrator)
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Deceased Patients
(Optional). Our practice may release IIHI to
a medical examiner or coroner to identify a
deceased individual or to identify the cause
of death. If necessary, we also may release
information in order for funeral directors
to perform their jobs.
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Organ and Tissue
Donation (Optional). Our practice
may release your IIHII to organizations that
handle organ, eye or tissue procurement or
transplantation, including organ donation
banks, as necessary to facilitate organ or
tissue donation and transplantation if you
are an organ donor.
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Research
(Optional). Our practice may use
and disclose your IIHI for research purposes
in certain limited circumstances, We will
obtain your written authorization to use
your IIHI for research purposes except when
an Institutional Review Board or Privacy
Board has determined that the waiver of your
authorization satisfies the following: (i)
the use or disclosure involves no more than
a minimal risk to your privacy based on the
following: (A) an adequate plan to protect
the identifiers from improper use and
disclosure; (B) an adequate plan to destroy
the identifiers at the earliest opportunity
consistent with the research (unless there
is a health or research justification for
retaining the identifiers or such retention
is otherwise required by law); and (C)
adequate written assurances that the PBI
will not be re-used or disclosed to any
other person or entity (except as required
by law) for authorized oversight of the
research study, or for other research for
which the use or disclosure would otherwise
be permitted; (ii) the research could not
practicably be conducted without the waiver;
and (iii) the research could not practicably
be conducted without access to and use of
the PBI.
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Serious Threats to
Health or Safety. Our practice
may use and disclose your IIHI when
necessary to reduce or prevent a serious
threat to your health and safety or the
health and safety of another individual or
the public. Under these circumstances, we
will only make disclosures to a person or
organization able to help prevent the
threat.
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Military.
Our practice may disclose your IIHI if you
are a member of US. or foreign military
forces (including veterans) and if required
by the appropriate authorities.
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National Security.
Our practice may disclose your IIHI to
federal officials for intelligence and
national security activities authorized by
law. We also may disclose your IIHI to
federal officials in order to protect the
President, other officials or foreign heads
of state, or to conduct investigations.
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Workers'
Compensation. Our practice may
release your IIHI for workers' compensation
and similar programs.
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Your Rights Regarding
Your IIHI
You have the following rights regarding the IIHI
that we maintain about you:
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Confidential
Communications. You have the right to
request that our practice communicate with you
about your health and related issues in a
particular manner or at a certain location. For
instance, you may ask that we contact you at
home, rather than work. In order to request a
type of confidential communication, you must
make a written request to Privacy Officer, the
Reed Center, 45 E. 85th St., New York, NY 10028;
1-212-772-8300 specifying the requested method
of contact, or the location where you wish to be
contacted. Our practice will accommodate
reasonable requests. You do not need to give a
reason for your request.
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Requesting Restrictions.
You have the right to request a restriction in
our use or disclosure of your IIHI for
treatment, payment or health care operations.
Additionally, you have the right to request that
we restrict our disclosure of your IIHI to only
certain individuals involved in your care or the
payment for your care, such as family members
and friends. We are not
required to agree to your request;
however, if we do agree, we are bound by our
agreement except when otherwise required by law,
in emergencies, or when the information is
necessary to treat you. In order to request a
restriction in our use or disc1osure of your
IIHI; you must make your request in writing to:
Privacy Officer, The Reed Center, 45 E. 85th
St., New York, NY 10028; 1-212-772-8300. Your
request must describe in a clear and concise
fashion:
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the information you wish restricted;
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whether you are requesting to limit our
practice's use, disclosure or both; and
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to whom you want the limits to apply.
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Inspection and Copies.
You have the right to inspect and obtain a copy
of the IIHI that may be used to make decisions
about you, inc1uding patient medical records and
billing records, but not including psychotherapy
notes. You must submit your request in writing
to Privacy Officer,
The Reed Center,45 E.85th St., New York, NY
10028; 1-212-772-8300 in order to inspect and/or
obtain a copy of your IIHI. Our practice may
charge a fee for the costs of copying, mailing,
labor and supplies associated with your request.
Our practice may deny your request to inspect
and/or copy in certain limited circumstances;
however, you may request a review of our denial.
Another licensed health care professional chosen
by us will conduct reviews.
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Amendment.
You may ask us to amend your health intonation
if you believe it is incorrect or incomplete,
and you may request an amendment for as long as
the infom1ation is kept by or for our practice,
To request an amendment, your request must be
made in writing and submitted to Privacy
Officer, The Reed Center, 45 E. 85th St., New
York, NY 10028; 1-212-772-8300.
You must provide us with a reason that supports
your request for amendment. Our practice will
deny your request if you fail to submit your
request (and the reason supporting your request)
in writing. Also, we may deny your request if
you ask us to amend information that is in our
opinion: (a) accurate and complete; (b) not part
of the IIHI kept by or for the practice; (c) not
part of the IIHI which you would be permitted to
inspect and copy; or (d) not created by our
practice, unless the individual or entity that
created the intonation is not available to amend
the intonation.
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Accounting of
Disclosures. All of our patients have
the right to request an "accounting of
disclosures." An "accounting of disclosures" is
a list of certain non-routine disclosures our
practice has made of your IIHI for
non-treatment, non-payment or non-operations
purposes. Use of your IIHI as part of the
routine patient care in our practice is not
required to be documented. For example, the
doctor sharing information with the nurse; or
the billing department using your information to
file your insurance claim. In order to obtain an
accounting of disclosures, you must submit your
request in writing to Privacy Officer, The Reed
Center, 45 E.85th St., New York, NY 10028;
1-212-772-8300. All requests for an "accounting
of disclosures" must state a time period, which
may not be longer than six (6) years from the
date of disclosure and may not include dates
before April 14, 2003. The first list you
request within a 12-month period is free of
charge, but our practice may charge you for
additional lists within the same 12-month
period. Our practice will notify you of the
costs involved with additional requests, and you
may withdraw your request before you incur any
costs.
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Right to a Paper Copy
of This Notice. You are entitled to
receive a paper copy of our notice of privacy
practices. You may ask us to give you a copy of
this notice at any time. To obtain a paper copy
of this notice, contact Privacy Officer, The
Reed Center, 45 E. 85th St., New York, NY 10028;
phone, 1-212-772-8300.
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Right to File a
Complaint. If you believe your
privacy rights have been violated, you may file
a complaint with our practice or with the
Secretary of the Department of Health and Human
Services. To file a complaint with our practice,
contact Privacy Officer, The Reed Center, 45 E.
85th St., New York, NY 10028; 1-212-772-8300.
All complaints must be submitted in writing. You
will not be penalized for filing a complaint.
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Right to Provide an
Authorization for Other Uses and Disclosures.
Our practice will obtain your written
authorization for uses and disclosures that are
not identified by this notice or permitted by
applicable law. Any authorization you provide to
us regarding the use and disclosure of your IIHI
may be revoked at any time in writing. After you
revoke your authorization, we will no longer use
91' disclose your IIHI for the reasons described
in the authorization. Please note, we are
required to retain records of your care.
Again, if you have any questions regarding this
notice or our health information privacy
policies,
please contact Privacy Officer; The- Reed
Center, 45 E.85th St., New York, NY 10028
phone: 1-212-772-8300.
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