Notice of Privacy Practices

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 MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

PLEASE REVIEW THIS NOTICE CAREFULLY.

A.    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 are also required to provide you with this notice

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.

B.  PRIVACY OFFICER: 
Laura Bernstein, is in charge of privacy matters at our office, 192-13 Union Turnpike, Fresh Meadows, New York, 718/468-9800.  You may contact her at the above location for further information.

C.  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.

1.       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.  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.

2.      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. 

3.      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. 

4.      Appointment Reminders and Treatment Options.
Our practice may use and disclose your IIHI to contact you and remind you of an appointment or to provide information about treatment alternatives unless you instruct us otherwise, we may leave a message for you on any answering device or with any person who answers the phone at your residence.

5.      Disclosures Required By Law.
Our practice will use and disclose your IIHI when we are required to do so by federal, state or local law.

D.  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 without further notice to you, or specific authorization by you, where

• Required for Public Health Risks
• Required by law to report child abuse or neglect
• Required for Health Oversight Activities authorized by law such as the Department of  Health, Office of Professional Discipline or Office of Professional Medical Conduct.
• Required for Lawsuits and Similar Proceedings
• Required for Law Enforcement purposes by a law enforcement official
• Required by a medical examiner or coroner
• Required by law to a funeral director
• Permitted by law for Organ and Tissue Donation
• Research purposes (see details at 45 CFR Section 164.512 (i) ) 
• Permitted by law to avert Serious Threats to Health or Safety
• Permitted by law and required by military authorities if you are a member of the armed forces of the United States Permitted by law for Workers’ Compensation

YOUR RIGHTS REGARDING YOUR IIHI

You have the right to request restrictions on certain of the uses and disclosures described above.  Except as stated below, we are not required to agree to such restrictions.

You have the right to inspect and obtain a copy of your medical information (a reasonable fee will be charged).

You may ask us to amend your health information if you believe it is incorrect or incomplete, To request an amendment, your request must be made in writing and submitted to Laura Bernstein, privacy officer, at 192-13 Union Turnpike, Fresh Meadows, New York 11366. 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 we disagree with any requested amendment, and will further notify you of your rights.

All of our patients have the right to request an “accounting of disclosures” we make of your medical information, except for: disclosure we make to you, or to carry out treatment, payment of health care operations, or as requested by your written authorization, or as permitted or required under 45 CFR Section 164.502, or for emergency or notification purposes, or for national security or intelligence purposes as permitted by law, or to correctional facilities or law enforcement officials as permitted by law (or for research or public health purposes after being de-identified or limited to remove personally identifiable information) or disclosures made before April 14, 2003.

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.

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 Laura Bernstein, 192-13 Union Turnpike, Fresh Meadows, New York.  All complaints must be submitted in writing.  No retaliatory action will be taken against you for any complaint you may make.