OUR SERVICES
 

Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
(Required by federal regulation 45 CFR 164.520)

THIS PATIENT CONFIDENTIALITY STATEMENT EXPLAINS YOUR RIGHTS, OR LEGAL DUTIES AND OUR PRIVACY PRACTICES. WE DISCLOSE THAT WE PROTECT THE CONFIDENTIALITY OF OUR PATIENT'S PERSONAL HEALTH AND PERSONAL FINANCIAL INFORMATION, INTERNAL POLICIES, AND PROCEDURES AS REQUIRED BY LAW.

PLEASE READ THIS NOTICE CAREFULLY. WE MUST PROVIDE YOU WITH THE FOLLOWING IMPORTANT INFORMATION:

  • How we may use and disclose your PHI
  • Your privacy rights in your PHI
  • Our obligations concerning the use and disclosure of your PHI

Our Pledge Regarding Your Health Information

We are dedicated to maintaining the privacy of your health. We are required to provide you with this notice of the privacy practices that we maintain in our practice concerning your health information. The terms of this notice apply to all records of your health information 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. We collect, use and disclose information provided by and about you for healthcare, payment and operations, or when we are otherwise permitted or required by law to do so.

For Treatment

We will use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. For example, we may ask you to have laboratory tests (such as blood tests), and we may use the results to help determine pre-operative wellness. We might use your PHI in order to write a prescription for you. Many of the people who work for our practice, including buy not limited to, our doctor and nurses, may use or disclose your PHI in order to treat you or to assist others in our treatment. Additionally, we may disclose your PHI to others who may assist in your care, such as your spouse, children our parents.
In addition, we may disclose your PHI from time-to-time to another provider (e.g., a specialist or laboratory) who, at the request of your provider, becomes involved in your care.

Payment

Our practice may use and disclose your PHI in order to bill and collect payment for the services and products you may receive from us. We also may use and disclose your PHI to obtain payment from other third parties, such as a collection agency, and to bill you directly for services and supplies.

Healthcare Operations

Our practice may use and disclose your PHI to operate our business. These activities include, but are not limited to, quality assessment activities, employee review activities, licensing, marketing, and for business activities. For example, your name may called in the waiting room when it is time for your appointment. We may use or disclose your PHI to contact you to remind you of your appointment.

"Business Associates" perform various activities (e.g., answering service) for us. We will share your PHI with business associates whenever appropriate. A written contract with the business associate will outline the terms that will protect the privacy of your PHI.

Communications From Our Office

We might use or disclose your PHI to discuss with you information about treatment alternatives or other health-related services. We may also use and disclose your PHI for other marketing activities. For example, your name and address may be used to send you a newsletter about services our practice offers. You may contact our Privacy Officer to request that these materials not be sent to you.

Other uses and disclosures we can make without your written authorization or opportunity to agree or object

We may use and disclose PHI about you in the following circumstances without your authorization or opportunity to agree or object, provided that we comply with certain conditions that may apply.

Disclosures Required By Law

We may use and disclose PHI as required by federal, state or local law. Any disclosure must comply with the law and is limited to the requirements of the law.

Public Health Activities

We may use or disclose PHI to public health authorities or other authorized persons to carry out certain activities related to public health, including the following:

  • To prevent or control disease, injury or disability;
  • To report disease, injury, birth or death;
  • To report child abuse or neglect;
  • To report reactions to medications or problems with products or devices regulated by the federal Food and Drug Administration or other activities related to quality, safety, or effectiveness of FDA-regulated products or activities;
  • To locate and notify persons of recalls of products they may be using;
  • To notify a person who may have been exposed to a communicable disease in order to control who may be at risk of contracting or spreading the disease; or
  • To report to your employer, under limited circumstances, information related primarily to workplace injuries or illness, or workplace medical surveillance.

Health Oversight Activities

We may disclose PHI to a health oversight agency for oversight activities including, for example, claims audits, investigations, inspections, licensure and disciplinary activities, and other activities conducted by health oversight agencies to monitor the health care system, and compliance with certain laws.

Lawsuits and Other Legal Proceedings

We may use or disclose PHI when required by a court or administrative tribunal order. We may also disclose PHI in response to subpoenas, discovery requests, or other required legal processes when efforts have been made to advise you of the request or to obtain an order protecting the information requested.

Law Enforcement

Under certain conditions, we may disclose PHI to law enforcement officials for the following purposes where the disclosure is:

  • About a suspected crime victim if, under certain limited circumstances, we are unable to obtain a person's agreement because of incapacity or emergency;
  • To alert law enforcement of a death that we suspect was the result of criminal conduct;
  • Required by law;
  • In response to a court order, warrant, subpoena, summons, administrative agency request, or other authorized process;
  • To identify or locate a suspect, fugitive, material witness, or missing person;
  • About a crime or suspected crime committed at the workplace; or
  • In response to a medical emergency not occurring at the workplace, if necessary to report a crime, including the nature of the crime, the locations of the crime or the victim, and the identity of the person who committed the crime.

Release of Information to Family/Friends

Our practice may release your PHI to a friend or family member that is involved in your care or who assists in taking care of you. For example, a family member or friend who would be taking care of you after surgery, may be given aftercare instructions, or you may ask your friend or family member to pick up a prescription, which would give them access to your medical information.

Disclosures Required by HIPAA Privacy Rule

We are required to disclose PHI to the Secretary of the United States Department of Health and Human Services when requested by the Secretary to review our compliance with the HIPAA Privacy Rule. We are also required to certain cases to disclose PHI to you upon your request to access PHI or for an accounting of certain disclosures of PHI about you as described in Section "Your Rights" of this notice.

Emergencies

We may use or disclose your PHI in an emergency treatment situation.

Your Rights

Under regulations that were in effect April 14, 2003, you have a right over your health information. Under these rules, you have the right to:

  • Confidential Communications. Request that we communicate with you about medical matters using reasonable alternative means or at an alternative address, if communications to your home address could endanger you.
  • You have the right to request a restriction of your PHI. Send us a written request to see or to get a copy of information that we have about you, or to amend your personal information that you believe is incomplete or inaccurate. Request additional restrictions on uses or disclosures of your health information. This facility is not required to agree to a restriction. If Dr. O'Neil believes it is in your best interest to permit use and disclosure of your PHI, your PHI will not be restricted. If Dr. O'Neil does agree to the requested restriction, we may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with Dr. O'Neil. In order to request a restriction in our use or disclosure of your PHI, you must make your request in writing to . Your request must describe in a clear and concise fashion:
    • The information you wish restricted;
    • Whether you are requesting to limit our practice's use, disclosure or both; and
    • To whom you want the limits to apply.
  • You have the right to inspect and copy your PHI. This means you may inspect and obtain a copy of PHI about you that is contained in your medical record. A medical record contains medical and financial information and any other records that your provider uses for making decisions about you.

Under federal law, however, you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and PHI that is subject to law that prohibits access to PHI. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical record.
You must submit your request in writing to in order to inspect and/or obtain a copy of your medical record. Our practice may charge a fee for the costs of copying, mailing, labor and supplies associated with your request.

  • Right to Amend. You have the right to request that we amend PHI about you as long as such information is kept by or for our office. To make this type of request, you must submit your request in writing to our Privacy officer. You must also give us a reason for your request. We may deny your request to certain cases, including if it is not in writing or if you do not give us a reason for the request.
  • Right to Receive an Accounting of Disclosures. You have the right to request an accounting of certain disclosures that we made of PHI about you. This is a list of disclosures made by us during a specified period of up to six years except for disclosures made:
    • For treatment, payment, and health care operations;
    • For use in or related to a facility directory;
    • To family members or friends involved in your care;
    • To you directly;
    • Pursuant to an authorization of you and your personal representative;
    • For certain notification purposes (including national security, intelligence, correctional, and law enforcement purposes); or
    • Before April 14, 2003
  • Right to a Paper Copy of this Notice. You have a right to receive a paper copy of this notice at any time, even if you have previously agreed to receive this notice electronically. To obtain a paper copy of this notice, contact the Privacy Officer.

Complaints

If you believe your privacy rights have been violated, you have the right to file a complaint with our office or with the federal government. You will not be penalized for filing a complaint.

Contact Information

If you have any questions regarding this notice or our health information privacy policy, please contact the front office
personnel or: Valerie Arnaiz, Privacy Officer – 40971 Winchester Rd. Temecula, Ca. 92591 Ph# 800-541-3764