THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. THE PRIVACY OF YOUR HEALTH INFORMATION IS
IMPORTANT TO US.
We are required by law to maintain the
privacy of your health information. We
must provide you with this Notice about our privacy practices, our legal
responsibilities, and your rights concerning your health information. We will abide by the terms of this notice
effective 1/1/2012, remaining in effect until replaced. We will accommodate your reasonable requests
regarding methods to communicate health information with you.
the right to amend, change, or eliminate provisions in our privacy practices
and access practices and to enact new provisions regarding the protected health
information we maintain. If our
information practices change, we will amend our Notice. You are entitled to receive a revised copy of
the Notice by calling (571) 228-1708 and requesting a copy of our
USES AND DISCLOSURES OF HEALTH
use and disclose health information about you for treatment, payment, and
healthcare operations. For example:
Treatment: We may use or disclose your health
information to a physician or other healthcare provider providing treatment for
Payment: We may use and disclose your health
information to obtain payment for services for you. This includes health insurance companies as
well as any business associate helping us obtain payment.
Operations: We may use
and disclose your health information in connection with our healthcare
operations to include quality assessment and improvement activities, reviewing
the competence or qualifications of healthcare professionals, evaluating
practitioner and provider performance, conducting training programs, certification,
licensing, or credentialing activities.
addition to our use of health information for treatment, payment, or healthcare
operations, you may give us written authorization to use or disclose your
health information to anyone for any purpose.
Unless you give written permission, we cannot use or disclose your
health information for any reason except those described in this Notice. Authorization may be resolved at anytime with
Family and Friends: Using our
best judgment, we may disclose to a family member, other relative, close
personal friend, or any other person you identify, health information relevant
to that person's involvement in your care or in payment for such care only if
you agree that we may do so or in an emergency.
Health Related Services: We will
not use your health information for marketing communications without your
By Law: We may use
or disclose your health information when we are required to do so by law.
Neglect: We may
disclose your health information to appropriate authorities if we reasonably
believe that you are a possible victim of abuse, neglect, or domestic violence
or the possible victim of other crimes.
We may disclose your health information to the extent necessary to avert
a serious threat to your health or safety or the health or safety of others.
Security: We may
disclose to military authorities the health information of Armed Forces
personnel under certain circumstances.
We may disclose to any correctional institution or law enforcement
official having lawful custody of protected health information to the extent
necessary to avert serious threat to your health or safety or the safety of
Correspondence: We may use or disclose your health
information to provide you with company correspondence, courtesy calls,
and reminder calls through voicemail
messages, emails, postcards, or letters.
Access: You have the right to look at or get copies
of your health information. You must
make a request in writing to obtain access to your health information. Please send written requests to
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