NOTICE OF PRIVACY PRACTICES

 

This notice describes how medical information about you may be used and disclosed and how you can gain access to this information. Please review this carefully.

 

Introduction:

 

We are required by law to maintain the privacy of your health information and to provide you with this notice of Irie Heights LLC’s legal duties and privacy practices with respect to your health information.

If you have a legal guardian, we will also provide them with this information, including their right to act on your behalf in these matters.

 

Uses and Disclosures of Your Health Information, With Your Permission:

 

Examples of the types of uses and disclosures of your protected health care information Irie Heights LLC is permitted to make once you have signed the consent form include:

 

• We will have to disclose protected health information to another clinician/physician who may be treating you when we have the necessary permission from you to disclose your protected health information.

• Healthcare Operations. We may use or disclose, as needed, your protected health information in order to support the business activities of our practice. These activities include, but are not limited to, quality assessment activities, employee review activities 

 

Support

 

How We Will Use and Disclose Protected Health Information:

 

• We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use of the disclosure of all or part of your protected health information. Examples include:

• When we are required by law to provide your protected health information. You will be notified, as required by law, of any such disclosures.

• To avert serious health and safety risk.

• Health Oversight. We may disclose protected health information to a health oversight agency for the activities authorized by law, such as audits, investigations, and inspections.

 

Your Rights Regarding Protected Health Information

Below is a description of your rights with respect to your protected health information.

 

• You have the right to inspect and copy your protected health information. This means that you may inspect and obtain a copy of protected health information about you that is contained in a designated record. Please contact our Privacy Officer if you have questions about access to your medical record.

 

Complaints:

 

• If you believe your privacy rights have been violated, you may file a complaint by speaking with or writing our Medical Director at Irie Height’s LLC. The Medical Director can be contacted (571) 330-6328. You may also file a complaint with the United States Department of Health and Human Service.