WE ARE REQUIRED BY LAW TO
- Make sure that your medical information is kept private.
- Give you this notice of our legal duties and policies regarding how we use your medical information.
- Follow the terms of this notice.
How we may use and disclose medical information about you
- TREATMENT: We use medical information about you in order to provide you with the best treatment possible. There may be times when we need to contact your physician or physician assistant in order to obtain additional medical information regarding your condition to set up a proper therapy program.
- PATIENT CARE SERVICES: We may need to disclose medical information in the form of a patient status report to your physician, worker's comp carrier, or insurance company representative so that they may monitor how you are progressing with your therapy.
- PAYMENT: We may use and disclose information about you and the services that you receive to an insurance company, government agency, worker's comp, collection agency, or billing service in order to receive payment on your behalf for our services.
- QUALITY ASSURANCE: We may use your medical information to review how well we treated you and to evaluate the services we provide to you. We may also combine medical information about all of our patients to determine what additional services we should be providing and whether other services are no longer necessary. In addition, we may use your records to evaluate the performance of our staff in caring for you.
- APPOINTMENT REMINDERS: We may use your information to contact you in order to inform you of an upcoming appointment.
- HEALTH RELATED BENEFITS & SERVICES: We may use your personal and medical information to inform you of other services which may be of benefit to you.
- FAMILY MEMBERS AND/OR PATIENT CARE-GIVERS: We may use your personal and medical information to inform you of other services which may be of benefit to you.
- AS REQUIRED BY LAW: We may disclose your medical information when necessary according to California state and Federal Law. This includes; 1) court or administrative orders (subpoenas, discovery request, or other lawful process) in response to a legal dispute, 2) to identify a suspect or fugitive, and 3) in emergency circumstances to report a crime.
Your rights regarding medical information about you
Right to inspect and copy. You have the right to inspect and copy any medical information that may be used to make decisions about your care.
Right to amend. If you feel that any of the medical information that we have about you is incorrect or incomplete, you may ask us to amend the information.
Right to request restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. In addition, you may request a restriction on the amount of medical information that is revealed to a family member or care-giver. To request such restrictions, you must make your request in writing to us. Within the request please state the following; 1) what information is to be limited, 2) if you want to limit its use, disclosure, or both, and 3) to whom do the limits apply. We are not required to agree with your request.
Right to request confidential communications. You have the right to request that we only communicate with you via phone, fax, or mail. You may specify certain locations for contact as well. Please notify us of the best way to contact you about your care.
Right to a paper copy of this notice. You have the right to a paper copy of this notice. You may obtain one at any time. Any questions should be directed to the Privacy Officer, Farshid Farajzadeh.
Changes of this notice. We reserve the right to change this notice. We also reserve the right to make any changes to this notice effective for medical information that we already have about you, as well as future information.
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