Notice of Privacy Practices
This notice describes how health information about you, as a patient of this practice, may be used and disclosed, and how you can get access to your health information. This is required by the Privacy Regulations created because of the Health Insurance Portability and Accountability Act of 1996 (HIPPA).
Commitment to your privacy:
This practice is dedicated to maintaining the privacy of your health information. Healthcare practices are required by law to maintain the confidentiality of your health information. Also, in accordance with the law, you must be provided with the following information:
The following circumstances may require us to use or disclose your health information:
1. To public health authorities and health oversight agencies that are authorized by law to collect information.
2. Lawsuits and similar proceedings in response to a court or administrative order.
3. If required to do so by a law enforcement official.
4. When necessary, to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Disclosures will only be made to a person or organization able to help prevent the threat.
5. If you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
6. To federal officials for intelligence and national security activities authorized by law.
7. To correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official.
8. For workers compensation or similar programs.
Your rights regarding your health information:
1. You can request that this practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask to be contacted at home, rather than at work. Any reasonable requests will be accommodated.
2. You can request a restriction in the use or disclosure of your health information for treatment, payment, or health care operations. Additionally, you have the right to request that your health information be disclosed to only certain individuals involved in your care or the payment for your care, such as family members and friends. However, we are not required to agree to your request in certain emergency situations.
3. You have the right to inspect and obtain a copy of the health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Paw Kamwee, NMD, PO Box 173. Black Canyon City, AZ 8324. Note: this request must be responded to within 30 days.
4. You may ask that your health information be amended if you believe it is incorrect or incomplete. To request an amendment, submit a written statement to Paw Kamwee, NMD, PO Box 173. Black Canyon City, AZ 8324. You must provide a reason that supports your request for an amendment. Note: This practice must respond to your request within 60 days. If a physician believes the information is complete and accurate, that physician can refuse to make any changes.
5. You are entitled to receive a copy of the Notice of Privacy Practices. You may ask us to give you a copy of the notice at any time. To obtain a copy of the notice, contact Dr. Paw Kamwee.
6. If you believe your privacy rights have been violated, you may file a complaint with this practice or with the Secretary of the Department of Health and Human Services. To file a complaint with this practice, contact Paw Kamwee, NMD, PO Box 173. Black Canyon City, AZ 8324. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
7. This practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.
8. If you have any questions regarding this notice or our health information privacy policies, please contact Paw Kamwee, NMD, PO Box 173. Black Canyon City, AZ 8324.