Patient Privacy
Notice of Privacy Practices for Protected Health Information
This notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully.
Use and Disclosure of Your Health Information
With your consent, we are permitted by federal privacy laws to use and disclose your health information for:
1. Treatment
Protected health information includes documentation of your symptoms, examination results, diagnoses, treatment plans, and more.
Example:
A nurse records your treatment information in your health record. If your doctor needs to consult another specialist, your medical information may be shared to receive input.
2. Payment
We use your information to submit payment requests to your health insurance company.
Example:
We may provide your health insurance company with details about the care you received to process payment for services.
3. Health Care Operations
We use your information to obtain services like quality assessments, legal services, training programs, and medical reviews.
Example:
We may share your information with insurers or business associates to ensure quality improvement or obtain necessary services.
Your Health Information Rights
While we maintain the physical health records, the information belongs to you. You have the right to:
- Request Restrictions: Request limits on how your information is used or disclosed (requests must be submitted in writing; we will comply with granted requests).
- Inspect and Copy Records: You may inspect or request a copy of your health and billing records by submitting a written request.
- Request Amendments: You can request corrections to incomplete or inaccurate information in your records by submitting a written request.
- Disagree with Denials: File a statement of disagreement if your amendment request is denied.
- Obtain an Accounting of Disclosures: Request a list of disclosures made (excluding internal uses, disclosures to you, or disclosures for treatment and payment purposes).
- Request Alternative Communication Methods: Specify alternative methods or locations for communication.
- Revoke Authorizations: Revoke previous authorizations for information use or disclosure by submitting a written request.
To exercise your rights, please contact Ms. Lannette Ramirez at (562) 698-0387 during normal business hours.
Our Responsibilities
We are committed to:
- Maintaining the privacy of your health information as required by law.
- Providing you with a notice of our privacy practices.
- Abiding by the terms of this notice.
- Notifying you if we cannot accommodate a requested restriction.
- Accommodating reasonable requests for alternative communication methods.
We reserve the right to amend our privacy practices. You can request a revised copy of this notice at any time by calling our office or visiting in person.
To Request Information or File a Complaint
If you have questions, need more information, or wish to report an issue regarding the handling of your information, please contact:
Ms. Lannette Ramirez, Privacy Officer
Phone: (562) 698-0387
If you believe your privacy rights have been violated, you may file a complaint:
- In writing at our office: Deliver your complaint to Ms. Lannette Ramirez.
- With the Secretary of Health and Human Services:
Federal Office Building
50 United Nations Plaza, Room 322
San Francisco, CA 94102
Phone: (415) 437-8310
We will not retaliate against you for filing a complaint.
Other Disclosures and Uses
In certain situations, your health information may be used or disclosed as permitted by law:
1. Notification
We may notify a family member, personal representative, or another individual responsible for your care about your location, condition, or death unless you object.
2. Communication with Family
We may share relevant health information with family members or individuals involved in your care unless you object.
3. FDA Reporting
We may report information to the FDA regarding adverse events, product defects, or recalls.
4. Workers’ Compensation
If you are seeking compensation, we may disclose information necessary to comply with workers’ compensation laws.
5. Public Health
We may disclose information to authorities for disease prevention, injury control, or disability prevention as required by law.
6. Abuse and Neglect
We may report suspected abuse or neglect to public authorities as allowed by law.
7. Correctional Institutions
If you are incarcerated, we may disclose information to correctional institutions to ensure your health and the safety of others.
8. Law Enforcement
We may disclose information to law enforcement as required by law, such as for court orders or felony prosecutions.
9. Health Oversight
We may release information to health oversight agencies for oversight activities allowed by federal law.
10. Judicial or Administrative Proceedings
We may disclose information as directed by a proper court order or with your consent during legal proceedings.
11. Other Uses
Any other uses or disclosures will only be made as authorized by law or with your written consent. You may revoke consent at any time in writing.
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