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

We are required by law to maintain the privacy of your protected health information and provide you with notice of our legal duties and privacy practices with respect to protected health information.
This notice is effective as of April 14, 2003 and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of a revised Notice of Privacy Practices from this office.

You have recourse if you feel that your privacy protections have been violated. You have the right to file a formal written complaint with us at the address below, or with the Department of Health & Human Services, Office of Civil Rights, about violations of te provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint. Please contact us for more information:

For more information about HIPAA or to file a complaint:
The U.S. Department of Health & Human Services, Office of Civil Rights, 200 Independance Avenue, S.W. Washington, D.C. 20201
(202) 619-6775

Town Total Health
6 East 32 Street
5th Floor
New York, NY 10016
(212) 213-5570

 

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Notice Of Privacy Practice

The Health Insurance Portability & Accountability Act of 1996("HIPAA") is a Federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the patient, significant new rights to understand and control how your health information is used. As required by HIPPA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information. We may use and disclose your medical records only for each of the following purposes: Treatment, payment and health care operations.

Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include filling your prescription.

Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill to your insurance company for payment.

Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would be an internal quality assessment review.

We may contact you to provide refill reminders or other health-related benefits and services that may be of interest to you and to schedule deliveries.

We may release identifiable information if asked to do so by law enforcement officials, or to assist in a criminal investigation.

We will use and disclose your identifiable health information when we are required to do so by Federal State or Local authorities.

We may disclose your identifiable health information for Workers' Compensation and similar programs.

We may also create and distribute de-identified health information by removing all references to individually identifiable information.

Any other diclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization. You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer.

The right to request restrictions on certain uses and disclosures of protected health information, including those relates to disclosures of family members, other relatives, close personal friends, or any person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it. In order to request a restriction in our use or disclosure of your protected health information, you must make the request in writing or the appropriate form.

The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or alternative locations.

The right to inspect and copy your protected health information. You must submit your request in writing in order to inspect or obtain a copy of your protected health information. We may charge $2.50 per page plus postage for copies of your protected health information.

The right to ask to amend your protected health information. You must submit your request in writing.

The right to receive an accounting of disclosures of protected health information. All requests for an accounting of disclosures must be made in writing and must state the time period, which may not be longer than seven years and may not include dates prior to April 13, 2003.


E-mail: privacy@towntotal.com