Neurosurgical Medical Clinic, Inc.
Notice of Health Information Privacy Practices
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.
Uses and Disclosures: We will use and disclose elements of your protected health information (PHI) in the following ways:
Without your signed authorization
- Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students or other people who are taking care of you.
- Payment: We may use and disclose you medical information for payment purposes.
- Healthcare Operations: We may use and disclose your medical information for our healthcare operations. This might include measuring and improving quality, evaluating the performance of employees, conducting training programs and getting the accreditation, certificates, licenses and credentials we need to serve you.
- when release is required by law, including in judicial settings and to health oversight regulatory agencies and law enforcement
- in emergency situations or to avert serious health/safety situations
- to medical examiners, coroners or funeral directors to aid in identifying you or to help them in performing their duties
- to organ, tissue and other donations organization, upon or proximate to your death, if we have no indication on hand about your donation preferences (or a positive indication).
- to the sponsor of your health plan
All other uses and disclosures will require us to obtain written authorization from you in addition to any other permission you will provide us.
You have the following rights concerning your PHI:
Restrictions: To request restricted access to all or part of your PHI. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement, (except in the case of an emergency). To do this, you must describe in writing the restriction you are requesting and forward it to the contact indicated at the end of this notice.
Confidential Communications: To receive correspondence of confidential information by alternate means or location. To do this a request must be done in writing to the contact indicated at the end of this notice.
Access: To inspect or receive copies of your PHI. To inspect your PHI, forward such request in writing to the contact indicated at the end of this notice. To receive copies of your PHI please request and complete the required release form.
Amendments: To request changes be made to your PHI. To do this forward your request in writing to the contact indicated at the end of this notice. We are not required to grant your request.
Accounting: To receive an accounting of the disclosures by us of your PHI up to the six years prior to your request. To do this forward your request in writing to the contact indicated at the end of this notice.
This notice: To get updates or reissue of this notice, at your request.
Complaints: To complain to us or the U.S. Dept. of Health & Human Services if you feel your privacy rights have been violated. To register a complaint with us, please request and complete our complaint form. The law forbids us from taking retaliatory action against you if you complain.
NPP Notice: To get updates or reissue of this notice, at your request.
We are required by law to maintain the privacy of your PHI. We must abide by the terms of this notice or any update of this notice.
For more information about our privacy practices, please contact:
Neurosurgical Medical Clinic, Inc.
Georgia Jackson - Office Administrator
2100 Fifth Avenue, Ste. 200
San Diego , CA 92101
Effective date: April 1, 2003