We respect our legal obligation to keep health information that identifies your privacy. We are obligated by law to give notice of our privacy practices. This Notice describes how we protect your health information and what rights you have regarding it. TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you; faxing information to other physicians or hospitals; referring you for tests or procedures or to other physicians. USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us; some may never come up at our office at all. Such uses or disclosures are: When a states or federal law mandates that certain health information be reported for a specific purpose; For the public health purpose, such as a contagious disease reporting, investigation or surveillance; and notices to and from the Federal Food and Drug Administration regarding drugs or medical devices; uses and disclosures for health oversight activities, such as for the licensing of doctors; for audits by Medicare or Medicaid; or for the investigation of possible violations of health care laws; Disclosures for judicial and administrative proceedings such as in response to subpoenas or orders of courts or administrative agencies; Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of crime, to provide information about a crime at our office, or to report a crime that has happened somewhere else; Uses and disclosures to prevent a serious threat to health or safety; Uses and disclosures to prevent a serious threat to health or safety; Disclosures relating to worker's compensation programs; Disclosures of a "limited data set" for research, public health, or health care operations; Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures; Disclosures to "business associates" who perform health care operations for us and who commit to respect the privacy of your health information. APPOINTMENT REMINDERS We may call or write to remind you of scheduled appointments, or that it is time to make a routine appointment. We may also call or write to notify you of other treatments or services available to our office that might help you. Unless you tell us otherwise, we will mail you an appointment reminder on a post card, and/or leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home. OTHER USES AND DISCLOSURES We will not make any other uses or disclosures of your health information unless you sign a written "authorization form." The content of an "authorization form" is determined by federal law. Sometimes, we may initiate the authorization process if the use or disclosure is our idea. Sometimes, you may initiate process if it's your idea for us to send you information to someone else. Typically, in this situation you will give us a properly completed authorization form, or you can use one of ours. If we initiate the process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use of disclosure. If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be writing. Send them to attention of the privacy officer, Joe T. Wills, MD, FACS at the address listed at the top of this Notice. We may make your medical information available electronically through state, regional, or national information exchange services which help make your medical information available to other healthcare providers who may need access to it in order to provide care or treatment to you. Participation in health information exchange services also provides that we may see information about you from other participants. UNDERSTANDING YOUR HEALTH RECORD INFORMATION Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treament. This information, often referred to as your health or medical record serves as a: Basis for planning your care and treatment; means of communication among many health professionals who contribute to your care; legal document describing the care you received; means by which you or a third-party payer can verify that services billed were actually provided; A tool in educated health professionals; A source of data for medical research; A source of data for facility planning and marketing; A tool with which we can access and continually work to improve the care we render and the outcomes we achieve; Understanding of what is in your record and how your health information is used to help you to: Ensure its accuracy; Better understand who, what, when, where, and why others may access your health information; Make more informed decisions when authorizing disclosures to others. Ask us to communicate with you in a confidential way, such as by phoning you at work rather than at home, by mailing health information to a different address, or by using email to your personal email address. We will accomodate these requests if they are reasonable, and if you pay us for any extra costs. If you want to ask for confidential communications, send a written request to the attention of the privacy officer, Joe T Wills, MD, FACS at the address shown at the beginning of the Notice; Request a restriction on cretain uses and disclosures of your information as provided by 45 CFR 164.522; Obtain a paper copy of the notice of information practices request; Inspect and copy your health record as provided in 45 CFR 164.524; Amend your health record as provided in 45 CFR 164.524; Obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528; Request communications of your health information by alternative means or at alternative locations; Revoke your authorization to use or disclose health information except to the extent that action has already been taken; Revoke your authorization to use or disclose health information except to the extent that action has already been taken 164.528 OUR NOTICE OF PRIVACY PRACTICES By law, we must abide by the terms of this Notice of Privacy Practices until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices we will post the new notice in our office and have copies available in our office. COMPLAINTS If you think we have not properly respected the privacy of your health information, you are free to complain to us or the US Department of Health and Human Services Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the the attention of the privacy officer at the address shown at the beginning of the Notice. If you prefer, you can discuss your complaint in person or by phone. FOR MORE INFORMATION If you want more information about our privacy practices, call or visit the office at the address or phone number shown at the beginning of this Notice.