Notice of Privacy Practices
Arnold M. Phillips, MD
If you have any questions about this Notice please contact our Administrative
Offices at 212 355 8248
This Notice of Privacy Practices describes how we may use and
disclose your protected health information to carry out treatment,
payment or health care operations and for other purposes that are
permitted or required by law. It also describes your rights to
access and control your health information. Please review it carefully.
We are required to abide by the terms of this Notice.
We may change the terms at any time. The new notice
will be effective for all protected health information
that we maintain at that time. Upon your request, we will provide
you with any revised Notice.
1. Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your
physician, our office staff and others outside of our office that are involved
in your care and treatment, and in the processes of billing you or you insurer
in order to obtain payment for services.
For example
1a.Treatment: We will use and disclose your protected health
information to provide, coordinate, or manage your health care and
any related services. For example, your information may be provided
to a physician to whom you have been referred.
1b Payment: Your protected health information will be used, as needed,
to obtain payment for your health care services. This may include
certain activities that your insurer may undertake before it approves or
pays for the health care services we recommend.For example,we may
provide your information to obtain approval for specialized diagnostic testing.
1c Healthcare Operations: We may use or disclose, as-needed, your
protected health information in order to support the operationalactivities
of your physician’s practice. For example, In our efforts to deliver the highest
standards of care we may use your information in our quality assurance programs.
We will share your protected health information with third party“business associates”
that perform various activities (e.g.,billing, transcription services) for the practice.
1d Others Involved in Your Healthcare: With your approval, we may
disclose to a member of your family, or any other person you identify,
your protected health information that directly relates to that person’s
involvement in your health care.
1e Emergencies: We may use or disclose your protected health
information in an emergency treatment situation.
2. By law we may be required to disalocse your information:
In cases of audit investigations, health oversight, public health
activities .
For example: We may disclose your protected information, if authorized by law,
to a person who may have been exposed to a communicable disease or may
otherwise be at risk of contracting or spreading the disease .
Military Activity and National Security: When the appropriate
conditions apply, we may use or disclose protected health
information of individuals who are Armed Forces personnel for
activities deemed necessary by appropriate military command
authorities;
Workers’ Compensation: Your protected health information may be
disclosed by us as authorized to comply with workers’ compensation
laws .
Required Uses and Disclosures: Under the law, we must make
disclosures to you and when required by the Secretary of the
Department of Health and Human Services to investigate or determine
our compliance with the requirements of Section 164.500 et. seq.
3. Your Rights
You have the right to inspect and copy your protected health
information, however, you may not inspect or copy the
following records; psychotherapy notes; information compiled in
reasonable anticipation of, or use in, a civil, criminal, or
administrative action or proceeding, and protected health
information that is subject to law that prohibits access to
protected health information.
You have the right to request a restriction of your protected health
information. Your request must state the specific restriction
requested and to whom you want the restriction to apply.
Your physician is not required to agree to a restriction that you
may request if your request is contrary to law.
You have the right to request that our communication with you be confidential.
We will accommodate reasonable requests. You should be aware that some
requests may prevent payment by your insurance company, in which case you
may be responsible for payment.
You have the right to receive an accounting of disclosures
we have made. This right applies to disclosures for purposes
other than treatment, payment or healthcare operations. It
excludes disclosures we may have made to you, to family members
or friends involved in your care, or for notification purposes. You have the right to
receive specific information regarding these disclosures that
occurred after April 14, 2003.
3. Complaints
You may complain to us or to the Secretary of Health and Human
Services if you believe your privacy rights have been violated by
us. You may file a complaint with us by notifying our administrative
office of your complaint. We will not retaliate against you for
filing a complaint.
You may contact us at 212 355 8248
This notice was published and becomes effective on March 1st
2003
Arnold M. Phillips, MD
If you have any questions about this Notice please contact our Administrative
Offices at 212 355 8248
This Notice of Privacy Practices describes how we may use and
disclose your protected health information to carry out treatment,
payment or health care operations and for other purposes that are
permitted or required by law. It also describes your rights to
access and control your health information. Please review it carefully.
We are required to abide by the terms of this Notice.
We may change the terms at any time. The new notice
will be effective for all protected health information
that we maintain at that time. Upon your request, we will provide
you with any revised Notice.
1. Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your
physician, our office staff and others outside of our office that are involved
in your care and treatment, and in the processes of billing you or you insurer
in order to obtain payment for services.
For example
1a.Treatment: We will use and disclose your protected health
information to provide, coordinate, or manage your health care and
any related services. For example, your information may be provided
to a physician to whom you have been referred.
1b Payment: Your protected health information will be used, as needed,
to obtain payment for your health care services. This may include
certain activities that your insurer may undertake before it approves or
pays for the health care services we recommend.For example,we may
provide your information to obtain approval for specialized diagnostic testing.
1c Healthcare Operations: We may use or disclose, as-needed, your
protected health information in order to support the operationalactivities
of your physician’s practice. For example, In our efforts to deliver the highest
standards of care we may use your information in our quality assurance programs.
We will share your protected health information with third party“business associates”
that perform various activities (e.g.,billing, transcription services) for the practice.
1d Others Involved in Your Healthcare: With your approval, we may
disclose to a member of your family, or any other person you identify,
your protected health information that directly relates to that person’s
involvement in your health care.
1e Emergencies: We may use or disclose your protected health
information in an emergency treatment situation.
2. By law we may be required to disalocse your information:
In cases of audit investigations, health oversight, public health
activities .
For example: We may disclose your protected information, if authorized by law,
to a person who may have been exposed to a communicable disease or may
otherwise be at risk of contracting or spreading the disease .
Military Activity and National Security: When the appropriate
conditions apply, we may use or disclose protected health
information of individuals who are Armed Forces personnel for
activities deemed necessary by appropriate military command
authorities;
Workers’ Compensation: Your protected health information may be
disclosed by us as authorized to comply with workers’ compensation
laws .
Required Uses and Disclosures: Under the law, we must make
disclosures to you and when required by the Secretary of the
Department of Health and Human Services to investigate or determine
our compliance with the requirements of Section 164.500 et. seq.
3. Your Rights
You have the right to inspect and copy your protected health
information, however, you may not inspect or copy the
following records; psychotherapy notes; information compiled in
reasonable anticipation of, or use in, a civil, criminal, or
administrative action or proceeding, and protected health
information that is subject to law that prohibits access to
protected health information.
You have the right to request a restriction of your protected health
information. Your request must state the specific restriction
requested and to whom you want the restriction to apply.
Your physician is not required to agree to a restriction that you
may request if your request is contrary to law.
You have the right to request that our communication with you be confidential.
We will accommodate reasonable requests. You should be aware that some
requests may prevent payment by your insurance company, in which case you
may be responsible for payment.
You have the right to receive an accounting of disclosures
we have made. This right applies to disclosures for purposes
other than treatment, payment or healthcare operations. It
excludes disclosures we may have made to you, to family members
or friends involved in your care, or for notification purposes. You have the right to
receive specific information regarding these disclosures that
occurred after April 14, 2003.
3. Complaints
You may complain to us or to the Secretary of Health and Human
Services if you believe your privacy rights have been violated by
us. You may file a complaint with us by notifying our administrative
office of your complaint. We will not retaliate against you for
filing a complaint.
You may contact us at 212 355 8248
This notice was published and becomes effective on March 1st
2003