Weaverville Family Medicine Notice of Patient Information Practices

NOTICE OF PATIENT INFORMATION PRACTICES

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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO INFORMATION. PLEASE REVIEW IT CAREFULLY.

Uses and Disclosures of Health Information
Weaverville Family Medicine uses your personal health information primarily for treatment, obtaining payment for treatment, for administrative purposes, and evaluation of the quality of care that we provide. For example, Weaverville Family Medicine may use your personal health information to contact you to provide appointment reminders, or information about treatment alternatives or other health related benefits that could be of interest to you.

Weaverville Family Medicine may also use or disclose your personal health information without prior authorization for public health purposes, for auditing purposes, for research studies, and for emergencies. We also provide information when required by law, such as for law enforcement in specific instances.

In any other situation, Weaverville Family Medicine's policy is to obtain your written authorization before disclosing your personal health information. If you provide us with a written authorization to release your informaton for any reason, you may later revoke that authorization to stop future disclosures at any time.

Weaverville Family Medicine may change our policy at any time. When changes are made, a new Notice of Inforation Practices will be posted in the waiting room. You may also request an updated copy of our Notice of Information Practices at any time.

Patient's Individual Rights
In most cases, you have the right to review or obtain a copy of your personal health information at any time. If you request copies, we will charge you ten cents for each page, up to twenty dollars. You also have the right to request a list of instances where we have disclosed your personal health information for reasons other than treatment, payment, or other related administrative purposes. If you believe that information in your record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information.

You may request in writing that we not use or disclose your personal health information for treatment, payment and administrative purposes except when specifically authorized by you, when required by law, or in emergency circumstances. we will consider all such requests on a case by case basis, but the practice is not legally required to accept them.

Our Legal Duty
Weaverville Family Medicine is required by law to protect the privacy of your personal health information, provide this notice about our information practices, and follow the information practices that are described in this notice.

Concerns and Complaints
If you are concerned that Weaverville Family Medicine may have violated your privacy rights or if you disagree with any decisions we have made regarding access or disclosure of your personal health information, please contact our practice manager at the address listed below. You may also send a written complaint to the US Department of Health and Human Services. For further information on Weaverville Family Medicine's health information practices or if you have a complaint, please contact the following person:

Missy Ammons, Privacy Officer
P.O. Box 950, Weaverville, NC 28787
Telephone: (828) 645-3066 Fax: (828)658-1445

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