Notice of Privacy Practices Summary

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY. PLEASE SEE THE FRONT DESK AT YOUR APPOINTMENT TO RECEIVE A PRINTED VERSION OF OUR PRIVACY PRACTICES.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires all health care records and other individually identifiable health information used or disclosed to us in any form, whether electronically, on paper, or orally, to be kept confidential. This law gives patient significant new rights to understand and control how your health information is used. HIPAA provides penalties for the misuse of personal health information. In compliance with Federal Law, 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.

Without specific written authorization, we are permitted to use and disclose your health information for the purpose of treatment, payment and health care operations.

• Treatment means providing, coordinating, or managing health care or health related services with one or more subsequent healthcare providers to assist in your treatment.
• Payment means providing information to obtain reimbursement for healthcare services you receive. For example, we may disclose information when billing your insurance company to make reimbursement on your behalf.
• Operations means your information may be used to assess the care and outcomes in your case to improve the quality and effectiveness of the healthcare and service we provide including professional review and performance evaluation. This includes information requested by your employer for risk management auditing and benefit coordination.

We may use or disclose identifiable information about you without your authorization for several reasons. Subject to certain requirements, we may give out health information without your authorization for public health purposes, and auditing purposes. In the event of an emergency or your incapacity, we will use our professional judgment in disclosing only the protected health information necessary to facilitate needed care. We may use your protected health information for public health oversight, in response to a subpoena or court order, to military authorities, to federal officials for lawful intelligence, counterintelligence, and other national security activities, to correctional institutions or law enforcement officials; to report suspected abuse, neglect or domestic violence. Unless you request otherwise, we may use or disclose health information to a family member, friend or personal representative, to the extent necessary to help with your healthcare or with payment for your healthcare. Unless you request otherwise, we may use your confidential information to remind you of appointments by leaving messages at home and/or work. In any other situation, we will ask you for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses or disclosures.

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

• Request a restriction on certain uses and disclosures of your medical information about you for treatment, payment and healthcare operations. We must agree to your request if: (1) except as otherwise required by law, the disclosure is to a health plan for purpose of carrying out payment of healthcare operations (and is not for purposes of carrying out treatment); and (2) the medical information pertains solely to a healthcare item or service for which the healthcare provider involved has been paid out-of-pocket in full.
• Obtain a paper copy of the notice of privacy practices upon request.
• Access, inspect and obtain a copy of your health record, with limited exceptions. A reasonable fee may be assessed.
• Request to amend your health record. We may deny your request in certain situations.
• Obtain an accounting of disclosures of your health information made outside of treatment, payment, or health care operations…or based on your previous authorization.
• Request communications of your health information by alternative means at alternate locations or different methods.
• Revoke your authorizations to use or disclose health information except to the extent that action has already taken.

We are required to abide by the terms of the Notice of Privacy practices currently in effect. We reserve the right to change our policies at any time. Before we make a significant change in our policies, we will change our policies; we will change our notice and post the new notice in the waiting area. You can also request a copy of our notices at any time.

If you are concerned that we have violated your privacy rights, or you disagree with the decision we made about access to your records, you may contact the person listed below. You also may send a written compliant to the U.S. department of Health and Human services. The person listed below can provide you with the appropriate address upon request.

If you have any questions or complaints, please contact: 

Paul Granstrom

President                                                

1582, LLC                          

1855 N. McCarran Blvd                   .

Sparks, NV 89431                      

(775) 846-3413                        

For more information about HIPAA or to file a complaint:

The U.S. Department of Health & Human Services

Office of Civil Rights

200 Independence Avenue, S.W

Washington, D.C. 20201

(877) 696-6775 (Toll Free)