HIPAA Notice of Privacy Practices
Your health information privacy rights and how we protect your medical data
Your Health Information Rights
You have the following rights regarding your protected health information (PHI):
- • Right to Request Restrictions: You may ask us to limit how we use or share your health information
- • Right to Access: You can request to see or get copies of your medical records
- • Right to Amend: You may request corrections to your health information
- • Right to Accounting: You can request a list of disclosures we have made
- • Right to Alternative Communication: You can request we communicate with you in a specific way
- • Right to File a Complaint: You may file complaints about our privacy practices
How We Use Your Health Information
We may use and disclose your health information for the following purposes:
Treatment
We use your health information to provide medical care, coordinate treatment with other providers, and manage your ongoing care.
Payment
We use your information for billing purposes, insurance claims, and to collect payment for services provided.
Healthcare Operations
We may use your information for quality assurance, staff training, business planning, and other operational activities.
When We May Share Your Information
We may share your health information without your written permission in these situations:
- • When required by law or legal process
- • For public health activities and safety
- • To prevent serious harm or threats
- • For law enforcement purposes when required
- • For military, national security, or government activities
- • For workers' compensation claims
- • For organ donation purposes
- • For research with proper authorization
Your Written Authorization Required
We will obtain your written authorization before using or disclosing your health information for:
- • Marketing purposes
- • Sale of your health information
- • Psychotherapy notes (if applicable)
- • Any purpose not described in this notice
- • Before and after photos for promotional use
You may revoke your authorization at any time by providing written notice to our practice.
Our Privacy Responsibilities
We are required by law to:
- • Keep your health information private and secure
- • Provide you with this notice of our privacy practices
- • Follow the terms of the current notice
- • Notify you if we cannot agree to a requested restriction
- • Notify you of any breaches of your unsecured health information
- • Train our staff on privacy practices
Security Measures
We protect your health information through:
- • Physical safeguards: Locked files, restricted access areas
- • Technical safeguards: Encrypted electronic systems, secure networks
- • Administrative safeguards: Staff training, access controls
- • Regular security assessments and updates
- • Business associate agreements with third parties
Breach Notification
In the event of a breach of your unsecured protected health information, we will notify you within 60 days of discovery. The notification will include information about what happened, what information was involved, what we are doing to investigate and address the breach, and steps you can take to protect yourself.
Changes to This Notice
We reserve the right to change our privacy practices and this notice at any time. Changes will apply to all health information we maintain. When changes are made, we will post the new notice in our office and on our website, and provide copies upon request.
Contact Information & Complaints
For questions about this notice or to exercise your rights, contact our Privacy Officer:
Dr. Elliott B. Lavey, MD
Privacy Officer
913 San Ramon Valley Blvd, Suite 288
Danville, CA 94526
Phone: (925) 820-3633
Email: LaveyMD@gmail.com
You may also file complaints with:
U.S. Department of Health and Human Services
Office for Civil Rights
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/
Important: We will not retaliate against you for filing a complaint about our privacy practices. You have the right to file complaints without fear of retribution.