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This notice describes how
your health information may be used and
disclosed and how you can access this
information. Please review carefully. We are
required by law to provide you with this
notice that explains our privacy practices
with regard to your medical information and
how we may use and disclose your protected
health information or treatment, payment and
for health care operations, as well as for
other purposes that are permitted or
required by law. You have certain rights
regarding the privacy of our health
information an we also describe them in this
notice.
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The law permits us to use
or disclose your health information to
those involved in your treatment.
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We may use or disclose
your protected health information for
payment to obtain payment for the health
care services we provide you. We may
include information with a bill to a
third-party payer that identifies you,
your diagnosis, procedures performed and
supplies used in rendering services.
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We may use or disclose
your protected health information to
support the business activities of our
normal healthcare operations.
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We may share your medical
information with our business associates
such as a billing service. We have a
written contract with each business
associate that requires them to protect
your privacy.
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We will use and disclose
your protected health information to
contact you as a reminder about
scheduled appointments or treatments.
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We will use and disclose
your protected health information to
provide, coordinate, or manage your
health care and any related services. We
will also disclose your health
information to other physicians who may
be treating you.
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We will use and disclose
your protected health information to a
family member, a relative, or a close
friend, or any other person you identify
that is involved in your medical care of
payment for care.
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We will use and disclose
your protected health information when
required to by federal, state, or local
law. You will be notified of any such
disclosures.
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We will use and disclose
your protected health information to a
public health authority that is
permitted to collect or receive the
information for the purpose of
controlling diseases, injury, or
disability. If directed by that health
authority, we will also disclose your
health information to a foreign
government agency that is collaborating
with the public health authority.
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We will use and disclose
your protected health information for
worker's compensation or similar
programs that provide benefits for
work-related injuries or illness.
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You have the right to
receive a paper copy of this notice upon
your request.
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You have the right to
inspect and copy the protected health
information that we maintain about your
in our designated record set for as long
as we maintain that information. This
designated record set includes your
medical and billing records, as well as
any other records we use for making
decisions about you. Any psychotherapy
notes that may have been included in
records we received about you are not
available for your inspection or copying
by law. We may charge you a fee for the
costs of copying, mailing, or other
supplies used in fulfilling your
request.
If you wish to inspect or
copy your medical records information you
must submit your request in writing to our
Privacy Manager, c/o Westlake Gyn, 1250 La
Venta, #112, Westlake Village CA 91361. Upon
your request, we will have 30 days to
respond to your request for information that
we maintain at our practice. For any other
questions or additional information, please
call (805) 371-0770. Effective date: 4/14/03 |
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