Privacy Policy
Jimmy Sayegh Chiropractic Corp. is required by law to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information. We are required to abide by the terms of this notice currently in effect. We reserve the right to change the terms of this notice at any time. Per your request, we will provide you with a revised Notice of Privacy Practices. We will not disclose your health information without your written authorization, except as described in this notice.
DISCLOSURE OF YOUR HEALTHCARE INFORMATION
Your Health Information Rights
Unless otherwise required by law, your health record is the physical property of Jimmy Sayegh Chiropractic Corp. You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that Jimmy Sayegh Chiropractic Corp. is not required to agree to the restriction that you request. You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request. You have the right to inspect and copy your health information. All requests for such procedures must be made in writing. You have the right to request Jimmy Sayegh Chiropractic Corp. amend your protected health information if you believe it is incorrect or incomplete. Please be advised, however, that Jimmy Sayegh Chiropractic Corp. is not required to agree to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial. You have a right to receive an accounting of disclosures of your protected health information made by Jimmy Sayegh Chiropractic Corp. You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
Treatment
Information obtained by your doctor will be recorded in your record and used to determine the course of treatment that is best for you. We may disclose your healthcare information to other healthcare professionals within our practice for the purpose of treatment, payment, or healthcare operations. (example)
On occasion, it may be necessary to seek consultation regarding your condition from other healthcare providers associated with Jimmy Sayegh Chiropractic Corp. It may be necessary to request records from other providers who have information or diagnostic testing pertaining to your health care.
It is our policy to provide a substitute healthcare provider, authorized by Jimmy Sayegh Chiropractic Corp., to provide assessment and/or treatment to our patients without advance notice in the event of your primary health care provider’s absence due to vacation, sickness, or other emergency situations.
Payment
We may disclose your health information to your insurance provider for the purpose of payment or healthcare operations.
As a courtesy to our patients, we will submit an itemized billing statement to your insurance carrier for the purpose of payment to Jimmy Sayegh Chiropractic Corp. for healthcare services rendered. If you pay for your healthcare services personally we will, as a courtesy and at your request, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you or provide you with proper documentation to bill you carrier personally. The billing statement contains medical information, including diagnosis, date of injury or condition, and codes which describe the health care services received. Billing statements will be mailed to the address provided. Unresolved collection issues will be placed with a collection agency.
Worker’s Compensation
We may disclose your health information as necessary to comply with State Worker’s Compensation Laws.
Emergencies
We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your health about your medical condition in the event of an emergency or your death.
Public Health
As required by law, we may disclose your health information to public health authorities for purposes related to preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
Judicial and Administrative Proceedings
We may disclose your health information in the course of any administrative or judicial proceedings.
Law Enforcement
We may disclose your health information to a law enforcement officer for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.
Deceased Persons
We may disclose your health information to coroners or medical examiners.
Organ Donation
We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.
Research
We may disclose your health information to researchers conducting research that has been approved by an institutional Review Board.
Specialized Government Agencies
We may disclose your health information for military, national security, prisoner and government benefits purposes.
Marketing
As a courtesy to our patients, we may call your home to remind you of your appointment or a missed appointment. We may also call to discuss your account. If you are not at home, we may leave a message on your answering machine or with the person answering the phone. No personal information will be disclosed during the recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment.
Faxing Medical information
I understand that risk is involved in faxing records and confidentiality at the receiving end cannot always be guaranteed. All faxed information will contain a confidentiality statement and instructions for returning misdirected information.
Change of Ownership
In the event that Jimmy Sayegh Chiropractic Corp. is sold or merged with another organization, your health information will become the property of the new owner.
Changes to this notice of Privacy Practices
This practice reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, this practice is required by law to comply with this notice.
If you have any questions about any part of this notice or if you want more information about your privacy rights, please contact our Privacy Officer at (909) 989-6980. You may make an appointment for a personal conference or telephone conference within 2 working days.
If you believe your privacy rights have been violated, you may file a written complaint to our Privacy Officer at the address listed below or to the Secretary of Health and Human Services. All complaints must be in writing and must be addressed to the Privacy Officer (in the case of complaints to us) or to the person designated by the U.S. Department of Health and Human Services if we cannot resolve your problems. More information is available about complaints at the government’s website, http://www.hhs.gov.ocr/hippa.
Please be assured that all staff at Jimmy Sayegh Chiropractic Corp. has always placed patient confidentiality and privacy as our top priority. We value your confidence and trust in our staff.
DISCLOSURE OF YOUR HEALTHCARE INFORMATION
Your Health Information Rights
Unless otherwise required by law, your health record is the physical property of Jimmy Sayegh Chiropractic Corp. You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that Jimmy Sayegh Chiropractic Corp. is not required to agree to the restriction that you request. You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request. You have the right to inspect and copy your health information. All requests for such procedures must be made in writing. You have the right to request Jimmy Sayegh Chiropractic Corp. amend your protected health information if you believe it is incorrect or incomplete. Please be advised, however, that Jimmy Sayegh Chiropractic Corp. is not required to agree to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial. You have a right to receive an accounting of disclosures of your protected health information made by Jimmy Sayegh Chiropractic Corp. You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
Treatment
Information obtained by your doctor will be recorded in your record and used to determine the course of treatment that is best for you. We may disclose your healthcare information to other healthcare professionals within our practice for the purpose of treatment, payment, or healthcare operations. (example)
On occasion, it may be necessary to seek consultation regarding your condition from other healthcare providers associated with Jimmy Sayegh Chiropractic Corp. It may be necessary to request records from other providers who have information or diagnostic testing pertaining to your health care.
It is our policy to provide a substitute healthcare provider, authorized by Jimmy Sayegh Chiropractic Corp., to provide assessment and/or treatment to our patients without advance notice in the event of your primary health care provider’s absence due to vacation, sickness, or other emergency situations.
Payment
We may disclose your health information to your insurance provider for the purpose of payment or healthcare operations.
As a courtesy to our patients, we will submit an itemized billing statement to your insurance carrier for the purpose of payment to Jimmy Sayegh Chiropractic Corp. for healthcare services rendered. If you pay for your healthcare services personally we will, as a courtesy and at your request, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you or provide you with proper documentation to bill you carrier personally. The billing statement contains medical information, including diagnosis, date of injury or condition, and codes which describe the health care services received. Billing statements will be mailed to the address provided. Unresolved collection issues will be placed with a collection agency.
Worker’s Compensation
We may disclose your health information as necessary to comply with State Worker’s Compensation Laws.
Emergencies
We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your health about your medical condition in the event of an emergency or your death.
Public Health
As required by law, we may disclose your health information to public health authorities for purposes related to preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
Judicial and Administrative Proceedings
We may disclose your health information in the course of any administrative or judicial proceedings.
Law Enforcement
We may disclose your health information to a law enforcement officer for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.
Deceased Persons
We may disclose your health information to coroners or medical examiners.
Organ Donation
We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.
Research
We may disclose your health information to researchers conducting research that has been approved by an institutional Review Board.
Specialized Government Agencies
We may disclose your health information for military, national security, prisoner and government benefits purposes.
Marketing
As a courtesy to our patients, we may call your home to remind you of your appointment or a missed appointment. We may also call to discuss your account. If you are not at home, we may leave a message on your answering machine or with the person answering the phone. No personal information will be disclosed during the recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment.
Faxing Medical information
I understand that risk is involved in faxing records and confidentiality at the receiving end cannot always be guaranteed. All faxed information will contain a confidentiality statement and instructions for returning misdirected information.
Change of Ownership
In the event that Jimmy Sayegh Chiropractic Corp. is sold or merged with another organization, your health information will become the property of the new owner.
Changes to this notice of Privacy Practices
This practice reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, this practice is required by law to comply with this notice.
If you have any questions about any part of this notice or if you want more information about your privacy rights, please contact our Privacy Officer at (909) 989-6980. You may make an appointment for a personal conference or telephone conference within 2 working days.
If you believe your privacy rights have been violated, you may file a written complaint to our Privacy Officer at the address listed below or to the Secretary of Health and Human Services. All complaints must be in writing and must be addressed to the Privacy Officer (in the case of complaints to us) or to the person designated by the U.S. Department of Health and Human Services if we cannot resolve your problems. More information is available about complaints at the government’s website, http://www.hhs.gov.ocr/hippa.
Please be assured that all staff at Jimmy Sayegh Chiropractic Corp. has always placed patient confidentiality and privacy as our top priority. We value your confidence and trust in our staff.