1660 South Alma School Road ▪ Suite 125
Mesa, AZ 85210
P 480.669.6452 ▪ F 888.977.3601
LEGAL - PRIVACY l COPYRIGHT © 2017 l DR. NLGD LLC. ALL RIGHTS RESERVED.
LEGAL – PRIVACY
Monday thru Friday 10:00 am - 3:00 pm
Saturday & Sunday Closed
Healthcare Practice 'Providing High Quality Cost-Effective Healthcare To All'
Our Commitment to Your Privacy
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. To improve the efficiency and effectiveness of
DR. NLGD LLC Healthcare Practice, we recognize and abide by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191.
Please review the following information carefully.
Under federal privacy regulations, your medical record is protected from disclosure and you are granted certain rights to control how your specific health information is used. Protected health information means any health information used to identify you. This notice will describe your rights and our duties with respect to your medical information. The term ‘you(r)’ refers to the person receiving the care or services from DR. NLGD LLC Healthcare Practice.
The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral. The Security Rule is a Federal law that requires security for health information in electronic form.
How We May Use and Disclose Medical Information About You:
We may use and disclose medical information about you to provide, coordinate or manage your health care and related service needs. We may disclose medical information about you to doctors, licensed and unlicensed personnel, hospitals and other health care providers who become involved in your care. For example, we may provide nursing for the client on a ventilator, therapy for a client after surgery, personal care services for individuals in a retirement community or diagnostic test and medical equipment for the stroke client.
Medical information may be used and disclosed so we can be paid for the services we provide to you. This can include billing your insurance company, or third party payors. For example, we may need to provide your insurance company or a government program, such as Medicare, information about your medical condition and the services you need to determine if you are covered by that insurance or program.
For Health Care Operations
We may use and disclose medical information about you for our health care operations. Your medical information may be used to review the services we provide and evaluate the performance of our employees caring for you. These are necessary to maintain quality health care for our patients.
Health Oversight Activities
We may disclose medical information about you to a health oversight agency for activities including audits, inspections and licensure activities. These activities are necessary for entities subject to government regulations.
Right to Review, Copy and Amend
You are entitled to review the contents of your medical record and you have the right to make a written request that your medical rrecord be amended or altered. You also are entitled to a copy of all or part of the record although a fee may be charged for providing that to you. We may deny your request, if that occurs you can follow the agency complaint procedure to have the denial reviewed.
To learn more, visit www.hhs.gov/ocr/privacy/