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PRIVACY POLICY (effective date: April 1, 2006)

Why am I receiving this notice? Dr. Chen's office is legally required to maintain the privacy of your health information and to inform you of your legal duties and privacy practices regarding your protected health information. This policy describes how medical information about you may be used and disclosed. It also describes how you can get access to this information. In the absence of an expressed statement to the contrary, this notice is not intended to preclude or restrict uses or disclosures of health information that are otherwise permitted by law, or to give you rights that Dr. Chen's office is not required by law to give you. Dr. Chen's office reserves the right to change the terms of this policy, and to make such new policy effective for all health information maintained. You will be provided with an updated copy at your next office visit should such material changes be made to this policy.

How is your health information used and disclosed? Dr. Chen's office maintains health-related records about you, including medical records, and payment information. This information is used and disclosed to others for the following purposes:

Treatment: Your health information is used to provide health care to you and to coordinate your health care with other providers such as in coordinating care with your primary care provider or when you are referred to other specialists. Their access to your health information will assist them in evaluating and treating you.

Contacting You: Dr. Chen's office may contact you to provide appointment reminders, test results, information regarding treatment options or other health-related services available to you.

Payment: At your request and with your permission, Dr. Chen's office may send information regarding your health care to your insurance carrier(s) if needed to help in your own submission of invoice for partial or total reimbursement for services provided by Dr. Chen.

Health Care Operations: Your health information is used and disclosed as necessary to allow Dr. Chen to operate her medical practice. Examples include use of payment invoices for internal financial accounting, and to review health records to ensure quality. In the event that outside contractors and agents are utilized to assist Dr. Chen's office in these operations, your health information may be disclosed. A confidentiality agreement will be obtained from these outside contractors and agents before such disclosures will take place.

Others Involved In Your Care: Dr. Chen's office may disclose medical information regarding you to a friend or family member who is involved in your care, to the extent judged necessary for their participation, unless you object.

Other Disclosures: Your health information may be disclosed without your authorization to government agencies and private individuals or organizations in a variety of circumstances in which Dr. Chen is required or authorized to do so by law. Listed below are examples of such circumstances:

  1. Disclosures required by state or federal law
  2. Disclosures to public health authorities or those in connection such authorities
  3. Dislcosures to government agencies authorized to receive reports of abuse or neglect of children or dependent adults, or domestic violence
  4. Disclosures to agencies responsible for overseeing the health care system, for audits, inspections or investigations
  5. Disclosures for judicial and administrative proceedings, such as lawsuits
  6. Disclosures to law enforcement agencies
  7. Disclosures to coroners and medical examiners
  8. Disclosures to organ procurement agencies, if you are an organ donor or a possible donor
  9. Disclosures to researchers conducting research under the auspices of an Institutional Review Board or privacy board
  10. Disclosures to avert a serious threat to health or safety
  11. Disclosures to your military command authority or to the Veterans' Administration to assist in determining your eligibility for veteran's benefit, if relevant to your status
  12. Disclosures to assist authorized federal officials in national security activities, or for the provision of protective services to officials
  13. Disclosures to the overseeing institution or official if you are an inmate of a correctional facility or under the custody of a law enforcement official
  14. Disclosures to other agencies administering government health benefit programs, as authorized or required by law
  15. Disclosures to comply with workers' compensation laws.

Limitations: In some circumstances, the disclosure of your health information may be restricted, such as a government health benefit program limiting the disclosure of your health information for purposes unrelated to the program. There are also special restrictions which Dr. Chen honors on the disclosure of health information regarding HIV/AIDS status, mental health treatment, drug and alcohol abuse treatment, and developmental disabilities.

Authorization: Dr. Chen will not permit other uses and disclosures of your health information without your written authorization except as described above. You may also revoke your written authorization at any time in writing.

What are my legal rights as a patient in Dr. Chen's practice? Below are general statements regarding your rights and are subject to all limitations permitted or required by law:

  1. You have the right to ask Dr. Chen's office to restrict certain uses and disclosures of your health information, but her office is not required to honor them.
  2. You have the right to receive confidential communication from Dr. Chen's office, such as through telephone, post office box, or other addresses.
  3. You have the right to see and copy any certain records maintained by Dr. Chen's office. These include medical records and billing invoices regarding you. Your request may be denied under certain circumstances, and Dr. Chen's office will provide you with the reason in writing. You have the right to appeal such a denial.
  4. You have the right to request an amendment to your records if you feel the information is wrong. Your request may be denied under certain circumstances, and Dr. Chen's office will provide you with the reason in writing. If your request is denied, you have the right to submit a statement for inclusion in the record.
  5. You have the right to receive a report of non-routine disclosures that has been made regarding your health information, up to six years prior to the date of your request (but not earlier than April 1, 2006). Dr. Chen's office does not maintain records of disclosures made with your authorization; disclosures made for the purposes of treatment, regarding payment for health services, or medical practice operations; disclosures made to you; and certain other disclosures.
  6. You have the right to request a paper copy of this policy if you have received it electronically.

How do I exercise these rights? You can exercise any of your rights by sending a written request to Dr. Chen's office at the address and phone numbers listed at the letterhead of this document.

How to file a complaint if my privacy rights are violated? You have the right to file a complaint with Dr. Chen's office if you believe your privacy rights have been violated. You must provide a written document addressed to Dr. Chen which specifically details and supports your complaint. You may also file a complaint with the Secretary of Health and Human Services, Office for Civil Rights at 50 United Nations Plaza, Room 322; San Francisco, CA 94102.