Notice of Privacy Practices
notice describes how medical information about you may
be used and disclosed and how you can get access to this
Promise to You, Our Patients
information is important and confidential. Our
ethics and policies require that your information be
held in strict confidence.
We maintain protocols
to ensure the security and confidentiality of your
personal information. We have physical security in
our building, passwords to protect databases, compliance
audits, and virus/intrusion detection software.
Within our practice, access to your information is
limited to those who need it to perform their jobs.
At the offices of
James R. Dettling, M.D., Ltd., we are committed to
treating and using protected health information about
the personal information we collect, and how and when we
use or disclose that information. It also
describes your rights as they relate to your protected
health information. This Notice is effective April
14, 2003, and applies to all protected health
information as defined by federal regulations.
Each time you visit
James R. Dettling, M.D., Ltd., a record of your visit is
made. Typically, this record contains your
symptoms, examination and test results, diagnoses,
treatment, and a plan for future care or
treatment. This information, often referred to as
your health or medical record serves as a:
- Basis for
planning your care and treatment,
- Means of
communication among the many health professionals
who contribute to your care,
- Legal document
describing the care you received
- Means by which
you or a third-party payer can verify that services
billed were actually provided,
- Tool in educating
- Source of data
for medical research,
- Source of
information for public health officials charged to
improve the health of the state and nation
- Source of data
for our planning and marketing, and
- Tool by which we
can assess and continually work to improve the care
we render and outcomes we achieve.
is in your record and how your health information is
used helps you to: ensure its accuracy; better
understand who, what, when, where, and why others may
access your health information; and make more informed
decisions when authorizing disclosure to others.
YOUR HEALTH INFORMATION
Although your health
record is the physical property of James R. Dettling,
M.D., Ltd., the information belongs to you. You have the
- Obtain a paper
copy of this notice of privacy policies upon
- Inspect and
obtain a copy of your health record as provided by
45 CFR 164.524 (reasonable copy fees apply in
accordance with state law),
- Amend your health
record as provided by 45 CFR 164.526,
- Obtain an
accounting of disclosures of your health information
as provided by 45 CFR 164.528.
confidential communications of your health
information as provided by 45 CFR 164.522(b), and
- Request a
restriction on certain uses and disclosures of your
information as provided by 45 CFR 164.522(a)
(however, we are not required by law to agree to a
Our practice is
- Maintain the
privacy of your health information,
- Provide you with
this notice as to our legal duties and privacy
practices with respect to information we collect and
maintain about you,
- Abide by the
terms of this notice,
- Notify you if we
are unable to agree to a requested restriction, and
reasonable requests you may have to communicate your
We reserve the right
to change our practices and to make the new provisions
effective for all protected health information we
maintain. We will keep a posted copy of the most current
notice in our facility containing the effective date in
the top, right-hand corner. In addition, each time you
visit our facility for treatment, you may obtain a copy
of the current notice in effect upon request.
We will not use or
disclose your health information in a manner other than
described in the section regarding Examples Of
Disclosures For Treatment, Payment, And Health
Operations, without your written authorization, which
you may revoke as provided by 45 CFR 164.508(b)(5),
except to the extent that action has already been taken.
FOR MORE INFORMATION OR
TO REPORT A PROBLEM
If you have questions
and would like additional information, you may contact
our practice's Privacy Officer, Ms. Dianne Sviderski, at
If you believe your
privacy rights have been violated, you can either file a
complaint with Ms. Dianne Sviderski, or with the Office for
Civil Rights, U.S. Department of Health and Human
Services (OCR). There will be no retaliation for filing
a complaint with either our practice or the OCR. The
address for the OCR regional office for Nevada is as
Office for Civil
U.S. Department of Health and Human Services
50 United Nations Plaza - Room 322
San Francisco, CA 94102
EXAMPLE OF DISCLOSURES
FOR TREATMENT, PAYMENT, AND HEALTH OPERATIONS
We will use your
health information for treatment.
We may provide medical information about you to health
care providers, our practice personnel, or third parties
who are involved in the provision, management, or
coordination of your care.
Information obtained by a nurse, physician, or other
member of your health care team will be recorded in
your record and used to determine the course of
treatment that should work best for you. Your medical
information will be shared among health care
professionals involved in your care.
We will also
provide your other physician(s) or subsequent health
care provider(s) (when applicable) with copies of
various reports that should assist them in treating
We will use your
health information for payment.
We may disclose your
information so that we can collect or make payment for
the health care services you receive.
If you participate in a health insurance plan, we will
disclose necessary information to that plan to obtain
payment for your care.
We will use your
health information for regular health operations.
We may disclose your health information for our routine
operations. These uses are necessary for certain
administrative, financial, legal, and quality
improvement activities that are necessary to run our
practice and support the core functions.
Members of the quality improvement team may use
information in your health record to assess the care
and outcomes in your case and others like it. This
information will then be used in an effort to
continually improve the quality and effectiveness of
the healthcare and service we provide and to reduce
We may disclose medical information to provide
appointment reminders (e.g., contacting you at the
phone number you have provided to us and leaving a
message as an appointment reminder).
Consistent with applicable law, we may disclose
health information to a coroner, medical examiner,
or funeral director.
We may disclose health information to the extent
authorized by and necessary to comply with laws
relating to workers compensation or other similar
programs established by law.
- Public Health
As required by law, we may disclose your health
information to public health or legal authorities
charged with preventing or controlling disease,
injury, or disability.
We may disclose information to researchers when
their research has been approved and the researcher
has obtained a required waiver from the
Institutional Review Board/Privacy Board, who has
reviewed the research proposal.
- Organ Procurement
Consistent with applicable law, we may disclose
health information to organ procurement
organizations or other entities engaged in the
procurement, banking, or transplantation of organs
for the purpose of donation and transplant.
- As Required By
We may disclose health information as required by
law. This may include reporting a crime, responding
to a court order, grand jury subpoena, warrant,
discovery request, or other legal process, or
complying with health oversight activities, such as
audits, investigations, and inspections, necessary
to ensure compliance with government regulations and
civil rights laws.
We may disclose health information for military and
veterans affairs or national security and
There are some services provided in our organization
through contacts with business associates. Some
examples are billing or transcription services we
may use. Due to the nature of business associates'
services, they must receive your health information
in order to perform the jobs we've asked them to do.
To protect your health information, however, when
these services are contracted we require the
business associate to appropriately safeguard your
We may contact you to provide information about
treatment alternatives or other health-related
benefits and services that may be of interest to you
(for example, to notify you of any new tests or
services we may be offering).
- Food And Drug
We may disclose to the FDA health information
relative to adverse events with respect to food,
supplements, product and product defects, or post
marketing surveillance information to enable product
recalls, repairs, or replacement.
We may use or disclose information to your personal
representative (person legally responsible for your
care and authorized to act on your behalf in making
decisions related to your health care).
- To Avert A
Serious Threat To Health/Safety
We may disclose your information when we believe in
good faith that this is necessary to prevent a
serious threat to your safety or that of another
person. This may include cases of abuse, neglect, or
Unless you object, health professionals,
using their best judgment, may disclose to a family
member or close personal friend health information
relevant to that person's involvement in your care
or payment related to your care. We may notify these
individuals of your location and general condition.
- Disaster Relief
Unless you object, we may disclose health
information about you to an organization assisting
in a disaster relief effort.
For all non-routine
operations, we will obtain your written authorization
before disclosing your personal information. In
addition, we take great care to safeguard your
information in every way that we can to minimize any
The Medical Management Institute®