Clinic of Welsh
in collaboration with Dr. Amanda LaCombe
THE CLINIC OF WELSH, LLC
NOTICE OF PRIVACY PRACTICES
Effective date 05/01/08
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO INFORMATION. PLEASE REVIEW IT CAREFULLY.
THE CLINIC OF WELSH, LLC’S LEGAL DUTY
THE CLINIC OF WELSH, LLC is required by law to protect the privacy of your personal health information, provide this notice about our information practices and follow the information practices that are described herein.
USES AND DISCLOSURES OF HEALTH INFORAMTION
THE CLINIC OF WELSH, LLC uses your personal health information primarily for treatment; obtaining payment for treatment; conduction internal administrative activities and evaluation the quality of care that we provide. For example, THE CLINC OF WELSH, LLC may use your personal health information to contact you to provide appointment reminders, or information about treatment alternatives or other health related benefits that could be of interest to you.
THE CLINIC OF WELSH, LLC may also use or disclose your personal health information without prior authorization for auditing purposes and for emergencies. We also provide information when required by law.
In any other situation, THE CLINIC OF WELSH, LLC policy is to obtain your written authorization before disclosing your personal health information. If you provide us with a written authorization to release your information for any reason, you may later revoke that authorization to stop future disclosures at any time.
THE CLINIC OF WELSH, LLC may change its policy at any time. When changes are made, a new Notice Information Practices will be posted in the waiting room and patient exam areas and will be provided to you on your next visit. You may also request and updated copy of our Notice of Information Practices at any time.
PATIENT’S INDIVIDUAL RIGHTS
You have the right to review or obtain a copy of your personal health information at any time. You have the right to request that we correct any inaccurate or incomplete information in your records. You also have the right to request a list of instances where we have disclosed your health information for reasons other that treatment, payment or other related administrative purposes.
You may also request in writing that we not use or disclose your health information for treatment, payment and administrative purposes except when specifically authorized by you, when required by law or in emergency circumstances. THE CLINIC OF WELSH, LLC will consider all such request on a case by case basis, but the practice is not legally required to accept them.
CONCERNS AND COMPLAINTS
If your are concerned that THE CLINIC OF WELSH, LLC may have violated your privacy right or if you disagree with any decisions we have made regarding access or disclosure of your personal health information, please contact our practice manager at the address list below. You may also send a written complaint to the US Department of Health and Human Services. For further information on THE CLINIC OF WELSH, LLC health information practices or if you have a complaint, please contact the following person:
THE CLINIC OF WELSH, LLC
708 E Russell
Welsh, LA 70591