THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU WILL BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY!
This office is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. We will maintain the privacy of your health information as required by law. Such information may include documenting your symptoms, examinations, evaluating test results, diagnosing, medical treatment, and referrals for future care or treatment. It also includes billing documents for those services. We will provide you with a “Notice of Privacy Practices” outlining our duties and privacy practices concerning your health information and will abide by the terms of such notice. However, we reserve the right to amend, change, or eliminate any provisions in our privacy practices regarding protected health information allowed by law. If our information practices change, we will amend our Notice. You may receive the most recent copy by calling us at 907-562-6886 or by stopping at the office.
Treatment Purposes: We may obtain treatment information from you and record it in a health record. During the course of your treatment, the physician may determine that she will need to consult with another health care provider. She will share the information with this provider and obtain his/her input.
Payment Purposes: We submit requests for payment to your health insurance company. The health insurance company may request information from us regarding medical care given. We will provide information to them about you and the care given.
Health Care Operations: We obtain services from our business associates (information technology service providers, clearinghouses, collection agencies, and transcription services). We will share information about you with these business associates as necessary to obtain their services.
Communication with Family: Using our best judgment, we may disclose to a family member, other relative, or close personal friend (or any other person you may identify) health information relevant to their involvement in your care and for payment for such care if you do not object or in the case of an emergency.
Notification: Unless you object, we may use or disclose your protected health information to notify or assist in notifying a family member, personal representative, or any other persons responsible for your care about your location, your condition and/or your death.
Research: We may disclose information to researchers after their research has been approved by an institutional review board and has protocols in place to ensure the privacy of your protected health information.
Food and Drug Administration (FDA): We may disclose to the FDA your protected health information relating to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.
Workers Compensation: We may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.
Public Health: As authorized by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability; to report reactions to medications or problems with products; to notify people of recalls; to notify a person who may have been exposed to disease or who is at risk for contracting or spreading a disease or condition.
Abuse & Neglect: We may disclose your protected health information to public authorities as allowed by law to report abuse and/or neglect.
Law Enforcement, Judicial, and Administrative Proceedings: We may disclose your protected health information for law enforcement purposes or in the course of any judicial or administrative proceeding as allowed or required by law with your authorization or as directed by a proper court order.
For Specialized Government Functions: We may disclose your protected health information to governmental agencies such as those in charge of military personnel, national security, and/or public assistance.
Coroners, Medical Examiners, and Funeral Directors: We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary for them to carry out their duties.
Other Uses: Other uses and disclosures, besides those identified in this Notice, will be made only as otherwise required by law or with your written authorization and you may revoke the authorization in writing.
The health and billing records we maintain are the physical property of the office. The information in it belongs to you.
You Have the Right to Access Your Health Information: You have the right to inspect and copy your health record and billing record by delivering this request in writing to our office. You have the right to obtain a paper copy of the current “Notice of privacy Practices of Protected Health Information” by making a request to our office in person, by phone, or mail.
You Have the Right to Obtain an Accounting of Disclosures: You have the right to request a list of non-routine uses and disclosures of your health information by delivering a written request to our office. This list may include disclosures and uses required by law, made at your request, or with your permission.
You Have the Right to Restrict the Use of Your Records: You have the right to request that we place a restriction on the uses and disclosures of your health information by delivering the written request to our office. We are not required to grant your request; however, we will abide by any request granted.
You Have the Right to Request Amendments to Your Records: You have the right to request your health information be amended to correct incomplete or incorrect information by delivering a written request to our office. We may deny your request if you ask us to amend information that: was not created by us unless the person or entity that created the information is no longer available to make the amendment; is not part of the health information kept by or for the office; is not part of the information that you would be permitted to inspect and copy; is accurate and complete. If your request is denied, you will be informed of the reason for the denial and will have an opportunity to have a statement of disagreement placed in your chart.
You Have the Right to Revoke Authorizations: You have the right to revoke authorizations by delivering a written revocation to our office. This revocation will be in effect from the date received and will not affect information or action already taken.
You Have the Right to Alternative Communications: You have the right to request that communication of your health information be made by alternative means or at an alternative location (such as at work or by mail) or by delivering the request in writing to our office. The request must specify how and/or where you want to be contacted.
If you want to exercise any of the above rights, please contact Roxanne Laughlin at 907 562-6886, 3340 Providence Drive, Suite 363, Anchorage, Alaska 99508; in person or in writing, during regular business hours. She will inform you of the steps that need to be taken to exercise your rights.
If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact Roxanne Laughlin, Business Manager, at 907-562-6886. Also, if you believe your privacy rights have been violated, you may file a written complaint be delivering it to our office. You may also file a complaint by contacting, in writing, the United States Department of Health and Human Services (HHS). We cannot and will not require you to waive the right to file a complaint with HHS as a condition of receiving treatment from the office; furthermore, we cannot and will not retaliate against you by filing a complaint with the United States Department of Health and Human Services.
Anchorage and Kenai Peninsula Borough residents are invited to schedule a plastic surgery consultation with Dr. Sarah Troxel today.
Dr. Sarah Troxel
3340 Providence Dr. Ste 363
Anchorage, AK 99508