THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Coastal
Neurological Consultants, A Professional Corporation
is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide
our patients with notice of our legal duties and privacy practices with respect to your protected health information.
Disclosure of Your
Health Care Information
Treatment
We may disclose your health care information to other healthcare professionals within our practice for the purpose
of treatment, payment or healthcare operations. (examples)
“On occasion,
it may be necessary to seek consultation regarding your condition from other health care providers
associated with Coastal
Neurological Consultants, A Professional Corporation.”
“It is our policy to
provide a substitute health care provider, authorized by
Coastal Neurological Consultants, A Professional Corporation to provide assessment
and/or treatment to our patients, without advanced notice, in the event of your primary health care provider’s absence
due to vacation, sickness, or other emergency situation.”
Payment We may disclose
your health information to your insurance provider for the purpose of payment or health care operations.
Workers’ Compensation We may disclose your health information as necessary to comply with State Workers’ Compensation
Laws.
Emergencies
We may disclose your health information to notify or assist in notifying a family member, or another
person responsible for your care about your medical condition or in the event of an emergency or of your death.
Public Health As required by law, we may disclose your health information to public health authorities for purposes
related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic
violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting
disease or infection exposure.
Judicial and Administrative Proceedings We may disclose your health information in the course of any administrative or judicial proceeding.
Law Enforcement
We may disclose your health information to a law enforcement official
for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court
order or subpoena, and other law enforcement purposes.
Deceased Persons We may disclose
your health information to coroners or medical examiners.
Organ Donation We may disclose your health information to organizations
involved in procuring, banking, or transplanting organs and tissues.
Research We may disclose your health
information to researchers conducting research that has been approved by an Institutional Review Board.
Public Safety It may be necessary to disclose your health information to appropriate persons in order to prevent
or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.
Specialized Government
Agencies We may disclose your health information
for military, national security, prisoner and government benefits purposes.
Change of Ownership In the event that Coastal Neurological
Consultants, A Professional Corporation is sold or
merged with another organization, your health information/record will become the property of the new owner.
Your Health Information Rights
You
have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however,
that Coastal Neurological Consultants,
A Professional Corporation is not required
to agree to the restriction that you requested.
You have the right to have your health information received or communicated through
an alternative method or sent to an alternative location other than the usual method of
communication or delivery, upon your request.
You have the right to inspect and to obtain a copy your health information.
You have a right to request that Coastal Neurological Consultants, A Professional Corporation
amend your protected health information. Please be advised, however, that Coastal Neurological Consultants, A Professional Corporation is not required to agree to amend your protected health information. If your
request to amend your health information has been denied, you will be provided with an explanation
of our denial reason(s) and information about how you can disagree with the denial.
You have a right to receive an accounting of disclosures of your
protected health information made by Coastal
Neurological Consultants, A Professional Corporation.
You
have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
Changes to this Notice of Privacy Practices Coastal Neurological
Consultants, A Professional Corporation reserves the right to amend this Notice of Privacy Practices
at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment
is made, Coastal Neurological Consultants, A Professional Corporation
is required by law to comply with this Notice.
Coastal Neurological Consultants, A Professional Corporation is required by law to
maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with
respect to your health information. Please contact: Dr. Jeanette M Straga
by calling this office at 310-285-9700 if you have questions about any part of this notice or if you want more information
about your privacy rights. If Dr. Jeanette M Straga is not available, you may make an appointment with her, in person or by
telephone, for a personal conference within 5 working days.
Complaints Complaints about
your Privacy rights, or how Coastal Neurological Consultants, A Professional Corporation has
handled your health information should be directed to Dr. Jeanette M Straga by calling this office at 310-285-9700. If Dr.
Jeanette M Straga is not available, you may make an appointment with her, in person or by telephone, for a personal conference
within 5 working days.
If you are not satisfied with
the manner in which this office handles your complaint, you may submit a formal complaint to:
DHHS, Office of Civil Rights
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201