This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review carefully.
Information obtained by Eric Hartmann in his acupuncture practice or other members of his health care team will be recorded in your medical record and used to help decide what care may be right for you. We may also provide information to others providing you care. This will help them stay informed about you care.
Health plans and other payors need information from us about your medical care. Information from us to your payor may include your diagnoses, procedures performed, or recommended care.
We use your medical records to assess qualtiy and improve services. We may use and disclose medical records to review the qualifications and performance of our health care providers and to train the staff. We may contact you to remind you about appointments and give you information about treatment alternatives or other health-related benefits and services.
We may use and disclose your information to conduct or arrange for services including:
- Medical quality review by your health plan
- Accounting, legal, risk management, and insurance services
- Audit functions, including fraud and abuse detection and compliance programs
You have the right to ask us to restrict certain uses and disclosures. You must deliver this request in writing to us. We are not required to grant the request, but we will comply with any request granted.
You have the right to request that you be allowed to see and get a copy of your protected health information. You should make this request in writing. We have a form available for you for this type of request. A reasonable cost-based fee will be assessed for such records for the actual cost of copying, postage, and preparing the summary explanation.
You have the right to have us review a denial of access to your protected health information, except in certain circumstances. You have the right to ask us to change your health information; you should make this request in writing. If your request is denied, we will notify you of this fact in writing and you may write a statement of disagreement. It will be stored in your medical record and included with any release of your records.
You have the right to request a list of disclosures of your health information. The list will not include disclosures to third-party payors. You may receive this information without charge once every 12 months. We will notify you of the cost involved if you request this information more than once in 12 months.
You have the right to cancel prior authorizations to use or disclose health information by giving us a written revocation. Your revocation does not affect information that has already been released. It also does not affect any action taken before we have it. Sometimes, you cannot cancel an authorization if its purpose was to obtain insurance.
If you have questions, want more information, or want to report a problem about the handling of your protected health information, you may contact: Eric Hartmann, M.Ac. 206-769-6709.
If you believe your privacy rights have been violated, you may discuss your concerns with Eric Hartmann or any staff member. You may also deliver a written complaint to Eric Hartmann, M.Ac. at his acupuncture practice. You may also file a complaint with the U.S. Secretary of Health and Human Services.
We have the right to change our practices regarding the protected health information we maintain. If we make changes, we will update and amend this Notice of Privacy Practices. You may receive the most recent copy of the Notice by calling and asking for it.