THE DOSE BALI
Notice of Privacy Practices
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.
Uses and Disclosures
TREATMENT. Your health information may be used by staff members for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment.
HEALTHCARE AND OPERATIONS. Your health information may be used as necessary to review and adjust the day-to-day activities and management of THE DOSE BALI. For example, information on the services you received may be used to support budgeting and financial reporting, fraud and abuse detection and compliance programs, and activities to evaluate and promote quality.
LAW ENFORCEMENT. Your health information may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections, to facilitate law-enforcement investigations, to comply with government mandated reporting and for other law enforcement purposes.
REQUIRED BY LAW. As required by law in certain circumstances other than public health reporting, your health information may be used and disclosed by our staff, but such use and disclosure will be limited to the relevant requirements of the law concerning such specific circumstances. For example, we may be required to disclose information in the course of an administrative or judicial proceeding. Further, in the case of a breach of unsecured protected health information, we will notify you as required by law.
Additional Uses of Information
Appointment reminders. Your health information will be used by our staff to send you appointment reminders.
Other uses and disclosures require your authorization.
Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.
THE DOSE BALI Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.
We also are required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visit. We will also prominently post the current notice on our website. The revised policies and practices will be applied to all protected health information that we maintain, regardless of when it was created or received.
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending us an email outlining your concerns.
If you believe that your privacy rights have been violated, you should call the matter to our attention by contacting the Compliance Officer by sending an email describing the cause of your concern to the address set forth below.
You will not be penalized or otherwise retaliated against for filing a complaint.
For further information concerning our privacy practices please contact:
The Compliance Officee: info[at]thedosebali.com (please replace [at] with @, thank you)
This notice is effective on October 1, 2015.
– See more at: https://www.thedose.com/terms-of-use