HIPAA

NOTICE OF PRIVACY POLICY FOR PROTECTED
HEALTH INFORMATION (PHI)

The office of Valley ENT, P.C. is dedicated to protect your “nonpublic personal health information”. This notice is to tell you how and why we collect that information, and who has access to the information.

HOW WE COLLECT YOUR INFORMATION:

Your personal demographic information such as name, address, birth date, social security number and medical information is obtained from you. This is why we ask you to fill out the patient information sheet and why we ask for a copy of your insurance card. This ensures that the information we collect is correct.

If you came to our practice through a hospital encounter, we may obtain that information from the hospital. However, on your first visit to this office, we will ask you to fill out our information sheet to ensure that the information we received from the hospital was correct.

We may also ask a doctor or other health care provider who referred you to this practice to give us health information that will enable us to treat your medical condition. This benefits you in that we will have test results that have already been obtained by the referring entity.

WHY WE COLLECT THIS INFORMATION:

We collect this information so that we can treat your medical condition and obtain payment from you or your health insurance.

MAINTAINING ACCURATE AND TIMELY INFORMATION:

To ensure that the information we maintain is accurate, each time you visit this office you will be asked if any of your information needs to be updated.

WHO HAS ACCESS TO THIS INFORMATION:

Any person or persons you designate in writing, people directly involved in your medical care, people creating and maintaining your medical record, and those entities that need your information to process health care claims and obtain payment for our services have access to your Protected Health Information (PHI).

Entities such as Government Oversight Agencies, Judicial and Administrative Proceedings, Law Enforcement Agencies, Coroners and Medical Examiners, and Organ Procurement Organizations may obtain copies of your Protected Health Information (PHI). Law mandates the entities and this practice has no jurisdiction over such entities.

HOW WE PROTECT YOUR INFORMATION:

We release your information only to those people who need your information. We maintain physical, electronic, and procedural safeguards so that no one but persons in your healthcare or entities that need this information for claims processing have access to your Protected Health Information (PHI).

YOUR RIGHTS:

You have the right to inspect your Protected Healthcare Information (PHI). You also have the right to amend any errors you may find in your record (the physician is not required to make such amendments). You may file a statement of disagreement if your amendment is denied and require that the request for amendment and any denial be attached in all future disclosures of your Protected Healthcare Information (PHI).

If you leave this practice, your Protected Healthcare Information (PHI) will continue to receive the protection outlined in this notice.

COMPLAINTS/COMMENTS:

If you feel your privacy rights have been violated, you may file a written complaint at our office or you may contact the HIPAA compliance officer at (480) 614-5406. You may also file a complaint by mailing it to the Secretary of the Department of Health and Human Services at 200 Independence Avenue, S.W. Room 509F, HHH Building, Washington, D.C., 20201.

Back to Top