Notice of Health Information 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.

Understanding Your Health Record/Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

  • basis for planning your care and treatment
  • means of communication among the many health professionals who contribute to your care
  • legal document describing the care you received
  • means by which you or a third-party payer can verify that services billed were actually provided
  • a tool in educating health professionals
  • a source of data for medical research
  • a source of information for public health officials charged with improving the health of the nation
  • a source of data for facility planning and marketing
  • a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve
  • Understanding what is in your record and how your health information is used helps you to:
    o ensure its accuracy
    o better understand who, what, when, where, and why others may access your health information
    o make more informed decisions when authorizing disclosure to others


Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that
compiled it, the information belongs to you.

You have the right to:

  • request a restriction on certain uses and disclosures of your information as provided by 45
    CFR 164.522
  • obtain a paper copy of the notice of information practices upon request
  • inspect and obtain a copy of your health record as provided for in 45 CFR 164.524. (We may charge you a fee for the cost of copying, mailing, or other supplies used in fulfilling your request.)
  • amend your health record as provided in 45 CFR 164.528
  • obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528
  • request communications of your health information by alternative means or at alternative locations
  • revoke your authorization to use or disclose health information except to the extent that action has already been taken

Our Responsibilities

This organization is required to:

  • maintain the privacy of your health information
  • provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
  • abide by the terms of this notice
  • notify you if we are unable to agree to a requested restriction
  • accommodate reasonable requests you may have to communicate health information by alternative means or at alternative location

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you’ve supplied us. We will not use or disclose your health information without your authorization, except as described in this notice.

If you have questions and would like additional information, you may contact the director of health information management at 714-986-3360.

If you believe your privacy rights have been violated, you can file a complaint with the Office Manager or with the secretary of Health and Human Services. There will be no retaliation for filing a complaint.

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. We will also disclose your health information to other physicians who may be treating you. Additionally, we may from time to - time disclose your health information to another physician who we have requested to be involved in your care, such as a specialist. We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used in rendering the service. We will use your health information for regular health operations.
For example: We will use and disclose your protected health information to support the business activities of our practice. We may use medical information about you to review and evaluate our treatment and services or to evaluate our staff’s performance while caring for you. In addition,
we may disclose your health information to third party business associates who perform billing, consulting, or transcription services for our practice.

Other Examples of Disclosure

Appointment Reminders: We will use and disclose health information to contact you as a reminder about scheduled appointments or
Others involved in your care: We will use and disclose your protected health information to a family member, relative, close friend, or any other person you identify that is involved in your medical care or payment related to your care.
Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Public health: As required by law, we may disclose your health information to public health or
legal authorities charged with preventing or controlling disease, injury, or disability.
Correctional institution: Should you be an inmate of a correctional institution, we may disclose
to the institution or agents thereof health information necessary for your health and the health
and safety of other individuals.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
Federal law makes provision for your health information to be released to an appropriate healthoversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.