We Respect Your Privacy
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Uses & Disclosures of Health Information
We are committed to protecting the privacy of the information you provide to us regarding your health. Information regarding your health will be recorded and maintained in a record kept in our office. Information contained in that record may be used in your treatment (for example, copies of your medical information may be sent to the physician who referred you to your surgeon), obtaining payment for that treatment (for example, submitting a claim for payment to your insurance company), and for administrative purposes (for example, quality assurance and business planning purposes).
We may, under certain circumstances, use or disclose your medical information without your authorization. Subject to certain requirements, we may use or disclose your medical information for: public health purposes; health oversight activities; the report of suspected abuse or neglect; workers’ compensation purposes; research purposes; and for judicial and administrative proceedings. We may disclose your medical information when otherwise required by law, such as for law enforcement purposes under certain circumstances. Other uses or disclosures of your medical information will be made only with your written authorization. You may revoke a written authorization for the use or disclosure of your medical information at any time.
We reserve the right to change the terms of this notice at any time and to make the new notice provisions effective for all medical information that we maintain. We will post a copy of the current notice in our waiting room, which will include the effective date of the notice. You may also request a copy of the notice at any time by contacting the person listed below.
Your Rights Regarding Your Medical Information: In most cases, you have the right to inspect and receive a copy of the medical information used to make decisions about your care. We may charge you for a fee for copies of your medical information. You have the right to amend the medical information we have regarding you, if you believe that information is incorrect or incomplete. You also have the right to receive a list of the instances in which your medical information was disclosed for reasons other than treatment, payment, or our health care operations.
You have the right to request that we communicate with you regarding your medical information in a certain confidential manner, for example by mail sent to you directly.
You have the right to request in writing that we not use or disclose your medical information for treatment, payment, or our health care operations purposes, or to other persons involved in your care except when specifically authorized by you, except when required by law or in an emergency. We will consider your written request, but are not required to accept such a request.
To exercise any of your rights regarding your medical information, please contact the person listed below.
If you believe your privacy rights may have been violated, you may contact any of the below listed entities.
Stony Point Surgery Center
8700 Stony Point Parkway, Suite 100
Richmond, VA 23235
Center for Quality Health Care Services
& Consumer Protection
3600 Broad Street
Richmond, VA 23230
Office of the Medicare Beneficiary Ombudsman