Patient Privacy Policy

SUMMARY - NOTICE OF PRIVACY PRACTICES

THIS IS A SUMMARY OF OUR NOTICE OF PRIVACY PRACTICES, WHICH DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. WE HAVE ALSO MADE AVAILABLE TO YOU A FULL VERSION OF THE NOTICE.

Our pledge to protect your privacy:

The Dermatology Group is committed to protecting the privacy of your medical information. So that we can best meet your needs, we share your medical information with all the healthcare providers involved in your care. Only to the extent necessary, we also use and share your information to conduct our business operation, to collect payment for the services we provide to you and to comply with the laws that govern healthcare. We will not use or disclose your information for any other purpose without your permission.

You have the following rights to access and control your health information:

To inspect and obtain a copy of your medical and billing records, subject to local, state and/or federal laws; To request restrictions on certain uses or disclosures of your medical information; To request an accounting of The Dermatology Group disclosures of your medical information; To add an addendum to your medical record; To request that we communicate with you in a certain way or at a certain location; To receive a copy of the full version of our Notice of Privacy Practices.

Examples of how we may use and disclose your health information:

• To provide you with medical treatment and services
• To bill and receive payment for the treatment and services you receive
• For functions necessary to run our practice and to assure that our patients receive quality care
• To provide minimum necessary information to those associates who require information to perform their job tasks
• To support our research mission as an academic medical center with approval of the Privacy Board
• For workers' compensation or similar programs
• For required public health activities (e.g., reporting abuse or adverse reactions to medications)
• For healthcare oversight
• For law enforcement in certain limited circumstances
• To a coroner, medical examiner or funeral director as required by law
• For organ procurement or transplantation, if you are a potential donor

For further information about the full Notice, please contact: Antoinette Conwell at 513.770.4212