Uses and Disclosures

Treatment. Your health information may be used by Consultants for Lung Diseases- staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment.

Payment. Your health information may be used to seek payment from your health plan or other payors. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Health care operations. Your health information may be used as necessary to support the day-to-day activities and management of Consultants for Lung Diseases. For example, information on the services you received may be used to evaluate and promote quality.

Law enforcement. Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.

Public health reporting. Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state's public health department.

Other uses and disclosures require your authorization. Disclosure or use of your health information 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 revoke you're authorization In writing. 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 to revoke your authorization.

Additional Uses of Information

Appointment reminders. Your health information will be used by our staff to send you appointment reminders.

Information about treatments. Your health information may be used to send you information that you may find interesting on the treatment and management of your medical condition.. We may also send you information describing other health-related products and services that we believe may interest you.

Information for Family Members, Caregivers, or Friends. Unless you object, we may use or disclose your medical Information to notify a family member, a personal representative, or another person responsible for your care of your location, general condition, or death

Individual Rights

You have certain rights under the federal privacy standards. These include:

• The right to inspect and copy your medical information. However, Consultants for Lung Diseases may deny your request for certain specific reasons. If your request is denied, we will provide you with a written explanation for the denial and give you additional Information about your rights.
  
  
• The right to request additional confidentiality for protected health information when used by Consultants for Lung Diseases for the purposes of treatment, payment, or healthcare operations.
  • However, we have the right to approve or deny your request.
  • Additionally, if we approve your request, we have the right to terminate that agreement, provided we notify you in writing of our decision to do so.
    
    
• The right to request a correction or amendment to your health information. However, Consultants for Lung Diseases may deny your request for certain specific reasons. If your request is denied, we will provide you with a written explanation for the denial and give you additional Information about your rights.
  
  • The right to receive an accounting of the disclosures of your medical information made by Consultants for Lung Diseases in the six years prior to your request. This right begins on April 14, 2003 and applies to disclosures made on or after April 14, 2003. However, the following disclosures do not require an accounting under federal law:
  • Disclosures made for treatment, payment, or other healthcare operations purposes;
    Disclosures made to you;
  • Disclosures made in such a way that your identity was kept confidential by restricting the amount and type of information that was disclosed;
  • Disclosures made to health oversight agencies or law enforcement agencies if they provide us with a written statement that temporarily prevents us from making such an accounting;
  • Disclosures made for national security or intelligence purposes;
  • Disclosures made to correctional institutions or to law enforcement officials.
    
    
• The right to request a paper copy of this Notice of Privacy Practices for Protected Health Information.

Consultants for Lung Diseases 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.

Consultants for Lung Diseases 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. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all protected health information we maintain.

Requests to Inspect Protected Health Information

You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting Consultants for Lung Diseases or the Consultants for Lung Diseases Privacy Officer. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

Complaints

If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:

Earl Gomerg
Privacy Officer
Consultants for Lung Diseases
3808 Riverside Dr. Suite 403
Burbank, CA 91505

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.

You will not be penalized or otherwise retaliated against for filing a complaint. You can also file a complaint with the Federal Office of Civil Rights.

Contact Person

The name and address of the person you can contact for further information concerning our privacy practices is:

Earl Gomberg
Privacy Officer
Consultants for Lung Diseases
3808 Riverside Dr. Suite 403
Burbank, CA 91505

Effective Date

This Notice is effective on or after April 14, 2003.

(818) 842-1327 - Burbank and Glendale, California