NOTICE OF PRIVACY 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. 

Our commitment to your privacy: 

Our practice is dedicated to maintaining the privacy of your health information. We are required by law to do this. These laws are complicated, but we must provide you with important information. 

We will use this information about your health which we get from you or from others mainly to provide you with treatment which includes the communication within the EPPA Group team, to arrange payment for our services or for some other business activities which are called, in the law health care operations. After you have read this NPP, we will ask you to sign the bottom of our Consent and Authorization Form which includes consent to let us use and share your information for the reasons identified above. If you do not consent and sign this form, we cannot treat you. 

If we or you want to use or disclose (send, share, release) your information for any other purposes than identified above, we will discuss this with you and ask you to sign an Authorization to allow this. 

Of course, we will keep your health information private but there are some times when the laws require us to use or share it such as 

1. When there is a serious threat to your health and safety or the health and safety of another individual or the public. We will only share information with a person or organization that is able to help orient or reduce the threat. 

2. Some lawsuits and legal or court proceedings. Note: We must have a subpoena or court order to release your records without your consent. In all cases, we will contact you first to notify you of any requests for your records. 

3. If a law enforcement official requires us to do so in cases of an emergency or community security. 

4. We have to report suspected child abuse. There are some situations like these which don’t happen very often. 

Your rights regarding your health information: 

1. You can ask us to communicate with you about your health and related issues in a particular way or at a certain place. For example, you can ask us to call you at home and not at work to schedule or cancel an appointment. We will try our best to do as you ask. 

2. You have the right to ask us to limit what we tell certain individuals involved in your care or the payment for your care. We will not disclose information to family and friends without your written authorization to do so. We will honor your request except if it is against the law or in an emergency. 

3. You have the right to look at the health information we have about you such as your medical and billing records. You can even get a copy of these records, but we will charge you administrative and copy fees. Contact our Privacy Officer to arrange how to see your records. See information listed below. 

4. If you believe the information in your records is incorrect or incomplete, you can ask us to make some kinds of changes (called amending) to your health information. You have to make the request in writing and send it to our Privacy Officer. You must tell us the reasons you want to make the changes. 

5. You have the right to a copy of this notice. If we change this NPP we will post it in our offices, and you can always get a new copy of the NPP from the Privacy Officer. 

6. When we disclose information in your records, we keep some record of whom we sent it to, when we sent it and what was sent. You can get an accounting (a list) of many of these disclosures; however, you would have to be informed and must authorize any release of your records that do not relate to your treatment, payment or operations as described in the second paragraph of this notice. 

7. You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with our Privacy Officer and with the Secretary of the Department of Health and Human Services. All complaints must be in writing. Filing a complaint will not change the healthcare we provide to you in any way. 

If you have questions regarding this notice or our health information privacy policies, please contact our Privacy Officer, Tammie Scheurich, who can be reached by phone at 224-678-9180.