Notice of Privacy Practices
As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. This Notice of Privacy Practices describes how medical information about you may be used and disclosed. These Practices were designed to capture the true meaning of the HIPAA Laws in fact and in spirit. These Privacy Practices were originally written April 14, 2003, and last amended March 2, 2010.
Family Medicine of Gaithersburg, L.L.C., may use your health information in:
a. Treatment: We may use or disclose your health information to a physician, or other healthcare to provide treatment to you.
b. Payment: We may use or disclose your health information to obtain payment for services we provide you.
c. Health care operations: We may use or disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competency or qualifications of healthcare professionals, evaluating provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.
e. Other: Most other uses and disclosures of your information that don't fall under treatment, payment, or health care operations will require your written authorization, and you may revoke your authorization in writing at any time.
f. Special circumstances: There are some notable special circumstances that could require use of your information, these include:
Emergency Situations: In the event of your incapacity or an emergency situation, we may disclose health information to a family member, or another person responsible for your care, using our professional judgment. In an emergency situation, we would only disclose health information that is directly relevant to the person's involvement in your healthcare.
Required by Law: We may use or disclose your health information when required to by law.
Abuse or Neglect: We may use or disclose your health information to appropriate authorities if we reasonably believe that you are possibly a victim of abuse, neglect, or domestic violence, or the victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your, or other people's health or safety.
National Security: We may disclose the health information of Armed Forces personnel to military authorities under certain circumstances. We may disclose health information to authorized federal officials required for lawful intelligence, counterintelligence and other national security activities. We may disclose health information of inmates or patients to the appropriate authorities under certain circumstances.
Appointment Reminders: We may use or disclose your health information to provide you with appointment reminders via phone, e-mail, or letter.
Your Rights as a Patient:
- You have the right to restrict the disclosure of your protected health information in writing.
- You have the right to receive confidential communications regarding your protected health information.
- You have the right to a copy of your health information for a reasonable fee.
- You have the right to have your medical information amended if you believe that it is wrong, or, if information is missing, and Family Medicine of Gaithersburg, L.L.C. agrees. If Family Medicine of Gaithersburg, L.L.C., disagrees, you may have a statement of your disagreement added to your personal medical information.
- You have the right to receive a listing of disclosures of your protected health information. The listing will not include personal medical information about you that was disclosed at a part of Family Medicine of Gaithersburg, L.L.C.’s operations, or that which was given out for law enforcement purposes.
- You have the right to complain regarding the way your protected health information was handled.
- You may submit a complaint in writing to the Family Medicine of Gaithersburg, L.L.C., or you may call (301) 330 - 7644, and you will never be retaliated against in any manner for a complaint.
- You have the right to print a paper copy of this Notice of Privacy Practices.
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James Matthews, M.D.
