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Privacy and Your Protected Health Information

Dallas Neurosurgical and Spine Associates, P.A.
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.

Protecting your privacy
Protecting your privacy and your medical information (“Protected Health Information” or “PHI”) is at the core of our business. We recognize our obligation and duty by law to keep your PHI secure and confidential whether on paper or in electronic form. At Dallas Neurosurgical and Spine Associates, P.A. (hereinafter referred to as the “the Practice”), privacy is one of the highest priorities.

Providing you with this policy
We are required by law to provide you with this notice of our legal duties and privacy practices and are required to abide by the terms of the policy currently in effect. We, however, reserve the right to change the terms of this policy from time to time. We will provide you with notice of such changes by posting the most current policy online at our website as well as by mail, through the US Postal Service to the address we have for you on file. At any time, however, you have a right to request a paper copy of our current policy, even if you have agreed to receive such from us electronically.

Using your PHI
Maintaining the security of the medical and health information of our patients is one of our important responsibilities. We value your trust and will handle your PHI with care. Our employees access information about you, including PHI, when necessary to provide treatment, verify eligibility, obtain authorization, process payments, process claims, and perform healthcare operations. Such use will assist us with your treatment and the operations of our practice. We may also access information about you when considering a request from you or when exercising our rights under the law or any agreement with you. Any other uses and disclosures of your PHI will be made only with your written authorization, which you may subsequently revoke upon written request to us.

We may also contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

How and why information is shared
We limit who receives information from us and what type of information is shared.

Sharing information with the Practice. We may share your information, including PHI, within our company to deliver you the health care services and related information and education programs specified to your plan.

Sharing information with companies that work for us. To help us offer you our services, we may share certain information with companies that work for us, such as claim processing and mailing companies and companies that deliver health education and information directly to you. These companies act on our behalf and are obligated contractually to keep the information that we provide them confidential.

Other. Patient-specific personally identifiable data is released only when required to provide a service for you and only to those with need to know, or with your consent. Data is released with the condition that the person receiving the data will not release it further, unless you give permission.

If we receive a subpoena or similar legal process demanding release of any information about you, we will attempt to notify you (unless we are prohibited from doing so). Except as required by law or as described above, we do not share information with other parties, including government agencies.

The Practice does not share any patient information with third-party marketers who offer their products and services to our patients.

Your rights
With respect to the PHI that we maintain, you have the right to request restrictions on certain uses and disclosures of your PHI; however, the Practice may not be required to agree to such restriction. In addition, you have the right to receive confidential communications with respect to your PHI and the right to review and amend any inaccuracies or errors in your PHI. Finally, with respect to our disclosures of your PHI, you have a right to receive an accounting of such disclosures upon request to us.

Protecting your PHI
We safeguard PHI according to established security standards and procedures, and we will continue to employ such standards for protecting your PHI. Our employees are trained to understand and comply with these information principles.

Keeping information accurate
Keeping your information accurate and up-to-date is very important. If you believe that the information we have about you, including PHI, is incomplete, inaccurate or not current, please call or write us at the telephone numbers or addresses below. We will take appropriate action to correct any erroneous information as quickly as possible through a standard set of practices and procedures.

Violations of your privacy rights
If you believe that we have violated your privacy rights, please contact us immediately in writing at the address provided below and describe with specificity the acts or omissions that you believe to be in violation of your rights. In addition to contacting us, you may also file a complaint with the Office of the Secretary of the Department of Health and Human Services.

Contact us:
Dallas Neurosurgical and Spine Associates, P.A.
Attn: Gloria Cochran
8230 Walnut Hill Lane, #220
Dallas, Texas 75231
214-750-3646

Effective Date: July 28, 2010

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