Notice of Privacy Practices
This notice describes how information about you
may be used or disclosed and how you can access to this information.
Please review it carefully.
East Care Acupuncture Clinic (a.k.a. East Care)
is committed to treating and using protected all patient information
responsibly. East Care is required by law to maintain the privacy
of confidential information and provide individuals with notice
or its legal duties and privacy practices.
Uses and Disclosures: Examples
of how East Care typically uses information include planning, documenting,
facilitating and providing treatment and in assessing patient progress.
We typically do not bill third party payers (e.
g. insurance companies), but provide you with a coded statement
to do so upon request. While we regret any inconvenience that this
procedure may bring you, it does reduce the need to handle and share
your personal information and also keeps the cost of care down for
everyone. In cases where we do contact third party payers, we do
so only with your written permission.
 Patient files may be reviewed in an audit process,
for example, to assure that continuing competency requirements are
being met to maintain State of Alaska acupuncture licensure.
East Care may also use information to notify a
family member or other person legally responsible for your care.
Examples of when East Care is permitted or required
to disclose or use confidential patient information without the
individual's written authorization include: for public health protection
or to avert serious threat to health or safety; in cases of abuse,
neglect or domestic violence; or, in certain judicial or administrative
proceedings.
Individual Rights: Although your
health record is the physical property of East Care, the information
also belongs to you. You have the right to request restrictions
on certain uses and disclosures of information; to revoke your authorization
to use or disclose health information except to the extent that
the action has already taken place; to receive confidential communications;
to obtain a copy of or inspect your health information; to request
amendment of protected health information; and to receive an accounting
of disclosures of protected health information.
East Care's Rights: With respect
to your rights to access and control your protected information,
East care's rights include: 30 days to comply with a request to
access or copy health information and the right to charge a fee
for copying if necessary or for translation from Chinese or English
if necessary; to record or remove any information that it deems
harmful to the patient or to another individual; to supervise the
patient during any review of medical records to prevent removal
or alteration of the record.
East Care is required to abide by the terms of
this notice and reserves the right to change the terms of this notice
and to make the new notice provisions effective for all confidential
information that it maintains.
Revisions to this notice will be posted in the
waiting room. Concerns may be communicated or complaints made directly
to East Care at the address or phone number indicated in this notice.
You may also contact the Secretary of the U. S. Department of Health
and Human Services at 200 Independence Avenue, S.W., Room 509F,
HHH Building, Washington DC 20201
Be assured that East Care's desire is to respect
and protect your privacy and provide you the best care possible.
Thank you.
April, 2003
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