Disclosure of Your Health Care Information

Treatment

We may disclose your health care information to other health care professionals within our practices for the purpose of treatment, payment or healthcare operations. (example)

"On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with Robert E. Emig D.C. PLLC."

"It is our policy to provide a substitute health care provider, authorized by Robert E. Emig D.C. PLLC to provide assessment and/or treatment to our patients, without advanced notice, in the event of your primary healthcare provider's absence due to vacation, sickness, or other emergency situation."

Payment

We may disclose your health information to your insurance provider for the purpose of payment or healthcare operations. (example)

"As a courtesy to our patients, we will submit an itemized billing statement to your insurance carrier for the purpose of payment to Robert E. Emig D.C. PLLC for health care services rendered. If you pay for your health care services personally, we will, as a courtesy, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you. The billing statement contains medical information, including diagnosis, date of injury or condition, and codes which describe the health care services received."

Workers' Compensation

We may disclose your health information as necessary to comply with State Workers' Compensation Laws.

Emergencies

We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or of your death.

Public Health

As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Marketing

We may contact you for marketing purposes or fundraising purposes, as described below: (Example)

"As a courtesy to our patients, it is our policy to call your home on the evening prior to your scheduled appointment to remind you of your appointment time. If you are not home, we leave a reminder message on your answering machine or with the person answering the phone. No personal health information will be disclosed during this recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment."

"We will include just your name in our newsletter and also on our "Welcome board" in the office waiting room, to welcome you to our office, or to announce something special in your life. Also we will include your name on our "thank-you" board for referring a patient to you office."

Your Health Information Rights

You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that Robert E. Emig D.C. PLLC is not required to agree to the restriction that you requested.

You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.

You have the right to request that Robert E. Emig D.C. PLLC amend your protected health information. Pleased be advised, however, that Robert E. Emig D.C. PLLC is not required to agree to amend your protected health information. If your request is amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial.

You have the right to receive an accounting of disclosures of your protected health information made by Robert E. Emig D.C. PLLC.

You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.

Changes to this Notice of Privacy Practices

Robert E. Emig D.C. PLLC reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, Robert E. Emig D.C. PLLC is required by law to comply with this Notice.

Complaints

Complaints about your Privacy rights, or how Robert E. Emig D.C. PLLC has handled your health information should be directed to Karen Emig by calling this office at 502-964-9814. If Karen Emig is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.

If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to: