Notice of Privacy Practices
How we may use and disclose your protected health information — and your rights.
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.
Effective date: PLACEHOLDER — Review with counsel.
Uses and Disclosures for Treatment, Payment, and Operations
We may use and disclose your protected health information (PHI) for the following purposes:
- Treatment: To coordinate your orthopedic care, imaging, physical therapy, and referrals.
- Payment: To bill and collect payment from insurance carriers, workers' compensation carriers, or you.
- Healthcare Operations: Quality assessment, staff training, and business planning.
Workers' Compensation & Medical-Legal Cases
When you are treated under a workers' compensation claim or when Dr. Levine has been retained as a Qualified Medical Evaluator (QME), Agreed Medical Evaluator (AME), Independent Medical Evaluator (IME), or expert witness, records may be disclosed to employers, insurers, attorneys, and adjudicative bodies as required by law and the applicable engagement.
Other Permitted Disclosures
- As required by law, including public health and safety reporting
- To coordinate with other treating providers
- In response to a valid court order, subpoena, or authorization
Your Rights
- Right to inspect and copy your PHI
- Right to request corrections
- Right to an accounting of disclosures
- Right to request restrictions on certain uses and disclosures
- Right to request confidential communications
- Right to receive a paper copy of this notice
- Right to file a complaint with us or with the U.S. Department of Health and Human Services
Our Duties
We are required by law to maintain the privacy of your PHI, provide you with this notice, and follow the terms of the notice currently in effect.
Contact — Privacy Officer
North County Orthopedic Medical Group
Attention: Privacy Officer
(858) 457-4040