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.

Our Pledge

Allen Kamrava, MD MBA Inc. is committed to protecting the privacy of your protected health information ("PHI"). We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.

How We May Use and Disclose Your PHI

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your medical care, including consultation with and referral to other providers.

Payment

We may use and disclose your PHI to obtain payment for services, including verifying coverage, submitting claims, and collecting outstanding balances.

Healthcare Operations

We may use and disclose your PHI to operate our practice, including quality assessment, staff training, credentialing, audits, and business management.

Other Permitted Uses and Disclosures

• Appointment reminders, treatment alternatives, and health-related benefits.
• Individuals involved in your care or payment for your care (with your agreement when feasible).
• Public health activities and reporting required by law.
• Health oversight activities, judicial and administrative proceedings.
• Law enforcement, coroners, medical examiners, and funeral directors.
• Organ and tissue donation, research conducted under approved protocols.
• To avert a serious threat to health or safety.
• Workers' compensation, military and veterans, and national security activities as authorized.

Uses Requiring Your Written Authorization

The following uses and disclosures require your written authorization: most uses and disclosures of psychotherapy notes, marketing communications, and any sale of PHI. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Your Rights

• Inspect and copy your medical and billing records, in most cases.
• Request an amendment if you believe your PHI is incorrect or incomplete.
• An accounting of certain disclosures we have made of your PHI.
• Request restrictions on certain uses and disclosures (we are not required to agree, except for disclosures to a health plan when you have paid out-of-pocket in full).
• Request confidential communications by alternative means or at alternative locations.
• A paper copy of this Notice on request, even if you have agreed to receive it electronically.
• Be notified following a breach of your unsecured PHI.

Our Duties

We are required to maintain the privacy of your PHI, abide by the terms of this Notice currently in effect, notify you in the event of a breach of unsecured PHI, and notify you if we cannot agree to a requested restriction.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for all PHI we maintain. The current Notice will be posted in our office and on this website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, or by calling 1-877-696-6775. You will not be retaliated against for filing a complaint.