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NOTICE OF PATIENT INFORMATION PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY
BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO INFORMATION. PLEASE
REVIEW IT CAREFULLY.
Speechcenter, Inc.'s LEGAL DUTY
Speechcenter, Inc. is required by law to protect the privacy of your
personal health information, provide this notice about our information
practices and follow the information practices that are described herein.
USES AND DISCLOSURES OF HEALTH INFORMATION
Speechcenter, Inc. uses your personal health information primarily for
treatment; obtaining payment for treatment, conducting internal
administrative activities and evaluating the quality of care that we
provide. For example, Speechcenter, Inc. may use your personal health
information to contact you to provide appointment reminders, or
information alternatives or other health related benefits that could be of
interest to you.
Speechcenter, Inc. may also use or disclose your personal health
information without prior authorization for public health purposes, for
auditing purposes, for research studies and for emergencies. We also
provide information when required by law.
In any other situation, Speechcenter Inc.'s policy is to obtain your
written authorization before disclosing your personal health information.
If you provide us with a written authorization to release your information
for any reason, you may later revoke that authorization to stop future
disclosures at any time.
Speechcenter, Inc. may change its policy at any time. When changes are
made, a new Notice of Information Practices will be posted in the waiting
room and patient exam areas and will be provided to you on your next
visit. You may also request an updated copy of our Notice of Information
Practices at any time.
PATIENT'S INDIVIDUAL RIGHTS
You have the right to review or obtain a copy of your personal health
information at any time. You have the right to request that we correct any
inaccurate or incomplete information in your records. You also have the
right to request a list of instances where we have disclosed your personal
health information for reasons other than treatment, payment or other
related administrative purposes.
You may also request in writing that we not use or disclose your personal
health information for treatment, payment and administrative purposes
except when specifically authorized by you, when required by law or in
emergency circumstances. Speechcenter, Inc. will consider all such
requests on a case by case basis, but the practice is not legally required
to accept them.
CONCERNS AND COMPLAINTS
If you are concerned that Speechcenter, Inc. may have violated your
privacy rights or if you disagree with any decisions we have made
regarding access or disclosure of your personal health information, please
contact our practice manager at the address listed below. You may also
send a written complaint to the US Department of Health and Human
Services. For further information on Speechcenter Inc.'s health
information practices or if you have a complaint, please contact the
following person: Jeri Bates, Vice President, COO, HIPAA Privacy and
Security Officer, Speechcenter, Inc., 185 Charlois Blvd., Winston-Salem,
NC 27103, Telephone: 1-336-725-0222 Fax: 1-336-725-0454
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