This document describes the type of information Tri-City Audiology (TCA) gathers about you, with whom that information may be shared, and the safeguards we have in place to protect it. You have the right to the confidentiality of your medical information and the right to approve or refuse the release of specific information except when the release is required by law.
As part of our routine operations, we create a record of the care and services you receive. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Tri-City Audiology, whether made by Tri-City Audiology personnel or your personal doctor.
Federal law requires us to:
-Make sure that medical information that identifies you is kept private
-Give you this notice of our legal duties and privacy practices with respect to medical information about you.
-Follow the terms of the notice that is currently in effect
How We May Use and Disclose Your Medical Information
The following categories describe different ways that we use and disclose medical information These uses and disclosures are necessary to run the facility and make sure that all of our patients receive quality care :
For Treatment. We may use information about you to provide you with treatment or services
For Payment. so that the treatment and services you receive at the facility may be billed to and payment may be collected from you, an insurance company, or a third party
Appointment Reminders
Treatment Alternatives
Health-Related Benefits and Services
To Avert a Serious Threat to Health or Safety
As Required By Law. We will disclose information about you when required to do so by federal, state or local law.
Special Disclosure Situations
Military and Veterans
Workers' Compensation
Public Health Risks
Lawsuits and Disputes
Law Enforcement
Health Oversight Activities
Your Rights
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy
Right to Amend
Right to an Accounting of Disclosures
Right to Request Restrictions
Right to Request Confidential Communications
These requests should be made in writing and submitted to Tri-City Audiology.
Right to a copy of this notice, which can be obtained in our offices.
We reserve the right to change this notice. Each time you return to our offices, we will offer you a copy of the current notice in effect.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with Tri-City Audiology or with the Secretary of the Department of Health and Human Services. To file a complaint with Tri-City Audiology, contact Kay Kochman, at 480-899-0076. All complaints must be submitted in writing.
