HIPAA PRIVACY NOTICE

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO YOUR MEDICAL INFORMATION.

This notice describes the practices of Nassau Queens Pulmonary Associates, P.C. in connection with the use and disclosure of your medical information and your rights and certain obligations we have regarding the use and disclosure of your medical information. It applies to the physicians and other health care professionals within our practice who are involved in your care and/or are authorized to enter information into your medical records, and all of our employees, and staff working in our offices. We are required by law to maintain the privacy of your medical information and to provide you with this Notice describing our privacy practices. We are required to abide by the terms of this Notice describing our privacy practices. We are required to abide by the terms of this Notice as it is modified from time to time. We are permitted or required to use your medical information for various purposes. We cannot describe every possible use or disclosure of your medical information in this Notice. However, uses or disclosures that we are permitted or required to make will generally fall within one of the following categories:

FOR TREATMENT
We may use and disclose medical information about you in order to ensure that you receive proper medical treatment. For example, we may disclose your health information to another physician or health care provider involved in your care.

FOR PAYMENT
We may use and disclose medical information about you so that we obtain payment for the treatment and services we provide to you, to an insurance company or another third party. For example, we may need to give your health insurance plan information about your diagnosis and a description of the care that we provided to you in order to receive payment for your care.

FOR HEALTH CARE OPERATIONS
We may use and disclose medical information about you for your health care operations, which are activities that are necessary to run our offices, maintain licensure, and to make sure that our patients receive quality care. For example, we may use your medical information to review our treatment of you and the services we provided and to evaluate the performance of our staff caring for you.

YOUR RIGHTS IN CONNECTION WITH YOUR MEDICAL INFORMATION

Right to Accounting
You may request an accounting which is a listing of the entities or persons to whom NQPA has disclosed your health information without your written authorization. The accounting would not include disclosures for treatment, payment, health care operations, and certain or other disclosures exempted by law. Your request for an accounting of disclosures must be in writing, signed and dated.

Right to Amend
If you feel that health information we have about you is incorrect or incomplete, you have the right to ask us to amend your medical records. Your request for an amendment must be in writing, signed and dated. It must specify the records you wish to amend and give your reason for the request.

Right to Inspect and Obtain Copy
You have the right to inspect and obtain a copy of your completed medical records unless your doctor believes that disclosure of that information to you could harm you. Your request to inspect or obtain a copy of the records must be submitted in writing, signed and dated to our medical records department. We may charge a fee for processing this request.

Right to Request Restrictions
You have the right to ask us to restrict the uses or disclosures we make of your health information for treatment, payment or health care operations, but we do not have to agree. You also may ask us to limit the health information that we use or disclose about you to someone who is involved in your care or the payment of your care, like a family member or friend. Again, we do not have to agree. A request for a restriction must be signed and dated and you should describe the information you want restricted, say whether you want to limit the use or the disclosure of information or both, and tell us who should not receive the restricted information. You must submit your request in writing to our office. We will notify you if we agree with your request or not. If we do not agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Right to Request Confidential Communications
You have the right to request that we communicate with you about your health care in a certain way. For example, you can ask that we only contact you at work or by mail. Your request for confidential communications must be in writing, signed and dated. You need not tell us the reason for the request and we will not ask. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time.

Complaints
If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the U.S. Department of Health and Human Services.

Changes to this Notice
Nassau Queens Pulmonary Associates reserves the right to change this notice at any time.