Augusta Surgery

Privacy Policy Notice of Augusta Surgery, Inc.

The Health Insurance Portability and Accountability Act of 1996 (HIPPA) is a federal program that requires all medical records and other individually identifiable health information used or disclosed by Augusta Surgery, Inc. in any form to be kept properly confidential. HIPPA gives the patient new rights to understand and control how health information is used.

We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.

Augusta Surgery, Inc. may use and disclose health records for each of the following purposes: treatment, payment, and health care operations. Treatment means providing coordinating, or managing health care and related services by one or more health care providers. Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. We may also create and distribute de-identified health information by removing all references to individually identifiable information. If a diagnosis of malignancy is made during your treatment by this office, personal identifying information will be submitted to the Virginia Cancer Registry as is legally required by Chapter 548 of the Code of Virginia. We may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you. Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer for Augusta Surgery, Inc. You may request restrictions on certain uses and disclosures of protected health information, including those related to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree in writing to remove it. You may request to receive confidential communications of protected health information from us by alternative means or at alternative locations. You may inspect, copy, and amend your protected health information. You may receive an accounting of disclosures or protected health information. You may obtain a paper copy of this notice from us upon request.

This notice is updated as of April 17, 2007. We are required to abide by the terms of the Privacy Policy Notice currently in effect. We reserve the right to change the terms of our policy and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of any revised Privacy Policy Notice from this office.

**If you feel that your privacy protections have been violated, you have the right to file a written complaint with our office at 16 Ivy Ridge Lane, Suite 130, Fishersville, VA 22939; (540) 332-5909 or with the Department of Health, PO Box 2448, Richmond, VA 23218; (804) 367-2104.

Modified 4/17