Privacy Policy


Jun Xu, M.D.
Rehabilitation Medicine and Acupuncture Center
1171 E. Putnam Avenue
Riverside, Ct 06878

 

HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date (September 1, 2003)

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. If you have
any questions about this notice, please contact :
Jun Xu, M.D. at (203) 637-7720.
This notice describes the privacy practices at our office.

We are required by law to:

* Maintain the privacy of protected health information
* Give you this notice of our legal duties and privacy
practices regarding your health information
* Follow the terms of the notice currently in effect.

How we may use and disclose your health information

Described as follows are the ways we may use and disclose
your health information. Except for the following purposes
we will use and disclose your health information only with
your written permission. You may revoke such permission at
any time by writing to Jun Xu, M.D..

Treatment. We may use and disclose your health information
for your treatment and to provide you with treatment-
related health care services. For example, we may disclose
your health information to doctors, nurses, technicians,
or other personnel, including people outside our office,
who are involved in your medical care and need the
information to provide you with medical care.

Payment. We may use and disclose your health information
so that others or we may bill and receive payment from
you, an insurance company, or a third party for the
treatment and services you received. For example, we may
give information to your health plan so that they will pay
for your treatment.

Health Care Operations. We may use and disclose your
health information to evaluate and improve our medical
care and to operate and manage our office. For example, we
may use and disclose information to a peer review
organization or a health plan that is evaluating our care.
We may also share information with others that have a
relationship with you for their health care operation
activities.

Appointment Reminders, Treatment Alternatives, and Health-
Related Benefits and Services. We may use and disclose
your health information to contact you and remind you of
your appointment, to tell you about treatment alternatives
or health-related benefits and services you could use.

Individuals Involved in Your Care or Payment for Your
Care. When appropriate, we may share your health
information with a person involved in, or paying for, your
care (such as your family or a close friend). We may
notify your family about your location or condition or
disclose such information to an entity assisting in
disaster relief.

Research. We may use and disclose your health information
for research. For example, a research project may involve
comparing the health of patients who received one
treatment to those who received another for the same
condition. Before we do so, the project needs to go
through a special approval process. Even without special
approval, we may permit researchers to look at records to
help identify patients who may be included in their
research, as long as they do not remove or copy any of
your health information.

As Required by Law. We will disclose your health
information when required to do so by international,
federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use
and disclose your health information when necessary to
prevent a serious threat to the health and safety of you,
another person, or the public. Disclosures will be made
only to someone who can prevent the threat.

Business Associates. We may disclose your health
information to our business associates that perform
functions on our behalf or provide us with services if
necessary. For example, we may use another company to
perform billing services on our behalf. All of our
business associates are obligated to protect the privacy
of your information and are not allowed to use or disclose
the information for any other purpose than appears in
their contract with us.

Military and Veterans. If you are a member of the armed
forces, we may release your health information as required
by military command authorities. If you are a member of a
foreign military we may release your health information to
the foreign military command authority.

Worker’s Compensation. We may release your health
information for worker’s compensation or similar programs
that provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose your health
information for public health activities to prevent or
control disease, injury or disability. We may use your
health information in reporting births or deaths,
suspected child abuse or neglect, medication reactions or
product malfunctions or injuries, and product recall
notifications.

We may use your health information to notify someone who
may have been exposed to a disease or may be at risk for
contracting or spreading a disease or condition. If we are
concerned that a patient may have been a victim of abuse,
neglect, or domestic violence we may ask your permission
to make a disclosure to an appropriate government
authority. We will make that disclosure only when you
agree or when required or authorized to do so by law.

Health Oversight Activities. We may disclose your health
information to a health oversight agency for activities
authorized by law. These may include audits,
investigations, inspections, and licensure. These
activities are necessary to for the government to monitor
the health care system, government programs, and
compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or
dispute, we may disclose your health information in
response to a court or administrative order. We may
disclose your health information in response to a
subpoena, discovery request, or other lawful process by
someone else involved in the dispute, but only if efforts
have been made to tell you about the request or to obtain
an order protecting the information requested.

Law Enforcement. We may release your health information
request by law enforcement official if 1) there is a court
order, subpoena, warrant, summons or similar process; 2)
if the request is limited to information needed to
identify or locate a suspect, fugitive, material witness,
or missing person; 3) the information is about the victim
of a crime even if, under certain very limited
circumstances, we are unable to obtain your agreement; 4)
the information is about a death that may be the result of
criminal conduct; 5) the information is relevant to
criminal conduct on our premises; and 6) it is needed in
an emergency to report a crime, the location of a crime or
victims, or the identity, description, or location of the
person who may have committed the crime.

Coroners, Medical Examiners, and Funeral Directors. We may
release your health information to a coroner, medical
examiner, or funeral director to identify a deceased
person or cause of death, or other similar circumstance.

National Security and Intelligence Activities. We may
disclose your health information to authorized federal
officials for intelligence and other national security
activities authorized by law.

Inmates or Individuals in Custody. If you are an inmate of
a correctional institution or in custody we may disclose
your information 1) for the institution to provide you
with health care, 2) to protect your health and safety or
that of others, and 3) for the safety and security of the
institution.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

Right to Inspect and Copy. You have the right to inspect
and copy your medical and billing records by written
request to Jun Xu, M.D.

Right to Amend. You have the right to request an amendment
to your records by written request to Jun Xu, M.D.

Right to an Accounting Of Disclosures. You have a right to
an accounting of certain disclosures by written request to
Jun Xu, M.D.

Right to Request Restrictions. You have the right to
request restriction or limitation on your health
information used for treatment, payment or health care
operations. You may request us to limit disclosure to
someone involved in your care or in payment for your care
(such as a spouse) by written request to Jun Xu.
We are not required to agree with your request, but we
will try to comply.

Right to Request Confidential Communication. You have the
right to request that we communicate with you about
medical matters in a certain way or at a certain location.
You can ask, for example, that we contact you only by mail
or at work. Your written request must specify how or where
you wish to be contacted and be addressed to Jun Xu.
We will accommodate reasonable requests.

CHANGES TO THIS NOTICE

We may change this notice and make it effective for
medical information we already have about you as well as
new information. The current notice will be posted and
available at all times. You have a right to request a
paper copy of the current notice at any visit or by
written request to Jun Xu, M.D.

Jun Xu, M.D.
Rehabilitaion Medicine and Acupuncture center
1171 E Putnam Ave Bldg 2 1st Fl
Riverside, CT, 06878
(203) 637-7720

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