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Effective Date of this Notice:  April, 2018

This notice describes how medical information about you may be used and disclosed at HOPE Group and how you can get access to this information. Please review it carefully.

Patient Rights

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record.

We will provide a copy or a summary of your health information, usually within 30 days of your request.

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete.

We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a       different address.

We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations.

We are not required to agree to your request, and we may say “no” if it would affect your care.

If you pay for a service out-of-pocket in full, you can ask us not to share that information for the purpose of payment or operations with your health insurer. We will say “yes” unless a law requires us to share it.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

We will include all the disclosures except for those about treatment, payment, and health care operations.

Get a copy of this privacy notice

You can ask for a paper copy of this notice, even if you previously received a copy.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

File a complaint if you feel your rights are violated

You can call our office at 480-610-6981 to make a complaint to our Compliance Office, Dione Sage if you feel we have violated your information rights. We will not retaliate for filing a complaint.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, or calling 1-877-696-6775.

For certain health information, you can tell us your choices about what we share

You have the right to share information with your family, close friends, or others involved in your care.

Our Uses and Disclosures

Treat you – We can use your health information and share it with other professionals who are treating you.

Run our organization – We use and share your health information to run our practice, provide appointment reminders, and follow-up quality of care. Bill for your services –We can use and share your health information to bill and get payment from health plans or other entities. Help with public health and safety issues –We can share health information about you for certain situations if required by law for public safety .Comply with the law-

We will share information about you if state or federal laws require it, law enforcement, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. Respond to lawsuits and legal actions-We can share health information about you in response to a court order or in response to a subpoena.

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