Independently Owned and Operated since 2004
Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED BY Sensenbrenner Primary Care AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

YOUR RIGHTS – When it comes to your health information you have certain rights. This section explains your rights.
Upon written request:

You may also:

OUR RESPONSIBILITIES – The law requires us to:

YOUR CHOICES – For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in situations described below, talk to us.
In the cases below you have both the right and the choice to tell us to:

If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.                                       

In the cases below we never share your information unless you give us written permission:

OUR USES AND DISCLOSURE 

We typically use or share your health information in the following ways:
Treatment: We can use your health information and share it with other professionals who are treating you. Example: we may share your health information to an outside doctor for a referral. We will also provide your health care providers with copies of various reports to assist them in your treatment.
Payment: We can use or share your health information to bill and get payment from health plans or other entities. Example: we give information about you to your health insurance plan so it will pay for your healthcare.
Health Care Operations: We can use and share your health information to run our practice, improve you care, and contact you when necessary. Example: we use health information about you to manage your treatment and services.
Other ways we can use or share your health information – We are allowed or required to share you information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

CHANGES TO THIS NOTICE 

We can change the terms of this notice, and the changes will apply to all the information we have about you. The new notice will be available upon request, in our office, and on our website.

Privacy Officer c/o Practice Manager
tsamson@sensenbrennerprimarycare.com
704-887-1101

Effective date: July 19, 2004                 Revision Date: March 20, 2018