Health
and Recovery Institute of Central Florida
Hector
D. Barreto, MD, MPH
Notice
of Privacy Practices
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
Uses
and Disclosures
Treatment. Your health information
may be used by staff members or disclosed to other health care professionals for the purpose of evaluation your health, diagnosing
medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in
your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment. Your health information
may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit
card companies that you may use to pay for services. For example, your health plan may request and receive information on
dates of service, the services provided, and the medical condition being treated.
Health care operations. Your health
information may be used as necessary to support the day-to-day activities and management of Hector D. Barreto, MD, MPH and/or
the Health and Recovery Institute of Central Florida. For example, information on the services you received may be used to
support budgeting and financial reporting, and activities to evaluate and promote quality.
Law enforcement. Your health information
may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations,
and to comply with government mandated reporting.
Public health reporting. Your health
information may be disclosed to public health agencies as required by law. For example, we are required to report certain
communicable diseases to the state’s public health department.
Other uses and disclosures require
your authorization. Disclosure of your health information or its use for any purpose other than those listed above requires
your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you
may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or
undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.
Additional Uses of Information.
Appointment reminders. Your health
information may be used by our staff to send you appointment reminders via postcard or voice mail messages.
Information about treatments. Your
health information may be used to send you information that you may find interesting on the treatment and management of your
medical condition. We may also send you information describing other health-related products and services that we believe
may interest you.
Individual Rights.
You have certain rights under the federal privacy standards. These include:
- The right to request restrictions
on the use and disclosure of your protected health information.
- The right to receive confidential
communications concerning your medical condition and treatment.
- The right to inspect and copy
your protected health information.
- The right to amend or submit
corrections to your protected health information.
- The right to receive an accounting
of how and to whom your protected health information has been disclosed.
- The right to receive a printed
copy of this notice.
Our duties
We are required by law to maintain the privacy of your protected health information
and to provide you with this notice of privacy practices. We also are required to abide by the privacy policies and practices
that are outlined in this notice.
Right to Revise Privacy Practices.
As permitted by law, we reserve the right to amend or modify our privacy policies
and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations.
Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices
will be applied to all protected health information we maintain.
Request to Inspect Protected Health
Information.
You may generally inspect or copy the protected health information that we
maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be
submitted in writing. You may obtain a fom to request access to your records by contacting Hector D. Barreto, MD, MPH. Your request will be reviewed and will generally be approved unless there are legal or medical reasons
to deny the request.
Complaints.
If you would like to submit a complaint about our privacy practices, you can
do soy by sending a letter outlying your concerns to: Health and Recovery Institute
of Central Florida, 2205 E. Michigan Street, Orlando, FL
32806.
If you believe that your privacy rights have been violated, you should call
the matter to our attention by sending a letter describing the cause of your concern to the same address. You will not be
penalized or otherwise retaliated against for filing a complaint.
Contact Person.
The name and address of the person you can contact for further information
concerning our privacy practices is:
Hector D. Barreto, MD, MPH
2205 E. Michigan
Street
Orlando, FL 32806
Telephone 407-895-6846
Effective Date
This notice is effective on or after January
1, 2005.
