Patient Information

Privacy Policy

As required by law and as listed in this Policy, we will keep your medical information private and confidential and we will disclose the minimum necessary or required information to protect your privacy. Our current Policy will be posted in a prominent area of our office.

Medical Information That We May Disclose:

We will disclose your medical information in the following circumstances:

• To other health care providers that your doctor has referred you to for treatment/testing;
• To your insurance carrier to obtain authorization or payment;
• To health care organizations assessing the quality of your care that we have provided;
• To non-employee associates, such as transcription services, performing services on your behalf.

We may disclose your medical information as required by law, without your prior authorization, as follows:

• Health oversight audits or inspections
• Public Health agencies, research studies as required
• For organ donation
• For tracking of FDA regulated products
• In cases or abuse, neglect or domestic violence reporting
• For funeral arrangements
• Coroners or medical examiner services
• For Workers compensation purposes
• In case of emergencies
• To law enforcement or judicial agencies with valid administrative orders
• To our authorized representatives

WE WILL ASK FOR YOUR WRITTEN AUTHORIZATION BEFORE RELEASING ANY MEDICAL INFORMATION IN ALL OTHER CIRCUMSTANCES NOT MENTIONED IN THIS NOTICE. YOU CAN LATER REVOKE YOUR AUTHORIZATION BY NOTIFYING US IN WRITING.

Please note that we reserve the right to Call you or send appointment reminders.

Your Rights Regarding Medical Information:

• You have the right to look at your medical record, within a reasonable time, after sending your written request.
• You have the right to obtain a copy of your medical record, after submitting your written request. We have the right to charge you a reasonable fee to cover the retrieval, copying and mailing costs.
• You have the right to request that your doctor amends, corrects or adds information to your medical record, by submitting in writing the reason for requesting the changes. We reserve the right to deny your request if the information to be changed was not created by our doctors or if your doctor deems the record to be complete and accurate. If we deny your request for changes, you may submit a written request to review the denial.
• You have the right to request in writing a listing of all those instances where we may have disclosed your medical information, other than for treatment, payment, health care operations or where you specifically authorized a disclosure. The request must be received in writing and can only cover the period starting from April 14, 2003, for a maximum of six years. We have the right to charge you reasonable costs for retrieval and mailing of this information and will discuss this before you incur any costs.
• You have the right to request that medical information be communicated to you in a confidential manner, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to communicate with you.
• You may request in writing that your medical information not be disclosed for treatment, payment or healthcare operations, or to persons involved in your care except when specifically authorized by you, when required by law or in an emergency. We will consider your request but may not be able to accommodate you and we are not legally required to do so. We will inform you if we must deny your request.

Complaints:

If you have a complaint regarding the privacy of your medical information or confidentiality, you may contact our Privacy Officer as follows:

Pacific Coast Cardiac & Vascular Surgeons
Attention: Privacy Officer
2900 Whipple Avenue #210
Redwood City, CA 94062
Telephone: (650) 366-0225

Finally, you may also send a written complaint to the U.S. Department of Health and Human Services, Office of Civil Rights.