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DOCTORS BILLING CLERK^sm

SUMMARY OF NOTICE OF PRIVACY PRACTICES

This summary is provided to assist you in understanding our full Notice of Privacy Practices

The full Notice of Privacy Practices contains a detailed description of how our office will protect your health care information, your rights as a patient and our common practices in dealing with patient health information. Please refer to that Notice for further information.

Uses and Disclosures of Health Information. We will use and disclose your health information in order to obtain payment for services rendered to you by our Clients or to allow insurance companies to process insurance claims for services rendered to you. Finally, we may disclose your health information for certain operational activities such as quality assessment, licensing, accreditation and training of students.

Uses and Disclosures Based on Your Authorization. Except as stated in more detail in the Notice of Privacy Practices, we will not use or disclose your health information without your written authorization.

Uses and Disclosures Not Requiring Your Authorization. In the following circumstances, we may disclose your health information without your written authorization.

For certain limited research purposes;
To government agencies for purposes of their audits, investigations and other oversight activities;
To government authorities to prevent child abuse or domestic violence;
To law enforcement authorities to protect public safety or to assist in apprehending criminal offenders;
When required by court orders, search warrants, subpoenas and as otherwise required by law.

*Patient Rights. As a patient you have the following rights:

To have access to and /or a copy of your health information;
To receive an accounting of certain disclosures we have made of your health information;
To request restrictions as to how your health information is used or disclosed;
To request that we communicate with you in confidence;
To request that we amend your health information;
To receive notice of our privacy practices.

*Normally your requests will be made directly to you health care provider.

If you have a question, concern or complaint regarding our privacy practices, please refer to the full Notice of Privacy Practices for the person or persons whom you may contact.

Webmaster; Webmaster@DBClerk.com

09/11/2001 Never forget!