Effective Date: September 3, 2013
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. If you have any questions about this notice, please contact Jeffrey S. Liva M.D., M.P.H.,M.S..
Who will follow this notice?
This notice describes our practice’s privacy practices and that of:
Our pledge regarding medical information
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at our office. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by our office.
This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
How we may use and disclose medical information about you
The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. You may revoke such permission at any time by writing to our practice Privacy Officer.
We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to the practice’s office personnel who are involved in taking care of you at the office or elsewhere. We also may disclose medical information about you to people outside our office who may be involved in your care after you leave the office, such as family members or others we use to provide services that are part of your care, provided you have consented to such disclosure. These entities include third-party physicians, hospitals, nursing homes, pharmacies, and clinical laboratories with whom the office consults or makes referrals.
We may use and disclose medical information about you so that the treatment and services you receive at our office may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about procedures you received at the office so your health plan will pay us or reimburse you for the services. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
For health care operations
We may use and disclose medical information about you for medical office operations. These uses and disclosures are necessary to run our office and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what additional services the office should offer, what services are not needed, and whether certain new treatments are effective. We may also create and distribute de-identifiable health information by removing all references to individually identifiable information. We may also disclose information to our physicians, staff, and other office personnel for review and learning purposes.
We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the office.
We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-related benefits and services
We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
Individuals involved in your care or payment for your care
As required by law
To avert a serious threat to health or safety
Health oversight activities
We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
As required by law
To avert a serious threat to health or safety
Organ and tissue donation
Military & veterans
Public health risks
Data breach notification purposes
Lawsuits & disputes
We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the office to funeral directors as necessary to perform their duties.
National security & intelligence activities
Protective services for the president and others
Inmates or individuals in custody
Individuals Involved in Your Care or Payment for Your Care
Right to inspect and copy
Right to an electronic copy of electronic medical records
Right to get notice of a breach
Right to amend
If you feel that medical information, we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, your request must be made in writing and submitted to Jeffrey S. Liva M.D., M.P.H.,M.S. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
Was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you.
To request this list or accounting of disclosures, you must submit your request in writing to Jeffrey S. Liva M.D.,M.P.H.,M.S. Your request must state a time period, which may not be longer than 6 years. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to request restrictions
Right to request confidential communications
Right to a paper copy of this notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
You may obtain a copy of this notice at our Web site, www.preventive.com.
To obtain a paper copy of this notice, Contact:
Jeffrey S. Liva M.D., M.P.H., M.S.
Privacy Officer Preventive Plus, P.A.
1 West Ridgewood Avenue, Paramus, NJ 07652
Changes to this notice
Your written authorization is required for other uses and disclosures
Any personal information you provide us with via our website, including your e-mail address, will never be sold, or rented to any third party without your express permission. If you provide us with any personal or contact information in order to receive anything from us, we may collect and store that personal data. We do not automatically collect your personal e-mail address simply because you visit our site. In some instances, we may partner with a third party to provide services such as newsletters, surveys to improve our services, health, or company updates, and in such case, we may need to provide your contact information to said third parties. This information, however, will only be provided to these third-party partners specifically for these communications, and the third party will not use your information for any other reason. While we may track the volume of visitors on specific pages of our website and download information from specific pages, these numbers are only used in aggregate and without any personal information. This demographic information may be shared with our partners, but it is not linked to any personal information that can identify you or any visitor to our site.