Dear Valued Patient,
Your privacy is important. This notice describes my office policy for how medical information about you may be used and disclosed, how you can access this information, and how your privacy is protected.
In order to maintain the level of service that you expect from my office, I may need to share limited personal medical and financial information with your insurance company, worker’s compensation (as well as your employer, in this instance), or with other medical practitioners that you authorize.
Safeguards in place at my office include:
- Limited access to facilities where information is stored.
- Policies and procedures for handling information.
- Requirements for third parties to contractually comply with privacy laws.
- All medical files and records (including email, regular mail, telephone, and faxes sent) are kept on permanent file.
In administering your health care, I gather and maintain information that may include non-public personal information. Types of information that I gather and use include:
- Your financial transactions with me (billing transactions).
- Your medical history, treatment notes, all test results, and any letters, faxes, emails or telephone conversations to or from other health care practitioners.
- Information from health care providers, insurance companies, worker’s compensation, your employer, and other third party administrators (e.g. requests for medical records, claim payment information).
In certain states, you may be able to access and correct personal information we have collected about you, (information that can identify you - e.g. your name, address, social security number, etc.).
I value our relationship, and respect your right to privacy. If you have questions about my privacy guidelines, please call me during regular business hours at 971.322.8575.
Yours truly,
Julie M. Goss, L.Ac., MAcOM
Ageless-Acupuncture LLC