Associates in General Surgery, LLC
Notice of Privacy Practices for Protected Health Information
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!
Our office is permitted by federal privacy laws to make uses and disclosures of your health information for
purposes of treatment, payment, and health care operations. Protected health information is the information we
create and obtain in providing our services to you. Such information may include documenting your symptoms,
examination and test results, diagnoses, treatment, and applying for future care or treatment. It also includes
billing documents for those services.
Examples of uses of your health information for treatment purposes are:
• A nurse or medical assistant obtains treatment information about you and records it in a health record.
• During the course of your treatment, the physician determines he/she will need to consult with another
specialist in the area. He/she will share the information with such specialist and obtain his/her input.
Example of use of your health information for payment purposes:
• We submit requests for payment to your health insurance company. The health insurance company or
business associate helping us obtain payment requests information from us regarding your medical care
given. We will provide information to them about you and the care given.
Example of Use of Your Information for Health Care Operations:
We may obtain services from business associates such as quality assessment, quality improvement, outcome
evaluation, protocol and clinical guidelines development, training programs, credentialing, medical review,
legal services, and insurance. We will share information about you with such business associates as
necessary to obtain these services.
Your Health Information Rights
The health and billing records we maintain are the physical property of the doctor’s office. You have