This section describes your rights and the obligaton of this practice regarding the use and disclosure of your medical information. You have the following rights regarding medical information we maintain about you:
Your rights as a patient
- You have the right to considerate and respectful care
- You have the right to be well informed about your illness, possible treatments and likely outcomes and to discuss this with your doctor.
- You have the right to consent or refuse a treatment, as permitted by law, throughout your stay. If you refuse a recommended treatment, you will receive other needed an available care.
- You have the right to privacy. Athenix, your doctor and others caing for you will protect your privacy as much as possible.
- You have the right to expect that treatment records are confindential unless you have given permission to release information. When Athenix releases records to others, we emphasize that records are confidnetial.
- You have the right to review your medical records and to have the information explained.
- You have the right to know if Athenix has outside relationships with outside parties that may influence you treatment. These relationships may be with education institutions or other healthcare providers.
- You have the right to concent or decline to take part in research affecting your care. If you choose not to take part, you will receive the most effective care Athenix otherwise provides.
- You have the right to be told of realistic care alternatives.
- You have the right to know about Athenix rules that affect you and your treatment, and about charges and payments.
Your responsibilities as a patient
- You are responsible for providing information about your health, including past illnesses, hospital stays and use of alternative treatments
- You are responsible for asking questions when you do not understand information or instructions.
- You are responsible for telling your doctor if you believe you can't follow through with your treatment.
- You and your visitors are responsible for being considerate of the needs of other patients and staff
- You are responsible for providing information to arrange payment for your services at Athenix.
- You are responsible for recognizing the effect of your lifestyle on your personal health. Your health depends not just on our care, but in the long-term on the decisions you make in your daily life as well.
Right to Inspect and CopyYou have the right to inspect and copy medical information that may be used to make decisions about your care. This includes your own medical and billing records, but does not include psychotherapy notes. Upon proof of an appropriate legal relationship, records of others related to you or under your care (guardian or custodial) may also disclosed.To inspect and copy your medical record, you must submit your request in writing to our Privacy Officer. Ask the front desk person for the name of the Privacy Officer. If you request a copy of the information, we may charge a fee fro the cost of copying, mailing or other supplies (tapes, disks,etc.) associated with your request.We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you will be given a written explanation of the denial of request. You will be also given an opportunity to request a review of that decision by a licensed professional chosen by the proactive who was not involved in the original decision to deny the request. The proactive will complete this review with 30 days and the results will be communicated to you. Right to AmendIf you feel that the medical information we have about you in our record is incorrect or incomplete, then you may ask us to amend the information, following the procedure below. You have the right to request an amendment for as long as the Practice maintains your medical record. To request an amendment, your request must be submitted in writing, along with your intended amendment and a reason that supports you request to amend. The amendment must be dated and signed by you. The practice has a specific form available for this purpose. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request to amend. The amendment must be dated and signed by you. The practice has a specific form available for this purpose. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request to amend. The amendment must be dated and signed by you. The practice has a specific form available for this purpose. We may deny you 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, useless the person or entity that created the information is no longer available to make the amendment; - Is not part of the medical information kept by or for the Practice; - Is not part of the information which you would be permitted to inspect and copy; or - Is inaccurate and incompleteRight to an Accounting of DisclosuresYou have the right to request and "accounting of disclosures". This is a list of the disclosures we made of medical information about you, to others. To request this list, you must submit your request in writing. Your request must state a time period not longer than six (6) years back a may not include dates before April 14, 2003 (the actual implementation date of the HIPPA Privacy Regulations). Your request should indicate in what form you want the list (for example, on paper, electronically). 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 RestrictionsYou have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care (family member or friend). For example, you could ask that we not use or disclose the information by law.To request restrictions, you must make your request in writing. In your request, you indicate: - What information you want to limit; - Whether you want to limit or use, disclosure or both; and - To whom you want the limits to apply, (e.g., disclosures to your children, parents, spouse,etc.)Right to Request Confidential CommunicationsYou have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail, that we not leave voice mail or e-mail.To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. We will accommodate all reasonable request. Your request must specify how or where you wish us to contact you.Right to a Paper Copy of This NoticeYou 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.
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Del Mar Cosmetic Medical Center - 12845 Pointe Del Mar Way, Suite 100 Del Mar, San Diego, California 858-350-8400