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Diplomates, American Board of Urology
Adult and Pediatric Urology
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.
Section A: Use and Disclosures of Protected Health Information
- Under applicable law, we are required to protect the privacy of your individual health information (information we refer to in this notice as "Protected Health Information"). We are also required to provide you with this notice regarding our polices and procedures regarding your Protected Health Information, and to abide by the terms of this notice, as it may be updated from time to time.
We are permitted to make certain types of uses and disclosures under applicable law for treatment, payment and healthcare operations purposes. For the treatment purposes, such use and disclosure will take place in providing, coordination or managing healthcare and its related services by one or more of your providers, such as when your primary car physician consults with a specialist regarding your condition.
For payment purposes, such use and disclosure will take place to obtain or provide reimbursement for providing healthcare or when your case is reviewed to ensure that appropriate care was rendered.
For healthcare operations purposes, such use and disclosure will take place in a number of ways, including for quality assessment and improvement, provider review and training, underwriting activities, reviews and compliance activities, planning and development and management and administration. Your information could be used, for example, to assist in the evaluation of the quality of care that you were provided.
In addition, we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
You may use and disclose year Protected Health Information, without your authorization, as required and permitted under Nevada State law. These laws usually relate to public health and safety.
Other uses and disclosures will be made only with your written authorization and you may revoke authorization by notifying us as described in section B, as follows.
- You have the right to request the following with respect to your Protected Health Information: (i) inspection and copying; (ii) amendment or correction; (iii) and accounting of the disclosures of this information by us, and (iv) the right to receive a paper copy of this notice upon request. Such requests must be made in writing by contacting and coordinating with: Privacy Officer, Urology, Ltd., 7200 Cathedral Rock Drive, Suite 180, Las Vegas, NV 89128.
In addition, you may request and we must accommodate the request, if reasonable, to receive communications of Protected Health Information by alternative means or at alternative locations. To make this request, please write to: Privacy Officer, Urology, Ltd., 7200 Cathedral Rock Drive, Suite 180, Las Vegas, NV 89128.
Unless you object, we may disclose to one of your family members, to a relative, to a close personal friend or to any other person identified by you, Protected Health Information that is directly relevant to the person's involvement with your care or payment related to your care. In addition. unless you object, we may use or disclose the Protected Health Information to notify or identify or locate a member of your family, your personal representative, another person responsible for your care or certain disaster relief agencies of your location, general condition or death. Objection to this may be communicated in writing (preferred) or orally to: Privacy Officer, Urology, Ltd., 7200 Cathedral Rock Drive, Suite 180, Las Vegas, NV 89128.
If you are incapacitated, there is an emergency, or you otherwise do not have the opportunity to object to this use or disclosure, we will do what in our judgment is in your best interest regarding such disclosure and will disclose only the information that is directly relevant to the person's involvement with your healthcare. We will also use our judgment and experience regarding your best interest in allowing people to pick up medical supplies, x-rays or other similar forms of Protected Health Information.
- We reserve the right to change the terms of this notice and to make the new notice provisions effective for all Protected Health Information we maintain. You have a right to receive any new Notices of Privacy Practices we promulgate. We will post in our waiting room for your review.
Section B: Contacting Us
You may contact us for further information by writing or calling Privacy Officer at our facility: Privacy Officer, Urology, Ltd., 7200 Cathedral Rock Drive, Suite 180, Las Vegas, NV 89128. Phone: (702) 341-9000.
7200 Cathedral Rock Drive
Suite 180
Las Vegas, Nevada 89128
Tel 702.341.9000 / Fax 702.341.5864
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1701 North Green Valley Parkway
Building 10, Suite C
Henderson. Nevada 89074
Tel 702.563.0698 / Fax 702.563.2937
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