Privacy Policy
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Understanding your health record/information
Each time you visit Pediatricians of Dallas, a record of your visit is made. This record can be either written, oral, or in electronic format. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment and a plan for future care. This information is often referred to as your health or medical record.
Uses and Disclosures
Treatment: Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluation your health, diagnosing medical conditions, and providing treatment.
Payment: Your health information may be used to seek payment from your health plan or from other sources of coverage such as an automobile insurer. For example, your health plan may request and receive information on dates of service, the service provided, and the medical condition being treated. Health Care Operations: Your health information may be used as necessary to support day-to-day activities and management of Pediatricians of Dallas. Fore example, information on the services you receive may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
Law Enforcement: Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law enforcement investigations and to comply with government mandated reporting.
Public Health Reporting: Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
Additional Uses of Information
Photographs: We will display photographs that are sent to us unless you give specific instructions not to display them.
Appointment reminders: Your health information will be used by our staff to remind you of your upcoming appointments.
Other uses and Disclosure Require your Authorization: Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclose of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.
Individual Rights
You have certain rights under the federal privacy standards. These include a) the right to request restrictions on the use and disclosure of your protected health information, b) the right to receive confidential communications concerning your medical condition and treatment, c) the right to inspect and copy your protected health information, d) the right to amend or submit corrections to your protected health information, e) the right to receive an accounting of how and to whom your protected health information has been disclosed, and f) the right to receive a printed copy of this notice.
Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this “Notice of Privacy Practices.” We are also required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all protected health information that we maintain.
Request to Inspect Protected Health Information
You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the Front Office Manager or the Privacy Officer. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.
Complaints
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:
Privacy Officer
Pediatricians of Dallas, P.A.
8325 Walnut Hill Ln #225
Dallas, Texas 75231