LONE STAR PAIN INSTITUTE, P.L.L.C.

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.

If you have questions about this notice or want more information, please contact: Linda Jones at Lone Star Pain Institute P.L.L.C. The effective date of this notice is September 27, 2006.

To appropriately treat you and receive payment for the services we provide, we need to obtain information from you including your full name and address, insurance company, family medical history, current medical history, and current medical condition. We will use and disclose this information and other information we collect in the ways described below. To help you understand how we will use and disclose your information we have put the different uses and disclosures into categories and give examples of each. All of the ways we use or disclose your information will fit into one of the categories listed below, but we cannot list all of the uses and discloses in each category.

We may use and disclosure your health information for treatment, payment, and health care operations.

We may disclose and use your health information and you authorize us to use and disclose your information for:

We may also disclose your health information to outside entities without your consent or authorization in the following circumstances:

We will give you the opportunity to object to the following uses and disclosure of your information:

Your Rights

Our Duties

Complaints

If you believe your privacy rights have been violated you may contact: 

Linda Jones at Lone Star Pain Institute, P.L.L.C. or the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.