Notice of PrivacyPractices

7/21/2019 Notice of PrivacyPractices

http://slidepdf.com/reader/full/notice-of-privacypractices 1/1

 NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND

HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. THIS NOTICEOF HEALTH INFORMATION PRIVACY (NPP) PRACTICES SHALL BE POSTED IN THE RECEPTION AREA

AT EACH LOCATION.

Introduction:At Mercer Ph!"c#$ Ther#%& 'e #re c"tte* t tre#t"+, #+* -!"+, %rtecte* he#$th "+r#t"+ #/-t

- re!%+!"/$. Th"! Nt"ce He#$th I+r#t"+ Pr#ct"ce! *e!cr"/e! the %er!+#$ "+r#t"+ 'e c$$ect& #+*

h' #+* 'he+ 'e -!e r *"!c$!e th#t "+r#t"+. It *e!cr"/e! -r r",ht! #! the re$#te t -r %rtecte* he#$th

"+r#t"+ #! *e"+e* / e*er#$ re,-$#t"+!.

U+*er!t#+*"+, 'h#t "! "+ -r recr* #+* h' -r he#$th "+r#t"+ "! -!e* he$%! - t e+!-re "t!

#cc-r#c& /etter -+*er!t#+* 'h& 'h#t& 'he+& 'here #+* 'h ther! # #cce!! -r he#$th "+r#t"+& #+* #0ere "+re* *ec"!"+! 'he+ #-thr"1"+, *"!c$!-re t ther!.

Your Health Information rights

A$th-,h -r he#$th recr* "! the %h!"c#$ %r%ert Mercer Ph!"c#$ Ther#%& the "+r#t"+ /e$+,!

t -. Y- h#2e the r",ht t:

• O/t#"+ # %#%er c% th"! Nt"ce Pr"2#c Pr#ct"ce! -%+ re3-e!t

• I+!%ect #+* c% -r he#$th recr* #! %r2"*e* / HIPAA Re,-$#t"+! #+* GA $#'

• Re3-e!t th#t -r he#$th recr* /e #e+*e* #! %r2"*e* / HIPAA Re,-$#t"+!

• O/t#"+ #+ #cc-+t"+, *"!c$!-re! -r he#$th "+r#t"+ #! %r2"*e* / HIPAA Re,-$#t"+! #+*

GA $#'

• Re3-e!t # re!tr"ct"+! + cert#"+ -!e! #+* *"!c$!-re! -r "+r#t"+ #! %r2"*e* / HIPAA

Re,-$#t"+!

• Re20e -r #-thr"1#t"+ t -!e r *"!c$!e he#$th "+r#t"+ e4ce%t t the e4te+t th#t #ct"+ h#!

#$re#* /ee+ t#0e+.Other Responsibilities

Mercer Ph!"c#$ Ther#% "! re3-"re* t:

• M#"+t#"+ the %r"2#c -r he#$th "+r#t"+

• Pr2"*e - '"th th"! +t"ce #! t -r $e,#$ *-t"e! #+* %r"2#c %r#ct"ce! '"th re!%ect t "+r#t"+ 'e

c$$ect #+* #"+t#"+ #/-t -

• A/"*e / the ter! th"! +t"ce

•  Nt" - " 'e #re -+#/$e t #,ree t # re3-e!te* re!tr"ct"+

We re!er2e the r",ht t ch#+,e -r %r#ct"ce! #+* t #0e the +e' %r2"!"+! eect"2e r #$$ %rtecte* he#$th

"+r#t"+ 'e #"+t#"+. Sh-$* -r "+r#t"+ %r#ct"ce! ch#+,e& 'e '"$$ er # re2"!e* +t"ce t - -%+ -r+e4t "ce 2"!"t.

For more information or to Report a Problem:

I - h#2e 3-e!t"+! #+* '-$* $"0e #**"t"+#$ "+r#t"+& - # c+t#ct the C$"+"c D"rectr #t 567896859;.

I - /e$"e2e -r %r"2#c r",ht! h#2e /ee+ 2"$#te*& - c#+ "$e # c%$#"+t '"th the C%$"#+ce O"cer r

Mercer Ph!"c#$ Ther#% r '"th O"ce r C"2"$ R",ht!& US De%#rte+t He#$th #+* H-#+ Ser2"ce!. There '"$$ /e + ret#$"#t"+ r "$$"+, # c%$#"+t '"th the C%$"#+ce O"cer.

Revised 05-09-11