Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES  
 
LAURA WAGNER, INC
effective April 14, 2003
 

 
 
THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION (PHI) MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION:

  • Treatment: To provide, coordinate or manage your health care and related services.
  • Payment: To bill and collect payment for the services and items you may receive from us.
  • Health Care Operations: To operate our business.
  • Appointment Reminders: To contact your and remind you of an appointment.
  • Treatment Options: To inform you of potential treatment options or alternatives.
  • Health-Related Benefits and Services: To inform you of health-related benefits or services that may be of interest to you.
  • Release of Information to Family/Friends: Our practice may release your IIHI to a friend or family that is involved in your care, or assists in taking care of you.
  • Disclosures Required By Law: Our practice will use and disclose your IIHI when we are required to do so by federal, state or local law.

USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION IN SPECIAL CIRCUMSTANCES:

We may use and disclose your private health information in regards to: public health risks; health oversight activities; lawsuits and similar proceedings; law enforcement; deceased patients; organ and tissue donation; research; serious threats to health or safety; military purposes; national security; inmates; workers compensation.

AS A PATIENT YOU HAVE A RIGHT TO:

  • request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. We will accommodate reasonable requests.
  • request restrictions in our use or disclosure of your IIHI.
  • inspect and obtain a copy of your medical records and billing records, excluding psychotherapy notes.
  • request us to amend your health information if you believe it is incorrect or incomplete.
  • request an accounting of disclosures.
  • receive a paper copy of our Notice of Privacy Practices.
  • file a complaint if you believe your privacy rights have been violated.
  • provide and authorization for other uses and disclosures.

Please direct questions regarding this notice to:
Attn: Privacy Officer
Laura Wagner, Inc.
14377 Woodlake Drive Suite 111
Chesterfield, MO 63017
Phone (314) 441-1111 Fax (314) 441-1112


The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of our current Notice in our offices in a visible location at all times, and you may request a copy of our most current Notice at any time.

Copyright © 2017 Laura Wagner, MD. All Rights Reserved.
14377 Woodlake Dr. #111 • Chesterfield, MO 63017
314-434-1111