This notice describer how information about you may be used and disclosed and how you can gain access to this information. Please review if carefully.
NOTIC OF INFORMATION PRACTICES
Children's Urology of Virginia may use and disclose protected health information for treatment, payment, and healthcare operation. Examples of these include, but are not limited to, requested preschool, sports physicals, referral to nursing homes, foster care homes, home health agencies and/or referral to other providers for treatments. Payment examples include, but are not limited to, insurance companies for claims including coordination of benefits with other insures; collection agencies. Healthcare operation includes, but is not limited to, internal quality control and assurance including auditing of records.
Children's Urology of Virginia is permitted or required to use or disclose protected health information without the individuals written consent or authorization in certain circumstances. Two examples of such are for public health requirement or court orders.
Children's Urology of Virginia will not make any other use or disclosure of a patient's protected health information without the individual's written authorization. Such authorization may be revoked at any time. Revocation must be written.
Children's Urology of Virginia may at times contact the patient to provide appointment reminders or information regarding treatment alternative or other health-related benefits and services that may be of interest of the individual patient.
Children's Urology of Virginia will abide by the terms of this notice of the notice currently in effect at the time of the disclosure.
Children's Urology of Virginia reserves the right to change the terms of its notice and to make new notice provisions effective for all protected health information that it maintains.
Children's Urology of Virginia will provide each patient with a copy of any revisions of the Notice of Information Practice at the time of their next visit, or at their last known address if there is a need to sue or disclose any protected health information of the patient. Copies may also be obtained at any time at our offices.
Any person/patient may file a complaint to the Practice and to the Secretary of Health and Human Services if they believe their privacy rights have been violated. To file a complain with the Practice, please contact the Privacy Officer at the following address:
Children's Urology of Virginia
8700 Stony Point Parkway, Suite 250
Richmond, VA 23235
or you may call the office at (804) 272-2411. All complaints will be addressed and the results will be reported to the Corporate Compliance Officer.
It is the Children's Urology of Virginia's policy that no retaliatory action will be made against any individual who submits or conveys a complaint of suspected or actual non-compliance of the privacy standards.
For further information regarding the Notice of Privacy Practices for Children's Urology of Virginia, please contact the Office Manager at (804) 272-2411
