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.

Our commitment to your privacy

Prime Care Physicians is dedicated to maintaining the privacy of your health care information and to provide you with a notice of our privacy practices. We are required to abide by the terms of the notice that is currently in effect. We reserve the right to change our privacy practices at any time. If our privacy practices change, we will post a revised notice in our office (or on our website) and have available a copy of the revised notice at your next visit following the change.

Our use of your health care information

We may use your information for treatment, payment and health care operations. For example:

• For treatment: We may use your information to coordinate referrals to another health care provider.
• For payment: We may submit portions of your information to your insurance carrier or other third party for payment purposes.
• For health care operations: We may use your information in the course of quality assurance, evaluation, training, or audit activities.

We may also disclose information without your authorization as permitted or required by applicable law for any of the following purposes:

• To comply with public health statutes and rules
• To make any required reports of abuse or neglect
• To comply with health oversight activities by government agencies (for example a licensure survey)
• To comply with a court order, government subpoena, or other lawful process
• For research purposes
• In the event of your death, to a medical examiner or funeral director as necessary, or for organ and tissue donation purposes
• To avert a serious threat to health or safety
• For Worker's Compensation purposes

We may use your information to contact you for appointment reminders, or to provide information about treatment alternatives or other health services. Except as described above, we will not use or disclose your information, except with your written authorization. You may revoke your authorization at any time by giving written notice of revocation to Prime Care Physicians.

Your rights regarding your health information

• You have the right to request restriction on the use and disclosure of your information. However, we are not required to agree to your requested restriction. It is our policy not to agree to such restriction unless we determine that a compelling reason exists to do so.
• You can request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may request in writing that we contact you at home, rather than at work. We will try to accommodate reasonable requests.
• You have the right to inspect and obtain a copy of your health information. If you wish to do so, we will provide you with an opportunity to inspect your information within 30 days of receiving your written request. You may be charged reasonable costs of copying your information or preparing summaries that you request.
• You have the right to request that we amend your health care information. If you wish to do so, please submit the proposed amendment in writing to Prime Care Physicians’ Privacy Officer. You must provide us with a reason that supports your request for amendment.
• You have the right to an accounting of any disclosures of your health care information that you have not authorized. If you wish to receive such an accounting, please submit a request in writing to Prime Care Physicians’ Privacy Officer. You have the right to a paper copy of this Notice of Privacy Practices. You may ask us to give you a copy of this notice at any time. To obtain a copy of this notice, contact the Privacy Officer at Prime Care Physicians.
• If you believe your privacy rights have been violated, you may file a complaint with our practice. To file a complaint with our practice, contact: Privacy Officer Prime Care Physicians 13425 Ventura Blvd #102 Sherman Oaks, CA 91423
• All complaints must be submitted in writing. You will not be penalized for filing a complaint.
• Prime Care Physicians will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.

If you have any questions regarding this notice or our health information privacy policies, please contact us at 818-995-7784 for further information.