PATIENT HIPAA AWARENESS & RIGHTS

NOTICE OF PRIVACY POLICIES EFFECTIVE 2023

Please review the information below, which explains how your medical information can be used and how you can access this information. If you have any additional questions please do not hesitate to contact us. During your first visit, you will be asked to sign a form that addresses the information discussed below.

With your permission, Lederman and Lederman, LLP may use and disclose protected health information (PHI) about you to carry out treatment, payment and operations (TPO). Please refer to Lederman and Lederman, LLP Notice of Privacy Practices for a more complete description of such uses and disclosures.

You have the right to review the Notice of Privacy Practice prior to signing this consent. Lederman and Lederman, LLP reserves the right to revise its Notice of Practices at any time. A revised Notice of Privacy Practices may be obtained by forwarding a written request to the Privacy Officer.

With your permission, the office of Lederman and Lederman, LLP may call your home or other designated locations and leave a message on voice mail or in person in reference to any items that assist the practice in carrying out TPO, such as appointment reminders, insurance items and any call pertaining to my clinical care, including laboratory results among others.

With your permission, the office of Lederman and Lederman, LLP may use an SMS Appointment Reminder service. Message frequency may vary and data rates may apply. Users can text the keyword STOP to opt out. For help, contact the office at 914-417-6441. Carriers are not liable for messages that are delayed or undelivered. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All of the above categories exclude text messaging, originator opt-in data and consent. This information will not be shared with any third parties.

With your permission, the office of Lederman and Lederman, LLP may mail to your home or other designated location any items that assist the practice in carrying our TPO, such as appointment reminder cards and patient statements.

You give Lederman and Lederman, LLP permission to release information to school authorities.

With your permission the office of Lederman and Lederman, LLP may e-mail to your home or other designated location any items that assist the practice in carrying out TPO, such as appointment reminder cards and patient statements. You have the right to request that Lederman and Lederman, LLP restrict how it uses or discloses your PHI to carry out TPO. However, the practice is not required to agree to your requested restrictions, but if it does, it is bound by this agreement.

Lederman and Lederman, LLP is allowed to use and disclose your PHI for TPO.

You may revoke your consent in writing except to the extent that the practice has already made disclosures in reliance upon your prior request.

You may obtain a copy of your medical records. Please print and complete Patient Information Release Form and return it to us. We will provide a copy or a summary of your health information, usually within 30 days of your request.