THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY WILLIAM C

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY WILLIAM C. PORTER, MD, LTD.

By law, William C. Porter, MD, Ltd. is required to protect the privacy of your personal medical information. William C. Porter, MD, Ltd. is also required to give patients a Notice of Privacy Practices which details what information is protected under the law and what information may be disclosed to the appropriate party.

William C. Porter, MD, Ltd. must use and give out your personal medical information to provide information:

To you or someone who has the legal right to act for you (your personal representative),
To the Secretary of the Department of Health and Human Services, if necessary, to make sure your privacy is protected, and
Where required by law.

William C. Porter, MD, Ltd. may use or give out your personal medical information for the following purposes under limited circumstances:

To State and other Federal agencies that have the legal right to receive Medicare data (such as to make sure Medicare is making proper payments and to assist Federal/State Medicaid programs),
For public health activities (such as reporting disease outbreaks),
For government health care oversight activities (such as fraud and abuse investigations),
For judicial and administrative proceedings (such as in response to a court order),
For law enforcement purposes (such as providing limited information to locate a missing person),
For research studies that meet all privacy law requirements (such as research related to the prevention of disease or disability),
To avoid a serious and imminent threat to health or safety,
To contact you about new or changed benefits under Medicare or other government benefit plan.

By law, William C. Porter, MD, Ltd. must have your written permission to use or give out your personal medical information for any purpose that isn’t set out in this notice. You may take back (“revoke”) your written permission at any time.

By law, you have the right to:

See and get a copy of your personal medical information.
Have your personal medical information amended if you believe that it is wrong or if information is missing.
Get a listing of those getting your personal medical information from Medicare. The listing won’t cover your personal medical information that was given to you or your personal representative, that was given out to pay for your health care or for Medicare operations, or that was given out for law enforcement purposes.
Ask William C. Porter, MD, Ltd. to communicate with you in a different manner or at a different place (for example, by sending materials to a P.O. Box instead of your home address).
Ask William C. Porter, MD, Ltd. to limit how your personal medical information is used and given out to pay your claims.
Get a separate paper copy of this notice.

For more information regarding the Privacy Practices for William C. Porter, MD, Ltd. contact the office at 701-235-0161 Monday through Friday, 8:30 am to 5:00 pm.