Notice of Privacy Practices
Lake Grove ENT, PC (referred to below as “This Practice”) may use and disclose health information about you.
The health information may include information both created and received by the practice, may be in the form of written or electronic records or spoken words, an may include information about your health history, health status, symptoms, examinations, test results, diagnosis, treatment, procedures, prescriptions, and similar types of health related information.
This Practice may use and disclose my health information in order to:
- Make decisions about and plan for your care and treatment.
- Refer to, consult with, coordinate among, and manage along with other health care providers for your care and treatment.
- Determine your eligibility for health plan or insurance coverage, and submit bills, claims and other related information to insurance companies or others who may be responsible to pay for some or all of your health care.
- Perform various office, administrative and business functions that support your physician’s efforts to provide you with, arrange and be reimbursed for quality, cost-effective health care.
You have the right to receive and review a written description of how this Practice will handle health information about you. This written description is known as a Notice of Privacy Practices and describes the uses and disclosures of health information made and the information practices followed by the employees, staff and other office personnel of this Practice, and your rights regarding your health information.
The Notice of Privacy Practices may be revised from time to time, and your are entitled to receive a copy of any revised Notice of Privacy Practices. A copy or a summary of the most current version the This Practice’s Notice of Privacy Practices in effect will be available at the front desk.
You have the right to ask that some or all of your health information not be used or disclosed in a manner described in the Notice of Privacy Practices, and you understand that this Practice is not required by law to agree to such requests.
