Effective Date: January 1, 2017

At Foot & Ankle Center of Oklahoma, your privacy is very important to us. This notice explains how we may use and share your health information, and describes your rights regarding that information.

Our Responsibilities

We are required by law to:

• Protect the privacy and security of your personal health information.
• Give you this notice describing our privacy practices.
• Notify you if a breach occurs that may compromise your information.
• Follow the terms of this notice currently in effect.

How We May Use and Share Your Information

We may use and share your health information in the following ways:

• For treatment: To provide, coordinate, or manage your medical care.
• For payment: To bill insurance companies or collect payment for services provided.
• For healthcare operations: To run our office, improve care, and ensure quality services.

We may also share information when required by law, such as for:

• Public health reporting (for example, to prevent or control disease).
• Worker’s compensation claims.
• Law enforcement or court orders.
• Health oversight activities.

Your Rights

You have the right to:

• Get a copy of your medical record. You can ask for a paper or electronic copy.
• Ask us to correct your record if you believe something is incorrect or incomplete.
• Request restrictions on how we use or share your information (we’ll consider your request, but may not be able to agree to all restrictions).
• Ask for confidential communications, such as contacting you at a specific address or phone number.
• Get a list of disclosures showing who we’ve shared your information with, other than for treatment, payment, or operations.
• Receive a copy of this notice at any time.

Your Choices

You may choose whether we share your information:

• With family members or others involved in your care.
• For marketing, fundraising, or promotional purposes.

We will never sell your personal health information.

Questions or Complaints

If you have any questions about this notice or believe your privacy rights have been violated, please contact:

Privacy Contact
Michelle Wild
Foot & Ankle Center of Oklahoma
609 W Memorial Rd
Oklahoma City, OK 73114
Phone: (405) 227-9440
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

You may also file a complaint with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights.
We will not retaliate against you for filing a complaint.

Acknowledgment

You may be asked to sign a separate form acknowledging that you received this Notice of Privacy Policy.