© Therapeutic Pain Management Medical Clinic 2016 - Site created by Dr. Dhruva 1335 Buenaventura Blvd, Ste 100, Redding, CA 96001. T: (530) 247-7246; (530) 24-7-P-A-I-N.   F: (530) 245-0849   email: mail@TPMclinic.com
Therapeutic Pain Management Medical Clinic (TPM)
   Therapeutic Pain Management Medical Clinic (TPM) Privacy Policy                                                                                                                                                                                                        Your Personal Information, Privacy, and Medical Records This clinic, in order to evaluate and treat you here as a patient, collects certain information  about you and your health. The use and distribution of this information is governed by regulatory standards, including HIPAA (Healthcare Insurance Portability and Accountability Act of 1996). What information does this clinic (TPM) collect from you? Some of the information collected includes your Name, Age, Date of Birth, Tel Numbers, address, Social Security Number, information about your health, work, employment, family, medication use, diagnostic data, health insurance, email address, digital facial photographs. From where do we collect information about you? The information is obtained from you, your referring physician and other related healthcare providers, insurance carriers, pharmacies, and diagnostic facilities – where you have been evaluated medically. What is the purpose of the information collected? The information is used for: Evaluation and treatment at this clinic Identifying a particular patient to locate him/her within waiting areas Discussing diagnosis and treatment plan with staff and other health providers at TPM Discussing diagnosis and treatment with your family members or guardian Referring you for further diagnostic studies (X-Ray, MRI, CAT Scan, Blood Work etc) Referral to other providers such as Consultants, Physical Therapists, Surgeons, Psychologists etc Calling in, Faxing, or confirming prescriptions to pharmacies Billing and collection firms’ use Sending reports to your attorney, insurers, nurse case manager, W/C adjuster Dictation transcribing companies’ use Sending information to other persons or firms where you have signed a valid “Release of Information” How is this information stored? The information is stored in computers/digital storage devices at TPM. How do you transfer this information to others? It   is   shared   via   Fax,   E-Mail,   Mail,   Telephone,   Internet,   and   personal   communications.   We   share   as   minimum information as possible for an appropriate use. Do you sell the information to any one? TPM   does   not   to   provide,   or   sell,   or   market   the   information   to   any   one,   including   commercial   firms   for marketing reasons. With whom do we share your information? The    copies    of    reports    generated    by    this    clinic    (such    as    initial    consultation,    follow-up    visits,    results    of diagnostic   tests   ordered   by   us)   during   your   treatment   here   are   routinely    sent   to   your   referring   physician, your   primary   care   physician   and   in   case   of   work   comp,   to   your   adjuster,   and   your   attorney,   and   to   our   billing firm   “EMMI”.   Some   of   the   consultation   and   procedure   reports   are   also   sent   to   the   facilities   where   we perform the procedures for their records and billing purpose. If this information further forwarded to any one? Usually   most   of   the   insurance   companies   ask   for   copies   of   consultation   reports   and   procedure   reports   in order   for   them   to   make   payments   or   authorize   further   treatments   to   us.   At   their   request,   we   forward   them the necessary reports. Do you keep a log of data disclosure by your office? As of January 01, 2003, a log will be kept of all non-routine disclosure in your file. What security precautions are in place to protect against the loss, misuse, or alteration of your information? Your    information    is    stored    in    computers    as    Electronic    Medical    Record    (EMR)    and    database    files.The computers   and   the   databases   are   password   protected   and   the   data   is   regularly   backed   up.   Our   Internet connection uses firewall.  The employees are trained regarding privacy rules. How can you update or correct your Information? We   believe   you   should   have   the   ability   to   access   and   edit   the   personal   information   that   you   have   provided to   us.   Please   contact   the   Privacy   Officer   at   TPM   for   further   information.   In   addition,   as   a   security   measure, we   "back   up"   the   data   stored   on   our   systems,   and   such   prior   information   cannot   be   completely   removed from   our   databases.   As   a   result,   you   should   not   expect   that   all   of   your   Information   will   be   completely removed from our backed-up databases. Can you update or correct any information you desire? We   may   deny   your   request   for   an   amendment   if   it   is   not   in   writing   or   does   not   include   a   reason   to   support the   request.   In   addition,   we   may   deny   your   request   if   you   ask   us   to   amend   information   that:   a)   We   did   not create,    unless    the    person    or    entity    that    created    the    information    is    no    longer    available    to    make    the amendment.   b)   Is   not   part   of   the   health   information   that   we   keep.   c)   You   would   not   be   permitted   to   inspect and copy. d) Is accurate and complete. How can I restrict use and disclosure of my information? You   have   the   right   to   request   a   restriction   or   limitation   on   the   health   information   we   use   or   disclose   about you   for   treatment,   payment,   or   health   care   operations.   You   also   have   the   right   to   request   a   limit   on   the health   information   we   disclose   about   you   to   someone   who   is   involved   in   your   care   or   the   payment   for   it,   like a   family   member   or   friend.   We   are   not   required   to   agree   to   your   request   If   we   do   agree;   we   will   comply   with your   request   unless   the   information   is   needed   to   provide   you   emergency   treatment.   To   request   restrictions, you may complete and submit the Request for Restriction on Use/Disclosure Of Medical Information.   How can I obtain a copy of my medical records? A   written   request   is   required.   You   may   fill   out   a   request   for   copies   of   the   medical   records   at   the   clinic   or send   us   a   similar   Medical   Records   Release   form.   Once   we   receive   the   request   and   the   required   fees,   it   takes about 72 hours for the copies to be available. Are there any charges for the copies of the medical records? We   send   some   of   the   information   to   other   treating   physicians   at   no   charge   as   a   courtesy.   However,   if   you wish to obtain a copy of your medical records, the charge is $ 25 flat fee.  We accept cash or checks only. What is included in the copies of medical records? Only   the   reports   generated   by   this   office   (such   as   consultation   reports,   procedure   reports)   and   the   results   of diagnostic   tests   ordered   by   this   office   are   included.   Any   other   data   in   your   file,   which   is   a   copy   of   data   from other sources, is not included. How can I obtain a copy of disclosure log? A   written   request   is   required.   You   may   fill   out   a   request   for   a   disclosure   log   at   the   clinic   or   send   us   a   form. Once   we   receive   the   request,   it   takes   about   72   hours   for   the   log   to   be   available.   There   is   no   fee   for   a   copy   of the log. Privacy Policy changes: This   Privacy   Policy   was   last   changed   on   August   2nd,   2012.   If   TPM   makes   changes   to   any   terms   or   conditions of   the   Privacy   Policy,   the   changes   will   be   posted   in   this   document   so   that   you   will   always   know   what information   we   gather,   how   we   might   use   that   information   and   to   whom   we   will   disclose   it.   We   may   change, modify,    add,    or    remove    portions    of    this    Policy    at    any    time,    and    any    changes    will    become    effective immediately upon being posted unless we tell you otherwise. Contacting TPM about privacy questions or concerns If   you   have   any   questions   about   this   Privacy   Policy,   the   practices   of   this   clinic,   or   your   dealings   with   this clinic, please contact TPM Privacy Officer at this clinic. You may write us at: Attn: Privacy Compliance Officer TPM Medical Clinic 1335 Buenaventura Blvd., Suite 100 Redding, CA 96001
Improving Quality of Life
© Therapeutic Pain Management Medical Clinic 2016 Web designed and  created by Dr. Dhruva
Therapeutic Pain Management Medical Clinic
   Therapeutic Pain Management Medical Clinic (TPM) Privacy Policy                                                                                                                                                                                                        Your Personal Information, Privacy, and Medical Records This clinic, in order to evaluate and treat you here as a patient, collects certain information  about you and your health. The use and distribution of this information is governed by regulatory standards, including HIPAA (Healthcare Insurance Portability and Accountability Act of 1996). What information does this clinic (TPM) collect from you? Some of the information collected includes your Name, Age, Date of Birth, Tel Numbers, address, Social Security Number, information about your health, work, employment, family, medication use, diagnostic data, health insurance, email address, digital facial photographs. From where do we collect information about you? The information is obtained from you, your referring physician and other related healthcare providers, insurance carriers, pharmacies, and diagnostic facilities – where you have been evaluated medically. What is the purpose of the information collected? The information is used for: Evaluation and treatment at this clinic Identifying a particular patient to locate him/her within waiting areas Discussing diagnosis and treatment plan with staff and other health providers at TPM Discussing diagnosis and treatment with your family members or guardian Referring you for further diagnostic studies (X-Ray, MRI, CAT Scan, Blood Work etc) Referral to other providers such as Consultants, Physical Therapists, Surgeons, Psychologists etc Calling in, Faxing, or confirming prescriptions to pharmacies Billing and collection firms’ use Sending reports to your attorney, insurers, nurse case manager, W/C adjuster Dictation transcribing companies’ use Sending information to other persons or firms where you have signed a valid “Release of Information” How is this information stored? The information is stored in computers/digital storage devices at TPM. How do you transfer this information to others? It   is   shared   via   Fax,   E-Mail,   Mail,   Telephone,   Internet,   and   personal communications.   We   share   as   minimum   information   as   possible   for an appropriate use. Do you sell the information to any one? TPM   does   not   to   provide,   or   sell,   or   market   the   information   to   any one, including commercial firms for marketing reasons. With whom do we share your information? The    copies    of    reports    generated    by    this    clinic    (such    as    initial consultation,   follow-up   visits,   results   of   diagnostic   tests   ordered   by us)   during   your   treatment   here   are   routinely    sent   to   your   referring physician,   your   primary   care   physician   and   in   case   of   work   comp,   to your    adjuster,    and    your    attorney,    and    to    our    billing    firm    “EMMI”. Some   of   the   consultation   and   procedure   reports   are   also   sent   to   the facilities   where   we   perform   the   procedures   for   their   records   and billing purpose. If this information further forwarded to any one? Usually     most     of     the     insurance     companies     ask     for     copies     of consultation    reports    and    procedure    reports    in    order    for    them    to make    payments    or    authorize    further    treatments    to    us.    At    their request, we forward them the necessary reports. Do you keep a log of data disclosure by your office? As of January 01, 2003, a log will be kept of all non-routine disclosure in your file. What security precautions are in place to protect against the loss, misuse, or alteration of your information? Your   information   is   stored   in   computers   as   Electronic   Medical   Record (EMR)    and    database    files.The    computers    and    the    databases    are password    protected    and    the    data    is    regularly    backed    up.    Our Internet    connection    uses    firewall.        The    employees    are    trained regarding privacy rules. How can you update or correct your Information? We    believe    you    should    have    the    ability    to    access    and    edit    the personal   information   that   you   have   provided   to   us.   Please   contact the   Privacy   Officer   at   TPM   for   further   information.   In   addition,   as   a security   measure,   we   "back   up"   the   data   stored   on   our   systems,   and such    prior    information    cannot    be    completely    removed    from    our databases.    As    a    result,    you    should    not    expect    that    all    of    your Information     will     be     completely     removed     from     our     backed-up databases. Can you update or correct any information you desire? We   may   deny   your   request   for   an   amendment   if   it   is   not   in   writing   or does   not   include   a   reason   to   support   the   request.   In   addition,   we may   deny   your   request   if   you   ask   us   to   amend   information   that:   a) We    did    not    create,    unless    the    person    or    entity    that    created    the information   is   no   longer   available   to   make   the   amendment.   b)   Is   not part   of   the   health   information   that   we   keep.   c)   You   would   not   be permitted to inspect and copy. d) Is accurate and complete. How can I restrict use and disclosure of my information? You   have   the   right   to   request   a   restriction   or   limitation   on   the   health information   we   use   or   disclose   about   you   for   treatment,   payment,   or health   care   operations.   You   also   have   the   right   to   request   a   limit   on the   health   information   we   disclose   about   you   to   someone   who   is involved   in   your   care   or   the   payment   for   it,   like   a   family   member   or friend.   We   are   not   required   to   agree   to   your   request   If   we   do   agree; we   will   comply   with   your   request   unless   the   information   is   needed   to provide   you   emergency   treatment.   To   request   restrictions,   you   may complete   and   submit   the   Request   for   Restriction   on   Use/Disclosure Of Medical Information.   How can I obtain a copy of my medical records? A   written   request   is   required.   You   may   fill   out   a   request   for   copies   of the   medical   records   at   the   clinic   or   send   us   a   similar   Medical   Records Release   form.   Once   we   receive   the   request   and   the   required   fees,   it takes about 72 hours for the copies to be available. Are there any charges for the copies of the medical records? We   send   some   of   the   information   to   other   treating   physicians   at   no charge   as   a   courtesy.   However,   if   you   wish   to   obtain   a   copy   of   your medical   records,   the   charge   is   $   25   flat   fee.      We   accept   cash   or   checks only. What is included in the copies of medical records? Only    the    reports    generated    by    this    office    (such    as    consultation reports,    procedure    reports)    and    the    results    of    diagnostic    tests ordered   by   this   office   are   included.   Any   other   data   in   your   file,   which is a copy of data from other sources, is not included. How can I obtain a copy of disclosure log? A    written    request    is    required.    You    may    fill    out    a    request    for    a disclosure   log   at   the   clinic   or   send   us   a   form.   Once   we   receive   the request,   it   takes   about   72   hours   for   the   log   to   be   available.   There   is no fee for a copy of the log. Privacy Policy changes: This   Privacy   Policy   was   last   changed   on   August   2nd,   2012.   If   TPM makes   changes   to   any   terms   or   conditions   of   the   Privacy   Policy,   the changes   will   be   posted   in   this   document   so   that   you   will   always   know what   information   we   gather,   how   we   might   use   that   information   and to   whom   we   will   disclose   it.   We   may   change,   modify,   add,   or   remove portions   of   this   Policy   at   any   time,   and   any   changes   will   become effective     immediately     upon     being     posted     unless     we     tell     you otherwise. Contacting TPM about privacy questions or concerns If   you   have   any   questions   about   this   Privacy   Policy,   the   practices   of this    clinic,    or    your    dealings    with    this    clinic,    please    contact    TPM Privacy Officer at this clinic. You may write us at: Attn: Privacy Compliance Officer TPM Medical Clinic 1335 Buenaventura Blvd., Suite 100 Redding, CA 96001
Improving Quality of Life