THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW ITCAREFULLY.
I am required by law to protect the privacy of health information that may reveal your identity, and to provide you with a copy of this notice, which describes the health information privacy practices of my practice. You can also obtain additional copies of this notice by calling Kate DiMarco Ruck at 347-974-0872 or emailing kate@TheParentingStudio.com.
What Information is Protected:
I am committed to protecting the privacy of the information I gather about you while providing services. Some examples of protected health-related information are:
• Information indicating that you are a client of Kate DiMarco Ruck BA IBCLC or receiving services from me;
• Information about your health condition (such as a disease you may have)
• Information about health care products or services you have received or may receive in the future (such as an operation)
• Information about your health care benefits under an insurance plan (such as whether a prescription in covered);
When combined with:
• Demographic information (such as your name, address, or insurance status);
• Unique numbers that may identify you (such as your social security number or your phone number); and
• Other types of information that may identify who you are.
Requirement for Written Authorization: I will generally obtain written authorization before using your health information or sharing it outside of my practice. You may also initiate the transfer of your records by sending a written request to Kate DiMarco Ruck 411 DeGraw St. Brooklyn, NY 11217 or by sending an email to kate@TheParentingStudio.com. If you provide me with written authorization, you may revoke that authorization at any time, except to the extent I have already relied on it. All revocations of written authorization must be sent in writing to the above address. Email revocations are not valid.
Exceptions to Written Authorization Requirement: There are some situations when I do not need your written authorization before using your health information or sharing it with others. They are:
• Exception For Treatment, Payment, And Business Operations. I may use and disclose your health information to treat your condition, collect payment for that treatment, or run our business operations. In some cases, I also may disclose your health information to another health care provider or payor for its payment activities and certain of its business operations.
• Exception For Public Need. I may use or disclose your health information in certain situations to comply with the law or to meet important public needs. For example, I may share your information with public health officials at the New York state or city health departments who are authorized to investigate and control the spread of diseases.
• Exception If Information Is Completely Or Partially De-Identified. I may use or disclose your health information if I have removed any information that might identify you so that the health information is “completely de-identified.” I may also use and disclose “partially de-identified” information if the person who will receive the information agrees in writing to protect the privacy of the information.
-I may share your information with members of my company who have agreed in writing by signing a Business Associate Agreement to protect the privacy of the information.
How To Access Your Health Information. You generally have the right to inspect and copy your health information.
How To Correct Your Health Information. You have the right to request that I amend your health information if you believe it is inaccurate or incomplete.
How To Identify Others Who Have Received Your Health Information. You have the right to receive an “accounting of disclosures,” which identifies certain persons or organizations to whom I have disclosed your health information in accordance with the protections described in this Notice of Privacy Practices. Many routine disclosures I make will not be included in this accounting, but the accounting will identify many non-routine disclosures of your information.
How To Request Additional Privacy Protections. You have the right to request further restrictions on the way I use your health information or share it with others. I am not required to agree to the restriction you request, but if I do, I will be bound by our agreement.
How To Request More Confidential Communications. You have the right to request that I contact you
in a way that is more confidential for you, such as at home instead of at work. I will try to accommodate all reasonable requests.
How Someone May Act On Your Behalf. You have the right to name a personal representative who may act on your behalf to control the privacy of your health information. Parents and guardians will generally have the right to control the privacy of health information about minors unless the minors are permitted by law to act on their own behalf.
How To Learn About Special Protections For HIV, Alcohol and Substance Abuse, Mental Health And Genetic Information. Special privacy protections apply to HIV-related information, alcohol and substance abuse treatment information, mental health information, and genetic information. Some parts of this general Notice of Privacy Practices may not apply to these types of information. If your treatment involves this information, you will be provided with a separate notice explaining how the privacy of the
information will be protected.
How To Obtain A Copy Of This Notice. You have the right to a paper copy of this notice. You may request a paper copy at any time. To do so, please email Kate DiMarco Ruck at
How To Obtain A Copy Of Revised Notice. I may change my privacy practices from time to time. If I do, I will revise this notice so you will have an accurate summary of my practices. The revised notice will apply to all of your health information. You will also be able to obtain your own copy of the revised notice by emailing Kate DiMarco Ruck at , or asking for one at the time of your next visit. The effective date of the notice will always be noted at the end of the document. I am required to abide by the terms of the notice that is currently in effect.
How To File A Complaint. If you believe your privacy rights have been violated, you may file a complaint with me or with the Secretary of the Department of Health and Human Services. To file a complaint with me, please contact Kate DiMarco Ruck 411 DeGraw St. Brooklyn, NY 11217 347-974-0872 . No one will retaliate or take action against you for filing a complaint.