Patient Privacy
HIPAA Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Commitment to Your Privacy
Park Avenue Medical Group is required by law to maintain the privacy of your Protected Health Information (PHI), provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.
How We May Use & Disclose Your PHI
- Treatment: To provide medical care, coordinate with referring providers, or share results with consulting physicians.
- Payment: To bill insurance carriers, employers (for occupational health), or you directly.
- Healthcare Operations: For quality improvement, training, credentialing, and internal review.
- DOT / FMCSA Compliance: To report Medical Examiner's Certificate results to the FMCSA National Registry as required.
- Drug & Alcohol Testing: To share results with the designated employer representative, Medical Review Officer, and SAMHSA-certified laboratory.
- Required by Law: Public health reporting, court orders, workers' compensation, and law enforcement requests as permitted by law.
Uses That Require Your Authorization
Most uses and disclosures of psychotherapy notes, uses for marketing purposes, and disclosures that constitute a sale of PHI require your written authorization. You may revoke this authorization in writing at any time.
Your Rights
- Request access to and a copy of your medical records
- Request amendment of your records if you believe they are inaccurate
- Receive an accounting of certain disclosures
- Request restrictions on certain uses and disclosures
- Request confidential communications by alternative means or location
- Receive a paper copy of this notice upon request
- File a complaint with us or with the U.S. Department of Health and Human Services if you believe your privacy rights have been violated
We will not retaliate against you for filing a complaint.
Changes to This Notice
We reserve the right to change this notice and to make the revised notice effective for PHI we already have as well as any information we receive in the future. The current notice will always be available at our clinic and on our website.
Contact / Privacy Officer
To exercise any of your rights or to file a complaint, please contact our Privacy Officer:
Park Avenue Medical Group
Attn: Privacy Officer
160 S. Central Avenue, Elmsford, NY 10523
Phone: 914-380-8757
Fax: 914-380-8941
Email: medicalgroup160@gmail.com