Privacy Policies

Privacy Policies

Patient Health Information

Under federal law, your patient health information is protected and confidential.  Patient health information includes information about your symptoms, test results, diagnosis, treatment and related medical information. Your health information also includes payment, billing and insurance information.

How we use your Patient Health Information

We use health information about you for treatment, to obtain payment and for health care operations, including administrative purposes and evaluation regarding the quality of care that you received.

This Notice gives examples of how we will use or disclose your health information for treatment, payment and health care operations. This Notice also describes circumstances when we may have to use or disclose the information even without your consent.

Examples of Treatment, Payment and Health Care Operations

Treatment: We will use and disclose your health information to provide you with medical treatment or services.  For example, nurses, physicians and other members of your treatment team will record information in your record and use it to determine the most appropriate course of care. We may also disclose the information to other health care providers who are participating in your treatment, or pharmacists who are filling your prescriptions.

Payment: We will use and disclose your health information for payment purposes.  For example, we may need to obtain authorization from your insurance company before providing certain types of treatment. We will submit bills and maintain records of payments from your health plan.

Health Care Operations: We will use and disclose your health information to conduct our standard internal operations, including proper administration of records, evaluation of the quality of treatment and to assess the care and outcomes of your case and others like it.

Other Uses and Disclosures: We may use or disclose identifiable health information about you for other reasons, even without your consent. Subject to certain requirements, we are permitted to give out health information without your consent for the following purposes:

  • Required by law: We may disclose your health information in the course of any judicial or administrative proceeding as allowed by law, with your consent or as directed by a proper court order or administrative tribunal, provided that only the protected health information released is expressly authorized by such order, or in response to a subpoena, discovery request or other lawful process.
  • Law Enforcement: We may be required by law to report certain types of wounds or other physical injury.
  • Public Health: As required by law, we may disclose vital statistics, diseases, or information related to recalls of dangerous products to public health authorities and similar information.
  • Health Oversight: We may be required to disclose information to assist in investigations and audits, eligibility for government programs, and similar activities.
  • Coroners, Medical Examiners and Funeral Directors: We may disclose your information to funeral directors or coroners consistent with applicable law to allow them to carry out their duties.
  • Threat to Health and Safety: To avert a serious threat to health and safety we may disclose information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public.
  • Specialized Governmental Functions: We may disclose your information to specialized government functions as authorized by law, such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.
  • Research: We may disclose information for approved medical research.
  • Organ Procurement Organizations: Consistent with applicable law, we may disclose information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of donation and transplant.
  • Abuse and Neglect: We can disclose information to governmental or public authorities to the extent of the law, and in the exercise of professional judgment the doctor believes the disclosure is necessary to prevent harm to the individual or other potential victim.
  • Workers' Compensation: We may release information about you for workers' compensation or similar programs providing benefits for work-related injuries.
  • Correctional Institutions: If you are an inmate of a correctional institution, we may disclose your information to the institution or its agents necessary for your health and the health/safety of others.
  • Food and Drug Administration: We may disclose information to the FDA relating to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repair or replacements.

In any other situation, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures.

Individual Rights

You have the following rights with regard to your health information. Please contact the Privacy Officer listed below to obtain the appropriate form for exercising these rights.

Request restrictions: You may request restrictions on certain uses and disclosures of your health information. We are not required to agree to such restrictions, but if we do agree, we must abide by those.

Confidential Communications: You may ask us to communicate with you confidentially by, for example, sending notices to a special address or not using postcards to remind you of appointments.

Inspect and Obtain Copies: In most cases, you have the right to look at or obtain a copy of your health information. There may be a small charge for the copies.

Amend Information: If you believe that information in your record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information.

Our Legal Duty

We are required by law to maintain the privacy of your health information, to provide this Notice about our legal duties and privacy practices regarding protected health information, and to abide by the terms of the Notice currently in effect.

Changes in Privacy Practices

We may change our Notice at any time. Before we make a significant change in our policies, we will change our Notice and post the new Notice. You can also request a copy of our Notice at any time. For more information about our privacy practices, contact the Privacy Officer listed below.


If you are concerned that we have violated your privacy rights, or if you disagree with a decision we made about your records, you may contact the Privacy Officer listed below. You may also send a written complaint to the U.S. Department of Health and Human Services. The person listed below will provide you with the appropriate address upon request. You will not be penalized in any way for filing a complaint.

Contact Person

If you have any questions, requests or complaints, please contact:

Upper Cape Ear, Nose & Throat, PC
Roberta Tibbetts - Privacy Officer