WEBSITE PRIVACY PRACTICE
Dr. Tirgan does not collect any information from the website visitors other than what the visitors disclose themselves. The server however, may collect statistics as to number of visitors to our site, IP addresses and pages they visit, etc. This information is neither saved nor distributed to anyone.
MEDICAL PRACTICE PRIVACY POLICY
(This privacy policy applies only to the patients who are treated by Dr. Tirgan)
PRIVACY OFFICER
Dr. Tirgan is the privacy officer of the practice. If you have any questions about this notice or would like further information, please contact Dr. Tirgan at (212) 874 4200. 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.
We are 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/policies of our medical practice, our medical staff, and affiliated health care providers that may jointly provide health care services to you through our practice. You will also be able to obtain your own copy by calling our office at (212) 874 4200 or asking for one at the time of your next visit.
WHO WILL FOLLOW THIS NOTICE?
Dr. Tirgan provides health care to patients directly and at times jointly with physicians and other health care professionals and organization.. The privacy practices described in this notice will be followed by:
1- Any healthcare professional who treats you at any of our locations;
2- All employees, medical staff, trainees, students or volunteers at any of our locations;
PERMISSIONS DESCRIBED IN THIS NOTICE
This notice will explain the different types of permissions and consents we will obtain from you before we use or disclose your health information. The three types of permissions and consents are:
A general written consent, which we must obtain from you in order to use and disclose your health information in order to treat you, obtain payment for that treatment, and conduct our business operations. We must obtain this general written consent at your first visit to our office. This general written consent is a broad permission that does not have to be repeated each time we provide treatment or services to you in future.
An opportunity to object which we must provide to you before we may use or disclose your health information for certain purposes. In these situations, you will have an opportunity to object to the use or disclosure of your health information in person, over the phone, or in writing;
A written authorization, which will provide you with detailed information about the persons who may receive your health information and the specific purposes for which your health information may be used or disclosed. We are only permitted to use and disclose your health information described on the written authorization in ways that are explained on the written authorization form you may sign. A written authorization has an expiration date.
WHAT HEALTH INFORMATION IS PROTECTED
We are committed to protecting the privacy of information that we gather about you while providing healthcare services to you. Some examples of protected health information are:
- Information indicating that you are a patient of this practice or receiving treatment or other health-related services from us;
- 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); or
- Information about your health-care benefits under an insurance plan (such as whether a prescription is covered);
- Only 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, your phone number, or your drivers license number); and
- Any other types of information that may identify who you are.
HOW TO FILE A COMPLAINT
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services.
To file a complaint with us, please contact:
- Michael H. Tirgan MD, 23 West 73rd St. Suite GD, New York, NY 10023, Telephone: (212) 874 4200
No one will retaliate or take action against you for filing a complaint.
Important Summary Information:
Requirement for Written Authorization
We will generally obtain your written authorization before using your health information or sharing it with others outside the practice. You may also initiate the transfer of your records to another person by completing a written authorization form. If you provide us with written authorization, you may revoke that written authorization at any time, except to the extent that we have already relied upon it. To revoke a written authorization, please write to the Privacy Officer, Dr. Tirgan.
Exception for Treatment, Payment, and Business Operations
We will only obtain your general written consent one time to use and disclose your health information to treat your condition or run our business operations. For more information, see details in Treatment and Business Operations Section.
Exception for Disclosure to Family and Friends Involved in Your Care
We will ask you whether you have any objection to sharing information about your health with your friends and family members. We may use your health information and share it with family and friends involved in your care, without your written authorization. We will always give you an opportunity to object unless there is insufficient time because of a medical emergency (in which case we will discuss your preferences with you as soon as the emergency is over). We will follow your wishes unless we are required by law to do differently. If you do not object, we may share your health information with a family member, relative, or close personal friend who is involved in your care or payment for that care.
Exception in Emergencies or Public Need
We may use or disclose your health information in an emergency or for important public needs. For example, we 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. For more information, see details in Emergencies and Public Need Section.
Exception if Information Is Completely or Partially De-Identified
We may use and disclose your health information if we have removed any information that has the potential to identify you so that the health information is “completely de-identified.†We may also use and disclose “partially de-identified†health information about you if the person who will receive the information signs an agreement to protect the privacy of the information as required by federal and state law. Partially de-identified health information will not contain any information that would directly identify you (such as your name, street address, social security number, phone number, fax number, electronic mail address, website address, or license number).
How to Access Your Health Information
You generally have the right to inspect and copy your health information. For more information, see details in How to Access Your Health Information Section
How to Correct Your Health Information
If you believe that the health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept in our records. To request an amendment, please write to the Dr. Tirgan. Your request should include the reasons why you think we should make the amendment. Ordinarily we will respond to your request within 60 days. If we need additional time to respond, we will notify you in writing within 60 days to explain the reason for the delay and when you can expect to have a final answer to your request.
How to Identify Others Who Have Received Your Health Information
You have the right to receive an “accounting of disclosuresâ€, which identifies certain persons or organizations to whom we have disclosed your health information in accordance with the protections described in this Notice of Privacy Practices. Many routine disclosures we make will not be included in this accounting, but the accounting will identify many non-routine disclosures of your information. For more information, see details in Accounting of Disclosures
How to Request Additional Privacy Protections
You have the right to request that we further restrict the way we use and disclose your health information to treat your condition, collect payment for that treatment, or run our business operations. You may also request that we limit how we disclose information about you to family or friends involved in your care. For example, you could request that we not disclose information about a surgery or procedure that you had. To request restrictions, please write to the Dr. Tirgan. Your request should include (1) what information you want to limit; (2) whether you want to limit how we use the information, how we share it with others, or both; and (3) to whom you want the limits to apply.
We are not required to agree to your request for a restriction, and in some cases the restriction you request may not be permitted under law. However, if we do agree, we will be bound by our agreement unless the information is needed to provide you with emergency treatment or comply with the law. Once we have agreed to a restriction, you have the right to revoke the restriction at any time. Under some circumstances, we will also have the right to revoke the restriction as long as we notify you before doing so; in other cases, we will need your permission before we can revoke the restriction.
How to Request More Confidential Communications
You have the right to request that we communicate with you about your medical matters in a more confidential way by requesting that we communicate with you by alternative means or at alternative locations. For example, you may ask that we contact you at home instead of at work or be called on a cell phone. To request more confidential communications, please write to Dr. Tirgan. We will not ask you the reason for your request, and we will try to accommodate all reasonable requests. Please specify in your request how or where you wish to be contacted, and how payment for your health care will be handled if we communicate with you through this alternative method or location.
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.
Treatment, Payment and Business Operations
With your general written consent, we may use your health information or share it with others in order to treat your condition and run our business operations. Below are other examples of how your information may be used and disclosed for these purposes.
Treatment
We may share your health information with other doctors or nurses who will be involved in taking care of you, and they may in turn use that information to diagnose or treat you. In the event of admitting you to a hospital, we will share your health information with doctors and nurses and other staff of that hospital for the purpose of determining how to diagnose or treat you.
Business Operations
We may use your health information or share it with others in order to conduct our business operations. For example, we may use your health information to evaluate the performance of our staff in caring for you, or to educate our staff on how to improve the care they provide for you. Finally, we may share your health information with other health care providers and payors for certain of their business operations if the information is related to a relationship the provider or payor currently has or previously had with you, and if the provider or payor is required by federal law to protect the privacy of your health information.
Appointment Reminders, Treatment Alternatives, Benefits and Services
In the course of providing treatment to you, we may use your health information to contact you with a reminder that you have an appointment for treatment or services at our office. We may also use your health information in order to recommend possible treatment alternatives or health-related benefits and services that may be of interest to you.
Notes:
Once you sign this general written consent form, it will be in effect indefinitely until you revoke your general written consent. You may revoke your general written consent at any time, except to the extent that we have already relied upon it. For example, if we provide you with treatment before you revoke your general written consent, we may still share your health information with your insurance company in order to obtain payment for that treatment. To revoke your general written consent, please write to the Privacy Officer; Dr. Tirgan.
Emergencies or Public Need:
We may use your health information, and share it with others, in order to treat you in an emergency or to meet important public needs. We will not be required to obtain your general written consent before using or disclosing your information for these reasons. We will, however, obtain your written authorization for, or provide you with an opportunity to object to, the use and disclosure of your health information in these situations when state law specifically requires that we do so.
Emergencies
We may use or disclose your health information if you need emergency treatment or if we are required by law to treat you but are unable to obtain your general written consent. If this happens, we will try to obtain your written consent as soon as we reasonably can after we treat you.
Communication Barriers
We may use and disclose your health information if we are unable to obtain your general written consent because of substantial communication difficulties, and we believe you would want us to treat you if we could communicate with you as required by Law. We may use or disclose your health information if we are required by law to do so. We also will notify you of these uses and disclosures if such a notice is required by law.
Public Health Activities
We may disclose your health information to authorized public health officials (or a foreign government agency collaborating with such officials) so they may carry out their public health activities. For example, we may share your health information with government officials that are responsible for controlling disease, injury or disability. We may also disclose your health information to a person who may have been exposed to a communicable disease or be at risk for contracting or spreading the disease if a law permits us to do so. And finally, we may release some health information about you to your employer if your employer hires us to provide you with a physical exam and we discover that you have a work-related injury or disease that your employer must know about in order to comply with employment laws.
Health Oversight Activities
We may release your health information to government agencies authorized to conduct audits, investigations, and inspections of our facility. These government agencies monitor the operation of the health care system, government benefit programs such as Medicare and Medicaid, and compliance with government regulatory programs and civil rights laws.
Product Monitoring, Repair and Recall
We may disclose your health information to a person or company that is regulated by the Food and Drug Administration for the purpose of:
- Reporting or tracking product defects or problems;
- Repairing, replacing, or recalling defective or dangerous products; or
- Monitoring the performance of a product after it has been approved for use by the general public.
Lawsuits and Disputes
We may disclose your health information if we are ordered to do so by a court or administrative tribunal that is handling a lawsuit or other dispute.
Law Enforcement
- To comply with court orders or laws that we are required to follow;
- To assist law enforcement officers with identifying or locating a suspect, fugitive, witness, or missing person;
- If you have been the victim of a crime and we determine that: (1) we have been unable to obtain your general written consent because of an emergency or your incapacity; (2) law enforcement officials need this information immediately to carry out their law enforcement duties; and (3) in our professional judgment disclosure to these officers is in your best interests;
- If necessary to report a crime that occurred on our property; or
- If necessary to report a crime discovered during an offsite medical emergency (for example, by emergency medical technicians at the scene of a crime) to a person subject to the jurisdiction of the Food and Drug Administration (FDA) for purposes related to the quality, safety or effectiveness of an FDA-regulated product or service;
- To prevent or control disease, injury or disability;
- To report disease or injury;
- To report child abuse or neglect;
- To report reactions to medications and food or problems with products;
- To notify people of recalls or replacements of products they may be using;
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
- To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Military and Veterans
If you are in the Armed Forces, we may disclose health information about you to appropriate military command authorities for activities they deem necessary to carry out their military mission. We may also release health information about foreign military personnel to the appropriate foreign military authority.
Health Oversight Activities
We may disclose medical information about you to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure.
National Security and Intelligence Activities or Protective Services
We may disclose your health information to authorized federal officials who are conducting national security and intelligence activities or providing protective services to the President or other important officials.
Your Rights to Access and Control Your Health Information
We want you to know that you have the following rights to access and control your health information/medical records. These rights are important because they will help you make sure that the health information we have about you is accurate. They may also help you control the way we use your information and share it with others, or the way we communicate with you about your medical matters.
Right to Inspect and Copy Records
You have the right to inspect and obtain a copy of any of your health information/medical records that may be used to make decisions about you and your treatment for as long as we maintain this information in our records. This includes medical and billing records. To inspect or obtain a copy of your health information/medical records, please submit your request in writing to the Dr. Tirgan. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies we use to fulfill your request. The standard fee is $0.50 per page and must generally be paid before or at the time we give the copies to you.
We respond to your request for inspection of records within 10 days. We normally respond to requests for copies within 30 days. If we need additional time to respond to a request for copies, we will notify you in writing within the time frame above to explain the reason for the delay and when you can expect to have a final answer to your request.
Right to Amend Records
If you believe that the health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept in our records. To request an amendment, please write to Dr. Tirgan. Your request should include the reasons why you think we should make the amendment. Ordinarily we will respond to your request within 60 days. If we need additional time to respond, we will notify you in writing within 60 days to explain the reason for the delay and when you can expect to have a final answer to your request.
If we deny part or your entire request, we will provide a written notice that explains our reasons for doing so. You will have the right to have certain information related to your requested amendment included in your records. For example, if you disagree with our decision, you will have an opportunity to submit a statement explaining your disagreement which we will include in your records. We will also include information on how to file a complaint with us or with the Secretary of the Department of Health and Human Services. These procedures will be explained in more detail in any written denial notice we send you.
Right to an Accounting of Disclosures
After April 14, 2003, you have a right to request an “accounting of disclosures†which identifies certain other persons or organizations to whom we have disclosed your health information in accordance with applicable law and the protections afforded in this Notice of Privacy Practices. An accounting of disclosures does not describe the ways that your health information has been shared within and between the hospital and the facilities listed at the beginning of this notice, as long as all other protections described in this Notice of Privacy Practices have been followed (such as obtaining the required approvals before sharing your health information with our doctors for research purposes).
An accounting of disclosures does not include information about the following disclosures:
Disclosures we made to you or your personal representative;
Disclosures we made pursuant to your written authorization;
Disclosures we made for business operations;
Disclosures made to your friends and family involved in your care or payment for your care;
Disclosures that were incidental to permissible uses and disclosures of your health information (for example, when information is overheard by another patient passing by);
Disclosures for purposes of research, public health or our business operations of limited portions of your health information that do not directly identify you;
Disclosures made to federal officials for national security and intelligence activities;
To request an accounting of disclosures, please write to:
Dr. Tirgan, 23 West 73rd St. Suite GD, New York, NY 10023, Telephone: (212) 874 4200
Your request must state a time period within the past six years for the disclosures you want us to include. You have a right to receive one accounting within each calendar year for free. However, we may charge you for the cost of providing any additional accounting in that same year. We will always notify you of any cost involved so that you may choose to withdraw or modify your request before any costs are incurred.
We will respond to your request for an accounting within 60 days. If we need additional time to prepare the accounting you have requested, we will notify you in writing about the reason for the delay and the date when you can expect to receive the accounting. In rare cases, we may have to delay providing you with the accounting without notifying you because a law enforcement official or government agency has asked us to do so
Right to Request Additional Privacy Protections
You have the right to request that we further restrict the way we use and disclose your health information to treat your condition, collect payment for that treatment, or run our business operations. You may also request that we limit how we disclose information about you to family or friends involved in your care. For example, you could request that we not disclose information about a procedure or treatment that you had. To request restrictions, please write to Dr. Tirgan. Your request should include (1) what information you want to limit; (2) whether you want to limit how we use the information, how we share it with others, or both; and (3) to whom you want the limits to apply.
We are not required to agree to your request for a restriction, and in some cases the restriction you request may not be permitted under law. However, if we do agree, we will be bound by our agreement unless the information is needed to provide you with emergency treatment or comply with the law. Once we have agreed to a restriction, you have the right to revoke the restriction at any time. Under some circumstances, we will also have the right to revoke the restriction as long as we notify you before doing so; in other cases, we will need your permission before we can revoke the restriction.
RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS
You have the right to request that we communicate with you about your medical matters in a more confidential way by requesting that we communicate with you by alternative means or at alternative locations. For example, you may ask that we contact you at home instead of at work. To request more confidential communications, please write to Dr. Tirgan. We will not ask you the reason for your request, and we will try to accommodate all reasonable requests. Please specify in your request how or where you wish to be contacted, and how payment for your health care will be handled if we communicate with you through this alternative method or location.
Completely De-Identified or Partially De-Identified Information
We may use and disclose your health information if we have removed any information that has the potential to identify you so that the health information is “completely de-identified.†We may also use and disclose “partially de-identified†health information about you if the person who will receive the information signs an agreement to protect the privacy of the information as required by federal and state law.
Partially de-identified health information will not contain any information that would directly identify you (such as your name, street address, social security number, phone number, fax number, electronic mail address, website address, or license number).
Discuss your condition with family and friends
We may share your health information with family and friends involved in your care, without your written authorization. We will always give you an opportunity to object unless there is insufficient time because of a medical emergency (in which case we will discuss your preferences with you as soon as the emergency is over). We will follow your wishes unless we are required by law to do otherwise.
If you do not object, we may share your health information with a family member, relative, or close personal friend who is involved in your care or payment for that care. In some cases, we may need to share your information with a disaster relief organization that will help us notify these persons.
Incidental Disclosures
While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during or as an unavoidable result of our otherwise permissible uses or disclosures of your health information. For example, during the course of a treatment session, other patients in the treatment area may see, or overhear discussion of, your health information.