Our Location:
8598 Utica Ave. Suite 100
Rancho Cucamonga, CA 91730
Voice 909-987-3535
Fax 909-987-3536
Hours:
Monday - Friday
9:00 am until 5:00 pm
Sleep Studies:
By Appointment Only
Privacy Policy
Reason for a privacy policy
It is our desire to communicate to you that we are taking the new federal (HIPPA) Health insurance Portability and Accountability Act Laws written to protect the confidentiality of your health information seriously. The changes in the evolution of computer technology that is used in healthcare have prompted the government to seek a way to standardize and protect the electronic exchange of your health information. The Sleep Disorders Center respects your privacy; we understand that your personal health information is very sensitive. We will not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so. The law protects the privacy of the health information we create and obtain in providing our care and services to you. For example, your protected health information includes your test results, diagnosis, and treatment, health information from other providers, and billing and payment information relating to these services. Federal and state laws allow us to use and disclose your protected health information for purposes of treatments and health care operations. State law requires us to get your authorization to disclose this information for payment purpose.
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 read carefully.
Examples of use and Disclosure of Protected Health Information of Treatment, Payment and Health Operations.
For Treatment:
Information obtained by the Sleep Disorders Center or members of our health care team will be recorded in your medical records and will be used to help decide what care may be right for you. We may also provide information to others providing your care. This will help stay informed about your care.
For Payment:
Billing information to your insurance company, disclosures to consumer reporting agencies, (limited to specified identifying information about an individual, his/ her payment history, and identifying about the covered entity.)
For Health Care Operations:
Such as quality assurance reviews, coordination of care, and eligibility verification.
Public Health Activities:
Such as child abuse or neglect.
In addition to the above, your medical information may be used or disclosed for emergency treatment, when we are required by law to treat you, we attempt to obtain consent, and are to do so; we are unable to obtain consent due to substantial communication barriers and consent for treatment is implied under circumstances; or we created or received the information in treating an inmate.
Your Health Information Rights
The health and billing records we create and store are property of the SLEEP DISORDERS CENTER Inc. The protected health information in it, however, generally belongs to you. You have the right to:
Receive, read and ask questions about this notice.
- Request restrictions on certain uses and disclosures; however, we are not required to agree to any restriction.
- Receive confidential communications from us, upon written request.
- Inspect and request copies of your medical information.
- Receive an accounting of any disclosures made, upon written request.
- Receive a paper copy of the notice upon request or review out entire policy.
When you request we will give you a list of disclosures of your health information. The list will not include disclosure to third-party payers. You may receive this information without charge once every 12 months. We will notify you of the cost involved if you request this more than once in a 12 month period.
Our Responsibilities
We are required to:
- Maintaining the privacy of your medical information.
- Providing you this notice and obtaining written acknowledgement.
- Follow the terms of this notice.
- Abiding by terms of this notice.
- Providing written notice of any changes to this notice.
To ask for help or complain:
You may complain to us if you believe that your privacy has been violated. If you wish to file a complaint with us, please provide the office manager,
Carolina Pereira at:
confidential email- kathypereira@yahoo.com
voicemail- (909) 987-3535 EXT 201
fax- (909) 987-5484
With a written notice of how you believe we violated your privacy. All notices received will be investigated and
reviewed by a physician. We will respond to all notices within two (2) weeks of receipt, and we will not retaliate for any
allegations you make.
Other disclosure and uses of the Protected Health Information for Health care operations include:
Authorizations:
Upon your authorization, we may disclose your medical information to a requesting entity, such as an attorney, another
insurance company (apply for life insurance), or a relative. You may revoke any authorization you make at any time except to the
extent that it is already relied on.