THIS NOTICE DESCRIBES HOW PROTECTED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.    

IMAA is permitted to make uses and disclosures of protected health information of:    

  1. Treatment – i.e.; ordering and obtaining off site tests/results, writing prescriptions, etc. 
  2. Payment – i.e.; submitting insurance claims on your behalf for treatment rendered
  3. Health Care Operation – i.e.; internal business planning activities and quality of care evaluations.    

IMAA is permitted or required under specific circumstances, to use or disclose protected health information without the individual’s written authorization, including, but not limited to:    

  1. Disclosures required by law. 
  2. Disclosures to avert serious threats to health or safety. 
  3. Disclosures with references to workers compensation.    

Other uses and disclosures will be made only with the individual’s written authorization, and the individual may revoke such authorization. (Please see attached forms for identifying persons to whom you would like to allow disclosures of otherwise protected information).    

IMAA may contact the individual to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to the individual or patient. IMAA will routinely contact patients via telephone at home and/or work and, unless otherwise requested, may leave messages on the appropriate voice mail or answering machine regarding appointments, test results, etc.    

The individual has the following rights regarding protected health information: 

  1. The right to request restrictions on certain uses and disclosures of protected health information. IMAA is not required to agree to the restriction, however. 
  2. The right to receive confidential communications of protected health information, as applicable 
  3. The right to inspect and copy protected health information, as provided in the privacy regulation. (U.S. Department of Health and Human Services)
  4. The right to request changes in protected health information, as provided by the privacy regulation.
  5. The right to receive an accounting of disclosures of protected health information. 
  6. The right to obtain a paper copy of the notice from the covered entity upon request. This right extends to an individual who has agrees to receive notice electronically.    

IMAA is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information. IMAA is required to abide by the terms of the notice currently in effect.    

IMAA reserves the right to change the terms of this notice. The new notice provisions will be effective for all protected health information that it maintains. IMAA will provide individuals or patients with a revised notice by posting regulations in our office.    

Individuals may complain to IMAA and the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. IMAA’s contact person for matters relating to complaints is:    

IMAA Privacy Officer 

6035 Burke Centre Parkway, Suite 120 

Burke, VA 22015 

703-425-6010    

This notice is first in effect on April 14, 2003.