Mon. to Fri. 9am to 5pm    © Active Pain and Injury Inc 2012 - 2017    Phone: 407. 330.6500  -  Fax: 407. 330.6526    Se habla Espanol
1403 Medical Plaza Drive. Suites 108 & 109 Sanford, Florida 32771 Phone: 855 - PIP - PAIN 
          855 - 747 - 7246 Phone: 407 - 330 - 6500 
Fax:     407 - 330 - 6526

SE HABLA ESPANOL! OPENED MON - FRI 9:00 AM TO 5:00 PM

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You can ask to change any wrong information in your file or add information to your file if you think something is missing or incomplete. For example, if you and your hospital agree that your file has the wrong result for a test, the hospital must change it. Even if the hospital believes the test result is correct, you still have the right to have your disagreement noted in your file. In most cases, the file should be updated within 60 days.










































YOUR HEALTH INFORMATION
PRIVACY RIGHTS
You can ask to see or get a copy of your medical record and other health
information. If you want a copy, you may have to put your request in
writing and pay for the cost of copying and mailing. In most cases, your
copies must be given to you within 30 days.
Get It.
Most of us feel that our health information is private and should be
protected. That is why there is a federal law that sets rules for health care
providers and health insurance companies about who can look at and
receive our health information. This law, called the Health Insurance
Portability and Accountability Act of 1996 (HIPAA), gives you rights over
your health information, including the right to get a copy of your
information, make sure it is correct, and know who has seen it.
Check It.
Know Who Has Seen It.
By law, your health information can be used and shared for specific
reasons not directly related to your care, like making sure doctors give
good care, making sure nursing homes are clean and safe, reporting when
the flu is in your area, or reporting as required by state or federal law. In
many of these cases, you can find out who has seen your health
information. You can:
Learn how your health information is used and shared by your doctor
or health insurer. Generally, your health information cannot be used for
purposes not directly related to your care without your permission. For
example, your doctor cannot give it to your employer, or share it for things
like marketing and advertising, without your written authorization. You
probably received a notice telling you how your health information may be
used on your first visit to a new health care provider or when you got new
health insurance, but you can ask for another copy anytime.

Let your providers or health insurance companies know if there is
information you do not want to share. You can ask that your health
information not be shared with certain people, groups, or companies.
If you go to a clinic, for example, you can ask the doctor not to share
your medical records with other doctors or nurses at the clinic. You can
ask for other kinds of restrictions, but they do not always have to agree
to do what you ask, particularly if it could affect your care. Finally, you
can also ask your health care provider or pharmacy not to tell your health
insurance company about care you receive or drugs you take, if you pay
for the care or drugs in full and the provider or pharmacy does not need
to get paid by your insurance company.
Ask to be reached somewhere other than home. You can make
reasonable requests to be contacted at different places or in a different
way. For example, you can ask to have a nurse call you at your office
instead of your home or to send mail to you in an envelope instead of on
a postcard.
If you think your rights are being denied or your health information is not


To learn more, visit www.hhs.gov/ocr/privacy/.




being protected, you have the right to file a complaint with your provider,
health insurer, or the U.S. Department of Health and Human Services.
Your Health Information Privacy Rights 2
1 .