HIPAA Patient Privacy

Health Insurance Portability and Accountability Act of 1996 (HIPAA)


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.

Please read our website privacy policy here

Purpose of this Notice

In the course of doing business, Sacramento Colon & Rectal Surgery Medical Group – (AKA SCRSMG) gathers and retains personal information about our patients. SCRSMG respects the privacy of your personal information and understands the importance of keeping this information confidential and secure. This Notice describes how SCRSMG protects the confidentiality of your personal information that we receive. SCRSMG has implemented policies and procedures in accordance with Federal and State confidentiality and privacy laws to protect your privacy. SCRSMG is obligated to maintain the privacy and confidentiality of your personal information. SCRSMG is also obligated to provide you with notice of its legal obligations to maintain the privacy of your personal information and to provide you notice of its policies and procedures about privacy and confidentiality. These policies and procedures apply to past, present and future patients and past, present and future personal information.

What is “Personal Information”?

“Personal information” is information that identifies who you are and relates to your past, present, or future physical or mental health or condition, the provision of health care to you, or past, present, or future payment for the provision of health care to you. Personal information does not include information about you that is publicly available, or that is available or reported in summary form, but does not identify who you are.

Types of Uses and Disclosures of Personal Information Made by SCRSMG

Federal law allows SCRSMG to use and disclose your personal information in order to provide health care services to you as well as to bill and collect payments for the health care services provided to you by SCRSMG. Federal law also allows SCRSMG to use and disclose your personal information as necessary in connection with the health care operations of SCRSMG. For example, SCRSMG may use your personal information to receive payment for the services provided by SCRSMG. Certain governmental agencies may also request access to your personal information in order to monitor the activities of certain physicians or providers, or even to monitor your health plan or insurance company. SCRSMG may disclose your personal information in connection with court orders or subpoenas. While Federal law allows health care providers to use and disclose your personal information for treatment, payment, and health care operations, the law requires these providers to obtain your written consent to do so. Therefore, the first time you see a SCRSMG physician once these federal rules take effect, the physician will ask you to sign a consent form allowing the physician to use and disclose your personal information in connection with your treatment, the payment for your treatment, and the physician’s health care operations. SCRSMG is also allowed by law to use and disclose your personal information without your consent or authorization for the following purposes:

1. When required by law.
2. For public health activities, such as reports about communicable diseases or work-related health issues.
3. In reports about child abuse, domestic violence, or neglect.
4. For health oversight activities, such as reports to governmental agencies that are responsible for licensing physicians or other health care providers.
5. In connection with court proceedings or proceedings before administrative agencies.
6. For law enforcement purposes, such as responding to a court order or subpoena.
7. In reports to coroners, medical examiners, or funeral directors.
8. For tissue or organ donation.
9. For research, with the approval of certain oversight entities; otherwise, use and disclosure of your personal information required for research requires your authorization.
10. To avert a serious threat to the health or safety of a person or of the public.
11. For national security and intelligence activities, including the protection of the President.
12. In connection with services provided under workers’ compensation laws.
13. For limited marketing purposes when related to your treatment.

SCRSMG may disclose your personal information to your family members who are involved in your care without either your consent or your authorization. However, you must be provided with an opportunity to object prior to the disclosure. All other uses and disclosures of your personal information will be made by SCRSMG only with your written authorization.

How We Protect Personal Information

SCRSMG restricts access to your personal information to those employees who need access in order to provide services to our patients. We have established and maintained appropriate physical, electronic and procedural safeguards to protect your personal information against unauthorized use or disclosure. We have established a training program that SCRSMG employees must complete.

As a matter of federal and state law, you have the right to review and copy your personal information received and retained by SCRSMG. If you desire access to your personal information, you must notify SCRSMG in writing. We will respond to your request and provide a time and place, within normal business operating hours, for your inspection of the personal information SCRSMG has in its possession. If you request a copy of the information held by SCRSMG, a copy can be provided. We reserve the right to charge a reasonable administrative fee for copying your personal information, as allowed by applicable law.

Right to Amend Personal Information

State and federal law allows you the right to amend your personal information held by SCRSMG. A request to amend your personal information must be submitted to SCRSMG in writing. SCRSMG will attach your amendment to the record(s) of your personal information. Your amended personal information will be made available for your review upon request.

Right to Receive This Notice


You have the right to request and receive a copy of this Notice. You may contact SCRSMG for a copy, and one will be provided to you at no charge.

Right to Request Restriction on Disclosure of Personal Information

State and federal law permits you to request restrictions on the use and disclosure of your personal information by SCRSMG. SCRSMG reserves the right to accept or reject your request for restriction. All requests must be made in writing. Upon receipt, SCRSMG will review the request and notify you of its decision to either accept or reject the request. Even if SCRSMG agrees to honor your request and disclosures of your personal information, SCRSMG may cease to honor that restriction without your
consent, upon notice to you. In that event, SCRSMG will continue to honor the request for a restriction in connection with all personal information, which SCRSMG received or created prior to termination of the restriction. However, SCRSMG will not be obligated to honor the restriction after it provides you notice that it will cease to do so. If you agree to terminate, then SCRSMG may use and disclose all of your personal information in its possession in accordance with applicable law. All requests for restrictions, which are agreed to by SCRSMG, will be made part of your personal information and be made available for your review upon proper request.

Right to Confidential Communications

You have the right to request that SCRSMG provide your personal information to you in a confidential manner. For example, you may request that SCRSMG send your personal information by alternate means or to an alternate address, such as by telefax or to an office address rather than your home address. In addition, you may, for example, request that your personal information be sent in a sealed envelope rather than on a postcard.

Right to Complain

SCRSMG is obligated to comply with the privacy practices set forth in this Notice. If you believe that SCRSMG has violated this privacy policy, you have the right to file a complaint with SCRSMG, your Health Plan, the California Department of Managed Care or the United States Department of Health and Human Service, Office of Civil Rights.

Effective Date

The effective date of this Notice is April 15, 2003.