HIPAA Compliance

Foot Pain Relief Store LLC

Notice of Privacy Practices

Effective 05-01-03

This notice describes how medical information about you may be used, disclosed and how you can get access to this information.  Please review it carefully.  If you have any questions or want to make a request pursuant to the rights described below, please contact:

FPRSLLC Administrator

7801 N. Lamar, Suite C-59

Austin, TX  78752

Phone Number 512-374-0818

Fax Number 512-374-0810

Health Care Operations

Foot Pain Relief Store LLC provides health care to our patients in partnership with physicians and other professionals and organizations.  The information privacy in the Notice will be followed by:

                *Any health care professional who treats you at the health care facility;

                *All departments and units of our organization;

                *All employed associates and staff of our organization;

                *Any business associate or partner of Foot Pain Relief Store LLC with whom we share health  

                 information.

Our promise to you

We understand that the medical and billing information about you is personal.  We are committed to protecting the privacy of your medical and billing information.  We create a designated record of the care and services you receive to provide quality care and to comply with legal requirements.  This Notice applies to all of the records of your care that we maintain, whether created by facility staff or your personal doctor.  We are required by law to:

                *Keep medical and billing information about you private;

                *Give you this Notice of our legal duties and privacy practices with respect to your protected   

                 health information;

                *Follow the terms of the Notice currently in effect.

Changes to this Notice

We may change our policies and privacy practices at any time.  Changes will apply to your protected health information we already hold, as well as new information obtained after the changes occur.  When we make a significant change in our policies, we will change our Notice and post the new Notice in our waiting area.  You can receive a copy of the current Notice at any time.

How we may use and disclose your protected health information

We may use and disclose medical and billing information about you for treatment (such as sending medical information about you to a specialist as part of a referral); to obtain payment for treatment (such as sending billing information to your insurance company or Medicare); and to support our health care operation (such as comparing patient data to improve treatment methods).

We may use or disclose medical and billing information about you without your prior authorization for several other reasons.  Subject to certain requirements, we may give out protected health information about you without prior authorization for public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements, workers’ compensation purposes, or during emergencies.  We may also disclose protected health information when required by law, such as in a response to request from law enforcement officials in specific circumstances, or in response to valid judicial or administrative orders.  We may contact you by (telephone, mail, or both) to provide appointment reminders, or recommend possible treatment options, alternatives, health-related benefits or service that may be of interest to you.

Your rights regarding medical information about you

In most cases, you have the right to look at or obtain a copy of medical and billing information contained in the designated record set that we use to make decisions about your care.  If you request copies, we may charge a fee for the cost of copying, related supplies or postage.  Texas law requires us to be ready to provide copies of a narrative within 15 days of your request.  We will inform you when the records are ready or if we believe access should be limited.  If we deny your request to review or obtain a copy, we will inform you in writing and you may submit a written request for a review of that decision.

If you believe that information in your designated record set is incorrect or if important information is missing, you have the right to request that we correct the records.  Your request may be submitted in writing.  A request for an amendment must provide your reason for the amendment.  We could deny your request to amend a record if the information was not created by us; if it is not part of the medical or billing information maintained by us; or if we determine that the record is accurate.  You may appeal, in writing, a decision by us not to amend a record.

Accounting of Certain Disclosures

HIPAA privacy regulations permit you to request, and us to provide, an accounting of disclosures that are other than for treatment, payment, health care operations, or made via an authorization signed by you or your representative.  Please submit any request for an accounting to the person at the beginning of this document.  Your first accounting of disclosure (within 12-month period) will be free.  For additional requests within that period we permitted to charge for the cost of providing the list.  If there is a charge we will notify you, and you may choose to withdraw or modify your request before any costs are incurred.

You have the right to request, in writing, that we not use or disclose protected health information about you for treatment, payment or healthcare operation or to persons involved in your care except when specifically authorized by you, or when required by law, or emergency.  We will consider your request but we are not legally required to accept it.  We will inform you of our decision.

All written requests or appeals should be submitted to our Privacy Officer listed at the beginning of the Notice.

Complaints

If you are concerned that your privacy rights have been violated, you may contact the Privacy Officer.  You may also send a written complaint to the U.S. Department of Health and Human Services.  We will not retaliate against you for filing a complaint with us or the government.  The contact information for the United States Department of Health and Human Services is:

U. S. Department of Health and Human Services, HIPAA Complaint, 7500 Security Blvd., C5-24-04, Baltimore, MD  21244