Your privacy protection is our priority.

NOTICE OF PRIVACY PRACTICES

Effective: April 1, 2003 

This notice describes how acupuncture and oriental medicine information about you may be used and disclosed and how you can get access to this information.  

Please review it carefully. If you have any questions about this notice, please contact Dr. Yanfang Liu at 713-780-9777.

WHO WILL FOLLOW THE REQUIREMENTS OF THIS NOTICE.

This notice describes ACAOM’s practices and those of:

  • Any health care professional authorized to enter information into your ACAOM chart.
  • All departments and units of the ACAOM.
  • Any member of a volunteer group we allow to help you while under the care of the ACAOM.
  • All employees, staff, students, interns, and other ACAOM personnel.
  • All of the following entities, sites and locations comply with the terms of this notice. In addition, these entities, sites and locations may share acupuncture / Oriental medicine information with each other for treatment, payment or ACAOM operations purposes described in the notice.
  1. ACAOM’s clinic at University of Houston Clear Lake Health Center
  2. ACAOM’s clinic at Methodist Hospital Medical Center
  3. ACAOM’s clinic at Methodist Hospital Sugar Land
  4. ACAOM’s clinic at Methodist Hospital San Jacinto
  5. ACAOM’s clinic at Methodist Hospital Holly Hall
  6. ACAOM’s clinic at Methodist Hospital Willowbrook

OUR PLEDGE REGARDING ACUPUNCTURE / ORIENTAL MEDICINE INFORMATION:

We understand that acupuncture / Oriental medicine information about you and your health is personal. We are committed to protecting this information about you. We create a record of the care and services you receive at the ACAOM. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the ACAOM, whether made by ACAOM personnel, staff, students, or interns.

This notice will tell you about the ways in which we may use and disclose acupuncture / oriental medicine information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of acupuncture /Oriental medicine information

We are required by law to:

  • Assure acupuncture / oriental medicine information that identifies you is kept private;
  • Give you this notice of our legal  duties and privacy practices with respect to acupuncture / Oriental      medicine information about you; and
  • Follow the terms of the notice that is currently in effect.

HOW MAY WE USE AND DISCLOSE ACUPUNCTURE / ORIENTAL MEDICINE INFORMATION ABOUT YOU.

The following categories describe different ways that we use and disclose acupuncture / oriental medicine information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

  • For Treatment       We may use acupuncture / Oriental medicine information about you to provide you with treatment or services. We may disclose acupuncture / Oriental medicine information about you to doctors, nurses, licensed acupuncturists, healthcare professionals in training (such as students and      interns), or other ACAOM personnel who are involved in taking care of you through the ACAOM. Different departments of ACAOM may also share acupuncture /Oriental medicine information about you in order to coordinate the different things you need such as acupuncture treatments and herb preparation. We also may disclose acupuncture / Oriental medicine information about you to people outside the ACAOM who may be involved in your care, such as your western medical physician.
  • For Payment  We may use and disclose acupuncture / Oriental medicine information about you so that that the treatment and services you receive at the ACAOM may be billed to and payment may be      collected from you, an insurance company or a third party if applicable.
  • For Healthcare Operations  We may use and disclose acupuncture / Oriental medicine information about you for ACAOM operations. These uses and disclosures are necessary to run the ACAOM and make sure that all of our clients receive quality care. For example, we may use acupuncture / Oriental medicine    information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine acupuncture / Oriental medicine information about many ACAOM clients to decide what additional services that ACAOM should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, licensed acupuncturists, health professionals in training (such as students and interns), and other ACAOM      personnel for review and learning purposes. We may also combine the acupuncture / Oriental medicine information we have with other medical information from other health care providers to compare how we are doing  and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of acupuncture /Oriental medicine information so others may use it to study health care and health care delivery without learning who are specific patients are.
  • Appointment Reminders  We may use and disclose acupuncture / Oriental medicine information  to contact you as a reminder that you have an appointment for treatment or to remind you of services offered at the ACAOM, such as seasonal check-up  reminders.
  • Treatment Alternatives We may use and disclose acupuncture / Oriental medicine information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
  • Health-Related Benefits and Services We may use and disclose acupuncture / Oriental medicine information to tell you about health-related benefits or services that may be of  interest to you.
  • Fundraising Activities       We may use acupuncture / Oriental medicine information to contact you in an effort to raise money for the ACAOM and its operations. We only would release contact information, such as your name, address and phone number and the dates you received treatment or services at the ACAOM. If you do not want the ACAOM to contact you for fundraising efforts, you must notify Dr. Yanfang Liu in writing.
  • Individuals Picking Up Your Herbal Formula  We may release your herbal formula to a friend or family member sent by you to pick up your herbal refill.
  • Research  Under certain circumstances, we may use and disclose acupuncture / Oriental medicine information about you for research purposes. For example, a research project may involve comparing      the health and recovery of all patients who received one treatment to those who received another, for the same condition.
  • Required by Law  We will disclose acupuncture / Oriental medicine information about you when required to do so by federal, state or local law.
  • To Avert a Serious Threat to Health or Safety  We may use and disclose acupuncture / Oriental medicine information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to      someone able to help prevent the threat.

SPECIAL SITUATIONS

  • Military and Veterans  If you are a member of the armed forces, we may release acupuncture / Oriental medicine information about you as required by military command authorities. We may also release acupuncture / Oriental medicine information about foreign military personnel to the appropriate foreign military authority.
  • Workers’ Compensation We may release acupuncture / Oriental medicine information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
  • Public Health Risks       We may disclose medical / acupuncture / Oriental medicine information about you for public health activities.

These activities generally include the following:

  1. To prevent or control disease, injury or disability;
  2. To report births and deaths;
  3. To report child abuse or neglect;
  4. To report reactions to medications or problems with products;
  5. To notify people of recalls of products they may be using;
  6. To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
  7. To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
  • Health Oversight Activities We may disclose acupuncture / Oriental medicine information to a      health oversight ACAOM for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor      the health care system, government programs, and compliance with civil rights laws.
  • Lawsuits and Disputes  If you are involved in a lawsuit or a dispute, we may disclose acupuncture / Oriental medicine about you in response to a court or administrative order. We may also disclose acupuncture / Oriental medicine information about you in response to a subpoena, discovery request or      other lawful process by someone else involved in the dispute, but only if  efforts have been made to tell you about the request or to obtain an order protecting the information requested.
  • Law Enforcement We may release acupuncture / Oriental medicine information if asked to do so by a law enforcement official:
  1. In response to a court order, subpoena, warrant, summons or similar process;
  2. To identify or locate a suspect, fugitive, material witness, or missing person;
  3. About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
  4. About a death we believe may be the result of criminal conduct;
  5. About criminal conduct at ACAOM; and
  6. In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
  • Coroners, Medical Examiners and Funeral Directors  We may release acupuncture / Oriental      medicine information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release acupuncture / Oriental medicine      information about clients of ACAOM to funeral directors as necessary to  carry out their duties.
  • National Security and Intelligence  Activities  We may release acupuncture /Oriental medicine information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
  • Protective Services for the President and Others  We may disclose acupuncture / Oriental      medicine information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
  • Inmates  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release acupuncture / Oriental medicine information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

YOUR RIGHTS REGARDING ACUPUNCTURE / ORIENTAL MEDICINE

INFORMATION ABOUT YOU

You have the following rights regarding acupuncture / Oriental medicine information we maintain about you:

  • Right to Inspect and Copy  You have the right to inspect and copy acupuncture / Oriental medicine information that may be used to make decisions about your care. Usually, this includes acupuncture /Oriental medicine and billing records including psychotherapy notes. To inspect and copy acupuncture / Oriental medicine information that may be used to make decisions about you, you must submit your request in writing to Dr. Yanfang Liu. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to acupuncture / Oriental medicine information, you may request that the denial be reviewed. Another      licensed health care professional chosen by the ACAOM will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
  • Right to Amend If you feel that acupuncture / Oriental medicine information we have about you is incorrect or incomplete you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by, or for, the ACAOM. To request an amendment, your request must be made in writing and submitted to Dr. Yanfang Liu. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not  include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
  1. Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
  2. Is not part of the acupuncture / Oriental medicine information kept by or for the ACAOM;
  3. Is not part of the information which you would be permitted to inspect and copy; or
  4. Is accurate and complete.
  • Right to an Accounting of Disclosures You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of acupuncture / Oriental medicine  information about you. To request this list or accounting of disclosures, you must submit your request in writing to Dr. Yanfang Liu. Your request must state a time period that may not be longer than six years and may not include dates before April 1, 2003. Your request should indicate  in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
  • Right to Request Restrictions You have the right to request a restriction or limitation on the      acupuncture / Oriental medicine information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the acupuncture / Oriental medicine information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a treatment you had. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you  emergency treatment. To request restrictions, you must make your request in writing to Dr. Yanfang Liu. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our  use, disclosure, or both; and (3) to whom you want the limits to apply,  for example, disclosures to your spouse.
  • Right to Request Confidential Communications  You have the right to request that we communicate with you about acupuncture / Oriental medicine matters in a certain way or at a certain location. For example, you can ask that we  only contact you at work or by mail. To request confidential      communications, you must make your request in writing to Dr. Yanfang Liu. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. Our normal mode of communication is via regular mail to your home address and/or telephone to numbers provided by you.
  • Right to a Paper Copy of This Notice You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of this notice, please advice Dr.  Yanfang Liu in writing of this request.

CHANGES TO THIS NOTICE

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for acupuncture / Oriental medicine information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the ACAOM. The notice will contain the effective date on the first page. In addition, each time you register at or are re-admitted to the ACAOM for treatment or health care services, you will be offered a copy of the current notice in effect.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the ACAOM or with the Secretary of the Department of Health and Human Services. To file a complaint with the ACAOM, contact Dr. Yanfang Liu at 713-780-9777. All complaints must be submitted in writing.

You will not be penalized or discriminated against for filing a complaint.

OTHER USES OF ACUPUNCTURE / ORIENTAL MEDICINE INFORMATION

Other uses and disclosures of acupuncture / Oriental medicine information not covered by this notice or the laws that apply to use will be made only with your written permission. If you provide us permission to use or disclose acupuncture / Oriental medicine information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose acupuncture / Oriental medicine information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

Thanks for your cooperation.
The ACAOM Staff