Privacy Practices

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.

Genesis Medical Group, LLC. is required by law to maintain the privacy of Protected Health Information (“PHI”) and to provide individuals with notice of our legal duties and privacy practices with respect to PHI.  PHI is information that may identify you and that relates to your past, present or future physical or mental health condition and related health care services.  This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law.  The Notice also describes your rights with respect to PHI about you.

Genesis Medical Group, LLC. is required to follow the terms of this Notice.  We will not use or disclose PHI about you without your written authorization, except as described in this Notice.  We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain.  Upon request, we will provide any revised Notice to you.

Your Health Information Rights

You have the following rights with respect to PHI about you:

Obtain a paper copy of the Notice upon request.  You may request a copy of the Notice at any time.  Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy.  To obtain a paper copy, contact the   Genesis Medical Compliance Officer at (503) 231-1529.

Request a restriction on certain uses and disclosures of PHI.  You have the right to request additional restrictions on our use or disclosure of PHI about you by sending a written request to:  Genesis Medical Group, Attn: Compliance Officer, 10802 SE Washington Street, Portland OR 97216.

Inspect and obtain a copy of PHI.  You have the right to access and copy PHI about you contained in a designated record set for as long as Leading Edge Medical maintains the PHI.  The “designated record set” usually will include treatment and billing records.  To inspect or obtain a copy of PHI about you, you must send a written request to:  Genesis Medical Group,

Attn: Compliance Officer, 10802 SE Washington Street, Portland OR 97216.

We may charge you a fee for the costs of copying, mailing, or other supplies that are necessary to grant your request.  We may deny your request to inspect and copy in certain limited circumstances.  If you are denied access to PHI about you, you may request that the denial be reviewed.

Request an amendment of PHI.  If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it.  You may request an amendment for as long as we maintain the PHI.  To request an amendment, you must send a written request to: 10802 SE Washington Street, Portland OR 97216.

In addition, you must include a reason that supports your request.  In certain cases, we may deny your request for amendment.  If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we will give you a rebuttal to your statement.

Receive an accounting of disclosures of PHI.  You have the right to receive an accounting of the disclosures we have made of PHI about you after April 14^th, 2003 for most purposes other than treatment, payment, or health care operations.  The accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures to friends or family members involved in your care, and disclosures for notification purposes.  The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations.  To request an accounting, you must submit your request in writing to:  Genesis Medical Group, Attn: Compliance Officer, 10802 SE Washington Street, Portland OR 97216.

Your request must specify the time period, but may not be longer than six years.  The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings.  We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.

Request communications of PHI by alternative means or at alternative locations.  For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box.  To request confidential communication of PHI about you, you must submit your request in writing to:  Genesis Medical Group, Attn: Compliance Officer, 10802 SE Washington Street, Portland OR 97216.

Your request must state how or when you would like to be contacted.  We will accommodate all reasonable requests.

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