Family Practice of CentraState at Iron Bridge

Dr. Orlando F. Mills and Kasey Leung, APN

Summary Notice of Privacy Practices  

Dr. Mills Office is required by federal law to a Notice of Privacy Practices that describes how your protected health information (PHI) is maintained, may be used or disclosed.  The Notice describes each use and disclosure we are permitted to make, and provides a description of your rights and our obligations under federal and state privacy laws.  We may amend this Notice from time to time.  All amendments apply retroactively. 


Uses and disclosures:

We are permitted to use and disclose your health information under a variety of circumstances.  In most instances, we must obtain your authorization before we use or disclose information.  There may be circumstances where we may use your information without your authorization and without informing you of the use or disclosure. 

These circumstances include but are not limited to the following:

  1. To provide information about your health condition to others who may treat you.
  2. To provide information about the treatment that we provided in order to obtain payment from your health plan
  3. To report a communicable disease, domestic violence or criminal activity
  4. To comply with a court order requiring the disclosure of your medical record.


Your rights:

While the records that we maintain about you belong to us, under the federal privacy law you have a variety of rights with respect to the information maintained in those records.  You have the right to:

  1. Access and a copy the health information that we maintain about you
  2. Request that we amend information that you believe is incomplete or incorrect. 
  3. Restrict certain disclosures to health plans at your request and when services provided are paid “out of pocket”
  4. Request a list of each disclosure we have made of your health information unless subject to the exceptions described above. 
  5. Make a complaint to Dr. Mills, our office Privacy Officer or the Secretary of Health and Human Services if you believe your privacy rights have been violated by us.


Our obligations:

We are committed to safeguard your private and confidential medical information.  In the unlikely event of any incident of unsecured PHI, we will conduct an assessment to determine if the event is a breach notify the affected individuals as appropriate.

This is a summary of Dr. Mills Privacy Practices. A Full and Complete Notice of Privacy Practices is available to our patients upon request.  . 

Updated 11/29/18

Patients Rights and Responsibilities

Your Rights as a Patient of Dr. Mills

  1. You have the right to considerate and respectful care.
  2. You have the right to be well informed about your illness, possible treatments, likely outcome and to discuss this information with Dr. Mills
  3. You have the right to formulate an Advance Directive, also known as a Living Will.  You will decide on a health care proxy, or someone who will  speak for you on your behalf if you become unable to speak for yourself.
  4. You have the right to privacy & confidentiality of information about your illness.
  5. You have the right to expect that treatment records are confidential unless you have given permission to release information or reporting is required or permitted by law.
  6. You have the right to know the names of the Care Team
  7. You have the right to refuse any drug, treatment or procedure.  Dr. Mills will explain to you what can happen if you refuse.
  8. You have the right to be respected with regard to decisions you make
  9. You have the right to discuss your care with another doctor at your request and expense.


Your Responsibilities as a Patient in the Office of Dr. Mills

  1. You are responsible to call within 24 hours if you will miss an appointment
  2. You are responsible to bring all of your medications in their original containers to every visit including over the counter medications
  3. You are responsible for providing information about your health, including past illnesses, hospital stays, and use of medicine.
  4. You are responsible for asking questions when you do not understand information or instructions.
  5. You are responsible for being considerate of the privacy of patients in the office
  6. You are responsible for providing correct and updated insurance information to be sure that Dr. Mills participates with your insurance, for coordination of your benefits and ensuring that Dr. Mills is named as your Primary Care Provider if required.
  7. You are responsible for paying your co-payment & balances before the visit. 
  8. You are responsible for recognizing the effect of life-style on your personal health. Your health depends not just on your medical care, but on the long term decisions you make in your daily life.

By knowing your rights and adhering to these responsibilities, Dr. Mills can provide you with the highest quality of care you deserve.

Updated 11/29/18