Notice of Privacy Practices

This information is made available to all patients.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY HAVE ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

THIS NOTICE APPLIES TO ALL OF THE RECORDS OF YOUR CARE GENERATED BY THE PRACTICE, WHETHER MADE BY THE PRACTICE OR AN ASSOCIATED FACILITY.

This notice describes our practice’s policies, which extend to:

  • Any health care professional authorized to enter information into your chart (including physicians, assistants, nurses, etc.);

  • All areas of the practice (front desk, administration, billing and collection, etc.);

  • All employees, staff and other personnel that work for or with our practice;

  • Our business associates (including a billing service, or facilities to which we refer patients), on-call physicians, and so on.

The Practice provides this Notice to comply with the Privacy Regulations issued by the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Our Thoughts About Your Protected Health Information

We understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we create paper and electronic medical records about your health, our care for you, and the services and/or items we provide to you as our patient. We need this record to provide for your care and to comply with certain legal requirements.

We are required by law to:

  • Make sure that the protected health information about you is kept private;

  • Provide you with Notice of our Privacy Practices and your legal rights with respect to protected health information about you; and

  • Follow the conditions of the Notice that is currently in effect.

How We May Use and Disclose Medical Information About You

The following categories describe different ways that we use and disclose protected health information that we have and share with others. Each category provides a general explanation and examples. Not every use or disclosure in a category is listed. The explanation is provided for your general information only.

General Policy: As a general policy, we use personal information and user data for internal purposes only. We do not sell or rent information about you. We will not disclose personal information regarding text messaging opt-in or message data to third parties.

  • Medical Treatment: We use previously given medical information about you to provide you with current or prospective medical treatment or services. Therefore we may, and most likely will, disclose medical information about you to doctors, nurses, technicians, medical students, or hospital personnel who are involved in taking care of you. Different areas of the Practice also may share medical information about you including your record(s), prescriptions, requests of lab work and x-rays. Unless clearly instructed to the contrary, we may release medical information about you to a friend or family member who is involved in your medical care.

  • Payment: We may use and disclose medical information about you for services and procedures so they may be billed and collected from you, an insurance company, or any other third party. For example, we may need to give your health care information to obtain payment or reimbursement for your care.

  • Operational Uses: We may use and disclose medical information about you so that we can run our Practice more efficiently and make sure that all of our patients receive quality care. These uses may include reviewing our treatment and services to evaluate the performance of our staff, deciding what additional services to offer, and whether certain new treatments are effective. We may remove information that identifies you from this set of medical information so others may use it to study health care delivery without learning who the specific patients are.

  • Appointment and Patient Recall Reminders: We may use and disclose medical information to contact you as a reminder that you have an appointment for medical care with the Practice or that you are due to receive periodic care from the Practice. This contact may be by phone, in writing, e-mail, or otherwise and may involve leaving a message which could (potentially) be picked up by others.

  • Others Involved in Your Care: In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

  • Research: Under certain circumstances, we may use and disclose medical information about you for research purposes regarding medications, efficiency of treatment protocols, and the like. All research projects are subject to an approval process, which evaluates a proposed research project and its use of medical information.

  • Required By Law: We will disclose medical 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 medical information about you when necessary to prevent a serious threat either to your specific health and safety or the health and safety of the public or another person.

  • Organ and Tissue Donation: If you are an organ donor, we may release medical information to organizations that handle organ procurement or transplantation to facilitate donation.

  • Public Health Risks: Law or public policy may require us to disclose medical information about you for public health activities. This includes preventing or controlling disease, reporting child abuse or neglect, reporting reactions to medications, or notifying individuals of product recalls.

  • Investigation and Government Activities: We may disclose medical information to a local, state, or federal agency for activities authorized by law, such as audits, investigations, inspections, and licensure.

  • Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order, subpoena, or discovery request.

  • Law Enforcement: We may release medical information if asked to do so by a law enforcement official in response to a court order, warrant, subpoena, or to help locate a suspect or missing person.

  • Coroners, Medical Examiners and Funeral Directors: We may release medical information to a coroner, medical examiner, or funeral director as necessary to carry out their duties.

  • Inmates: If you are an inmate of a correctional institution, we may release medical information to the institution for health care access, safety, and operational security.

Changes to This Notice

We reserve the right to change this notice at any time. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we may receive in the future. We will post a copy of the current notice in the Practice, noting the date of last revision and effective date in the top right-hand corner.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services. To file a complaint with the Practice, contact our office manager in writing. All complaints shall be investigated without repercussion or penalty to you.

Patient Rights

Regarding the medical information we maintain about you, you have the following rights:

  • Right to Inspect and Copy: You have the right to inspect and copy medical and billing records used to make decisions about your care. To do so, you must submit your request in writing to our HIPAA Compliance Officer. We may charge a reasonable fee for copying and mailing costs.

  • Right to Amend:

    If you feel that the medical information we have in your record is incorrect or incomplete, you may ask us to amend it. The request must be submitted in writing, be dated, signed by you, notarized, and include a reason supporting your amendment.

  • Right to an Accounting of Disclosures: You have the right to request a list of the disclosures we made of your medical information for purposes other than treatment, payment, or healthcare operations. Your request must state a time period not longer than six (6) years back.

  • Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or operations. We are not required to agree to your request if it impacts emergency treatment care.

  • Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location (such as only contacting you at work or by mail).

  • Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time, even if you have agreed to receive it electronically.