HIPAA Privacy Notice

Effective Date: April 13, 2019

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed, and how you can access this information. Please review it carefully.

Our Obligations

We are required by law to:

Maintain the privacy of protected health information (PHI).
Provide you with this notice of our privacy practices.
Abide by the terms of this notice.

How We May Use and Disclose Health Information

For Treatment: To provide you with medical care and services.
For Payment: To bill and collect payment for services provided.
For Health Care Operations: To operate and manage our services and quality control.
Reminders and Health-Related Benefits: To inform you about appointments, services, or benefits.
Individuals Involved in Your Care: To family or friends involved in your care, unless you object.
For Research: With approval from an Institutional Review Board, under strict privacy guidelines.

Special Situations

As required by law.
To avert a serious threat to health or safety.
To business associates providing services on our behalf.
For organ or tissue donation.
For military and veteran affairs.
For workers’ compensation programs.
For public health and safety activities.
For health oversight activities such as audits and inspections.
For data breach notifications.
In lawsuits or legal disputes.
To law enforcement under specific conditions.
To coroners, medical examiners, and funeral directors.
For national security and intelligence purposes.
For protective services for officials.
If you are in custody or incarcerated, under certain conditions.

Uses and Disclosures Requiring an Opportunity to Object

Unless you object, we may share your PHI with family or others involved in your care or for disaster relief purposes.

Your Written Authorization Is Required For:

Marketing uses of your PHI.
Any sale of your PHI.
Other uses and disclosures not described in this notice.

You may revoke authorization at any time in writing.

Your Rights

Inspect and Copy: Request to view or obtain copies of your health records.
Electronic Copies: Request electronic access to your records.
Notice of a Breach: Be informed if a breach of your PHI occurs.
Amend: Request corrections to your PHI.
Accounting of Disclosures: Request a list of PHI disclosures made.
Request Restrictions: Limit how we use or share your PHI.
Out-of-Pocket Payments: Request non-disclosure of services you paid for in full.
Confidential Communications: Request how and where we contact you.
Paper Copy: Request a printed copy of this notice.

Changes to This Notice

We reserve the right to modify this notice and make it effective for all PHI we maintain. The current notice will always be posted at our office and website with the effective date noted.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. Complaints must be submitted in writing. You will not be penalized for filing a complaint.