HIPAA NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MUCH MEDICAL INFORMATION ABOUT YOU MAY BE USED, DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

Effective August 6, 2022

PLEASE REVIEW IT CAREFULLY

We are required by law to:

• Maintain the privacy of protected health information
• Give you this notice of our legal duties and privacy practices regarding health information about you
• Follow the terms of our notice that is currently in effect

We may use and disclose your medical records for each of the following purposes:

• Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. This includes downloading an electronic record of your current and past prescription medications. An example of this would include a physical examination.
• Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.
• Health Care Operations includes the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example of this would be an internal quality assessment review.

We may also use and disclose your medical records for:

• Public health support
• To protect victims of abuse, neglect, or domestic violence
• Health oversight activities such as investigations, audits, and inspections
• Law enforcement purposes
• When otherwise required by law
• When requested by law enforcement as required by law or court order
• To coroners, medical examiners, and funeral directors
• Organ and tissue donation
• Research under strict federal guidelines
• Reduce or prevent a serious threat to public health and safety
• Workmen’s Compensation or other similar programs if you are injured at work
• Accreditation purposes
• Specialized government functions such as intelligence and national security

We may also create and distribute de-identified health information by removing all references to individually identifiable information.

We may contact you to provide appointment reminders, information about treatment alternatives, or other health-related benefits and services that may be of interest to you.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer:

• The right to request restrictions on certain uses and disclosures of protected health information including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
• The right to request that we restrict the disclosure of certain health information to a health plan if the disclosure is for payment or health care operations and pertains to a health care item or service for which you have paid out of pocket in full.
• The right to reasonable request to receive confidential communications of protected health information from us by alternative means or at alternative locations.
• The right to inspect and copy your protected health information.
• The right to amend your protected health information.
• The right to receive an accounting of disclosures of protected health information.
• The right to obtain and we have the obligation to provide to you a paper copy of this notice from us at your first service delivery date.
• The right to provide and we are obligated to receive a written acknowledgement that you have received a copy of our Notice of Privacy Practices.
• The right to receive a privacy breach notice through written notification if the practice discovers a breach of our unsecured PHI and determine through a risk assessment that notification is required.
• The right to request an electronic copy of your protected health information.

We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.

We are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post revisions in our premises.

Providing Contact Information

By providing contact information, individuals are consenting to use their information for the stated purposes (reminder, notifications, alerts, billing, satisfaction surveys, etc).

Personal information collected may include:

• Name
• Email address
• Mobile and/or other telephone number
• Address and/or Zip code
• Any other details you voluntarily choose to submit

Re-Authorization to Communicate with You

When using your services, your organization will periodically re-confirm consent to communicate with individuals about those services.

Revoking Authorization to Communicate with Your Organization (Opt-Out)

Individuals may revoke (opt-out, cancel, discontinue) their consent to receive communications at any time by contacting our offices, or by responding to messages in a manner provided within the message (i.e. “you may

Unauthorized Disclosure and Use of Information

Your organization will not sell or rent information about you. Your organization will not share or disclose personal information, or information regarding SMS text messaging, in a manner that is not compliant with applicable Federal and State Regulations (ex: HIPAA).

Use of Personal Information

Your organization uses information obtained through delivery of services and other sources you provide during Treatment, Payment and Operations and other compatible purposes, such as responding to your inquiries, facilitating and improving your online experience, and maintaining the security and integrity of our website and messaging services.

As a general policy, we use personal information and user data for internal purposes only.

Contact Us

If you have any questions, queries, or concerns about this Privacy Policy or our personal information practices, please contact us directly via email or phone at the number listed on our website. Given the potential security risks associated with email, please use caution when sending any personal information via email or SMS text.