Notice of Privacy Practice (HIPAA)

Updated April 15, 2022

When it comes to your health information, you have certain rights.

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
• You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
•You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
• You can ask for a list of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

In these cases, you have both the right and choice to tell us to:
•Share information with your family, close friends, or others involved in your care.
• Share information in a disaster relief situation. Include your information in a hospital directory. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:
• Marketing purposes. Sale of your information In the case of fund-raising: We may contact you for fund-raising efforts, but you can tell us not to contact you again.

We typically use or share your health information in the following ways:
• Treat you: We can use your health information and share it with other professionals who are treating you.
• Run our organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.
• Bill for your services: We can use and share your health information to bill and get payment from health plans or other entities. We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
• Help with public health and safety issues. We can share health information about you for certain situations such as: Preventing disease Helping with product recalls. Reporting adverse reactions to medications. Reporting suspected abuse, neglect, or domestic violence. Preventing or reducing a serious threat to anyone’s health or safety.
• We can use or share your information for health research. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. We can share health information about you with organ procurement organizations.
• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
• We can use or share health information about you for workers’ compensation claims, for special government functions such as military, national security, and presidential protective services, and to respond to lawsuits and legal actions and/or subpoena.
• We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.