This notice describes information about disclosure of your medical
information and how your can obtain access to that information.
Please review this notice carefully.
Policy statement
This practice is committed to maintaining the privacy of your protected health information (PHI), which includes electronic protected health information, as well as information about your condition and the care and treatment you receive from the practice and other health care providers. This notice details the use and disclosure of your PHI to third parties for purposes of your care, payment for your care, health care operations of the practice, and other purposes permitted or required by law. This notice also details your rights regarding your PHI.
Use or disclosure of PHI
This practice is committed to maintaining the privacy of your protected health information (PHI), which includes electronic protected health information, as well as information about your condition and the care and treatment you receive from the practice and other health care providers. This notice details the use and disclosure of your PHI to third parties for purposes of your care, payment for your care, health care operations of the practice, and other purposes permitted or required by law. This notice also details your rights regarding your PHI.
Care
In order to provide your care, the practice will provide your PHI to those health care professionals, whether on the practice’s staff or not, directly involved in your care, so that they may understand your condition and needs, and provide advice or treatment. This includes communication with your primary physician and electronic interactions with you or your caregiver concerning your nutritional care.
Payment
In order to get paid for some or all of the health care provided by the practice, the practice may provide your PHI, directly or through a billing service, to appropriate third-party payers, pursuant to their billing and payment requirements. The practice may need to tell your insurance plan about your condition, so that the insurance plan can determine whether or not it will pay for the expense.
Health care operations
In order for the practice to operate, in accordance with applicable law and insurance requirements, and in order for the practice to provide quality and efficient care, the practice may need to compile, use, and/or disclose your PHI. For example, the practice may use your PHI in order to evaluate the performance of the practice’s personnel in providing care to you.
Authorization not required
The practice may use and/or disclose your PHI without a written authorization from you in the following instances:
Authorization
Uses and/or disclosures, other than those previously described, are made only with your written authorization, which you may revoke at any time.
Appointment reminder
The practice may, from time to time, contact you to provide appointment reminders. The reminder may occur in the form of a letter, email, text message, and/or phone call. The practice will try to minimize the amount of information contained in the reminder. If you are not available, the practice will leave a message for you.
Treatment alternative/benefit
The practice may, from time to time, contact you about treatment alternatives or other health benefits/services that may interest you.
Marketing
The practice may only use and/or disclose your PHI for marketing activities if it obtains from you prior written authorization. Marketing activities include communications to you that encourage you to purchase or use a product or service. The communication is not made for your care or treatment. Marketing does not include a newsletter sent to you about this practice. Marketing does include the receipt by the practice of remuneration, directly or indirectly, from a third party that plans to market its product or service to you. The practice will inform you if it engages in marketing and will obtain your prior authorization. Text messaging opt-in data are not being shared with third parties.
Family / friends
The practice may disclose to your family member, other relative, a close personal friend, or any other person identified by you, your PHI directly relevant to such person’s involvement with your care or the payment for your care. The practice also may use or disclose your PHI to notify or assist in notifying (including identifying or locating) a family member, a personal representative, or another person responsible for your care of your location, general condition, or death.
However, in both cases, the following conditions will apply:
All the above categories exclude text messaging originator opt-in data and consent, this information will not be shared with any third parties.
Your rights
You have the right to:
Practice’s requirements
The practice:
Effective date
This notice is in effect as of September 1, 2023