HIPAA Notice of Privacy Practices

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

Your rights

When it comes to your health information, you have certain rights. Contact us to exercise any of these rights.

Get an electronic or paper copy

• You may ask to see or receive an electronic or paper copy of health information we maintain about you.
• We will provide a copy or summary, usually within 30 days. We may charge a reasonable, cost-based fee when permitted by law.

Ask us to correct your information

• You may ask us to correct health information you believe is incorrect or incomplete.
• We may deny your request in some circumstances, but we will explain the reason in writing, usually within 60 days.

Request confidential communications

You may ask us to contact you in a specific way, such as at a particular phone number, or to send mail to a different address. We will accommodate reasonable requests.

Ask us to limit what we use or share

• You may ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree in every situation.
• If you pay in full out of pocket for an item or service, you may ask us not to share that information with your health plan for payment or operational purposes. We will agree unless the law requires disclosure.

Get a list of disclosures

You may ask for an accounting of certain disclosures made during the six years before your request. The list will not include disclosures for treatment, payment, health care operations, or certain other disclosures. One accounting in a 12-month period is free; a reasonable fee may apply to additional requests.

Get a copy of this notice

You may request a paper copy at any time, even if you agreed to receive it electronically.

Choose someone to act for you

If a person has legal authority to act for you, such as a legal guardian or a person with medical power of attorney, that person may exercise your rights. We will verify the authority before taking action.

File a complaint

You may complain to us using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting hhs.gov/hipaa/filing-a-complaint, calling 1-877-696-6775, or writing to 200 Independence Avenue SW, Washington, DC 20201. We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you may tell us your preferences about what we share. If you have a clear preference, tell us and we will follow your instructions when possible.

• You may ask us to share information with family, close friends, or others involved in your care or payment for your care.
• You may tell us how to contact you in a disaster-relief situation.
• If you cannot tell us your preference, such as when you are unconscious, we may share information if we believe it is in your best interest and as permitted by law.
• We will obtain written authorization before using health information for most marketing purposes or selling your health information. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

How we typically use and share information

Provide and coordinate your care

We may use and share health information with physicians, caregivers, suppliers, and other professionals involved in your care. For example, we may confirm equipment specifications with your prescribing provider.

Run our organization

We may use and share information to operate our business, improve services, train staff, manage quality, and contact you about orders, deliveries, maintenance, or service.

Bill for products and services

We may use and share information with Medicare, Medicaid, insurers, health plans, and other responsible parties to obtain payment and determine coverage.

Other uses and disclosures permitted or required by law

We may use or disclose your information when legal requirements are met, including:

• Public health and safety activities, product recalls, and reporting adverse events.
• Reporting suspected abuse, neglect, or domestic violence as authorized or required by law.
• Health oversight activities, audits, inspections, and government benefit programs.
• Workers’ compensation, law enforcement, correctional institutions, and other government requests.
• Responding to lawsuits, court orders, subpoenas, or other lawful process.
• Working with medical examiners, coroners, funeral directors, or organ and tissue donation organizations.
• Research when approved and permitted by law.
• Preventing or reducing a serious and imminent threat to health or safety.

To the extent we maintain substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records in civil, criminal, administrative, or legislative proceedings against you without your written consent or a qualifying court order and subpoena, as required by law.

Our responsibilities

• We are required by law to maintain the privacy and security of protected health information.
• We will notify affected individuals promptly if a breach occurs that may have compromised the privacy or security of their information.
• We must follow the duties and privacy practices described in the notice currently in effect and provide you a copy upon request.
• We will not use or share your information other than as described here unless you authorize us in writing. You may revoke that authorization in writing at any time, subject to actions already taken.
• We apply appropriate safeguards and limit uses, disclosures, and requests to the minimum necessary when that standard applies.

Changes to this notice

We may change the terms of this notice, and the revised terms may apply to all health information we maintain. A current notice will be available in our office, upon request, and on this website.