This notice outlines how your medical information may be used and disclosed and how you can gain access to this information. It describes your rights as well as our obligations regarding the use and disclosure of your medical information. The law requires us to keep your medical information safe, provide you this policy, and follow the policy’s terms.

Ways We May Use and/or Disclose Your Medical Information

The following sections describe different ways that we may use and disclose your medical information. For each category of uses or disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure will be listed, but the ways we are permitted to use and disclose information will fall within one of the following categories.

Some information such as certain drug and alcohol information, HIV information, and mental health information is entitled to special restrictions related to its use and disclosure. Our company follows all applicable state and federal laws related to the protection of this information.

• Supplies: We use your medical information to provide you with medical supplies and services. This could include sharing your information with healthcare professionals involved in your care, other providers, agencies, facilities, or even people outside our office who are involved in your ongoing care.
• Payment: We use and share your information to process payments for our services. This could include sharing information with your health plan for reimbursement or getting approval for a treatment.
• Internal Operations: We use and share your information to improve our services and comply with laws, regulations, and other business-related activities. This might involve using your information to improve patient services or for training purposes.
• Alternative Supplies: We might use your information to suggest other supply alternatives that might be useful to you.
• Benefits and Services: We might use your information to tell you about benefits or services we offer.
• Others Involved in Your Care: We might share your information with people involved in your care, such as family members or people who help pay for your care.
• Research: We might use and share your information for research purposes, but we’ll follow all confidentiality laws.
• Legal Requirements: We will share your information when required by law. This could be for law enforcement purposes, national security, or other legal requirements.
• Health or Safety Threats: We might use and share your information if it’s necessary to prevent or lessen a serious and immediate threat to your health and safety or the public’s health and safety.
• Workers’ Compensation: We may use or share your medical information for Workers’ Compensation or similar programs as authorized or required by law.
• Inmates: If you’re an inmate or under law enforcement custody, we may release your information to the correctional institution as authorized or required by law.

Your Rights Regarding Your Medical Information

• Inspect and Copy: You have the right to inspect and/or receive a copy of your medical and billing information, subject to certain exceptions. Please make your request in writing to our company’s mailing address. Fees may apply for these services, and in limited circumstances, we may deny your request. If denied, you can have this decision reviewed by another professional from our office.
• Request an Amendment or Addendum: You can request an amendment or addendum (additional note) to your medical information if you think it is incorrect or incomplete. Your request should be in writing and include a reason for the request. We may deny your request if it’s not in writing, doesn’t include a supporting reason, or for certain content-specific reasons. Addenda cannot exceed 250 words per alleged incorrect or incomplete item in your record.
• Accounting of Disclosures: You can request a list of disclosures we’ve made of your medical information for purposes beyond treatment, payment, health care operations, and certain other purposes. Your request must be in writing and must state a time period (not longer than six previous years). One free accounting is available per 12-month period, and additional requests within the same period may incur a fee.
• Right to Request Restrictions: You can request restrictions on the medical information we use or disclose about you for services, payment, or health care operations. You can also limit what we disclose about you to those involved in your care or payment for your care. Our agreement to your request must be in writing and will be honored unless the information is needed for emergency treatment.
• Right to Request Confidential Communications: You can request that we communicate with you about medical matters in a certain way or at a certain location. All reasonable requests will be accommodated, and must specify your preferred communication method or location.
• Right to a Paper Copy of This Notice: You can request a paper copy of this Notice at any time, even if you’ve previously agreed to receive it electronically.

Changes to Our Privacy Practices and This Notice

We reserve the right to change our privacy practices and this Notice. The revised Notice will apply to the medical information we already have about you and any information we receive in the future. We’ll post a copy of the current Notice at our office, and you can request a copy anytime.

Complaints

If you believe your privacy rights have been violated, you can file a complaint with our Office Manager in writing. You won’t be penalized for filing a complaint.

Other Uses of Medical Information

Other uses and disclosures of medical information not covered by this Notice or applicable laws will be made only with your written permission. You can revoke this permission in writing anytime, but we cannot retract any disclosures already made with your permission. We will retain our records of the care provided to you as required by law.

Effective Date:

Oct. 17, 2023