Notice of Privacy Practices

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

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. This notice also describes your rights to access and control your protected health information. “Protected health information” is information, that may identify you and that relates to your past, present and future physical, mental health or condition and related healthcare services.

Federal law requires us to abide by the terms of the Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain. We will provide you with any revised Notice of Privacy Practices upon request.

Uses and Disclosures of Protected Health Information

The use and disclosure of your protected health information will be used for treatment, payment and health care operation. Your protected health information may be used and disclosed by your physician, his staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information will also be used and disclosed to pay your health care bills and to support the operations of this practice.

Following are examples of the types of uses and disclosures of your protected health information that our office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made.

Uses and Disclosures of Protected Health Information Based Upon Your Written Authorization

Other uses and disclosures of your protected health information as described below will be made only with your written authorization, unless otherwise permitted or required by law. Your authorization will be required each time disclosure of your protected health information is made for uses other than treatment, payment or healthcare operations.

Disclosure of any health information related to HIV test orders or results will not be released without your written authorization.

Permitted and Required Uses and Disclosures That May Be Made Without Your Consent or Authorization

For the purpose of public health and safety as required by state and federal law. This includes disclosure of health information relating to communicable diseases.

For the purpose of patient and minor patient safety as required by state law. We may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

For the purpose of reporting adverse drug reactions, product defects, biologic product deviations and to enable product/drug recalls as required by the Food and Drug Administration.

For the purpose of any judicial or administrative proceedings, or in response to an order of a court or administrative tribunal or in certain conditions in response to a subpoena, discovery request or other lawful process.

For the purpose of law enforcement as applicable by legal requirements. This information includes limited information requests for identification and location purposes, information pertaining to victims of a crime, suspicion that death has occurred as a result of criminal conduct and in the event that a crime occurs on the premises of the practice. We may also disclose your protected health information if we believe it is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.

For the purpose of identification, cause of death or other investigation as performed by the coroner or medical examiner. We may also disclose such information in the reasonable anticipation of death.

For the purpose of military activity and national security as commanded by military authorities.

For the purpose of Worker’s Compensation as required by law.

For the purpose of Health Oversight we may disclose protected health information as required by law to government agencies that oversee the health care system, government benefit programs and other government regulatory programs. This includes audits of billing records and investigation and inspection of your medical records.

Individual Rights

You have the right to inspect and obtain a copy of your protected health information. You may inspect and obtain a copy of your protected health information about you that is contained in your record for as long as we maintain the protected health information. This information includes all medical and billing records and the practice uses for making decisions about you. There is a fifty cent per page charge for medical records beyond the first twenty pages.

Under federal law however, you may not inspect or copy the following records: information compiled in reasonable anticipation of, or use in a civil, criminal or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information. Also, your physician also has the right to exercise professional judgment if it is felt that the release of protected health information may endanger the life or physical safety of the individual or another person. Depending on the circumstances, you may have a right to have this decision reviewed.

You have the right to request a restriction of your protected health information. You may ask us not to use or disclose any part of your protected health information for purpose of treatment, payment or healthcare operations. Your physician is not required to agree to a restriction that you request. If your physician believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. If your physician does agree, we may not use or disclose your protected health information in violation of the stated restriction unless it is needed to provide emergency treatment. Please discuss any restrictions request with our privacy officer.

You have the right to receive confidential communications from us by alternative means. You may request that we contact you at an alternative address or phone number. You must provide us with an explanation of this request and the request will be considered. Your request must include alternate address, phone number and information as to how payment will be handled. We will accommodate reasonable requests.

You have the right to have your physician amend your protected health information. You may request an amendment of protected health information about you in a designated record set for as long as we maintain this information. In certain cases we may deny your request for amendment.

You have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.

You have the right to receive an account of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for the purposes than treatment, payment or healthcare operations as described in this policy.

You have the right to obtain a paper copy of this notice.

You have the right to file a complaint.

You may file a complaint to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us.

Questions or complaints about this notice: contact our Privacy Officer at 941-929-9355 or through our contact page.

This notice was published and becomes effective April 14, 2023