HIPAA Notice of Privacy Policy

Your Rights

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

• Get a copy of your medical record. You can ask us for an electronic or paper copy of your health information. We typically provide it within 30 days.
• Correct your medical record. You can ask us to correct health information that you think is incorrect or incomplete. We may say “no,” but we’ll tell you why in writing within 60 days.
• Request confidential communication. You can ask us to contact you in a specific way (for example, home phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to 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.
• Get a list of those with whom we’ve shared information. You can ask for a list of times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.
• Choose someone to act for you. A legal guardian or someone with medical power of attorney can exercise your rights and make choices about your health information.
• File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us at 844-425-3687. You can also file a complaint with the U.S. Department of Health and Human Services by sending a letter to 200 Independence Avenue, SW, Washington DC, 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Your Choices

You can tell us your preferences for how we use and share your health information with your family, close friends, or others involved in your care. We will never share your health information for marketing or sales purposes, unless you give us written permission.

Our Uses and Disclosures

We may use and share your health information as we:

• Treat you. We can use and share information with other healthcare professionals who are treating you.
• Run our pharmacy. We can use and share information to provide our services, improve your care, and contact you.
• Bill for services. We can use and share information to bill and get payment from health plans or other entities.

Under state and/or federal law, we are sometimes allowed or required to share your health information in other ways. This may include:

• Helping with public health and safety issues
• Doing health research
• Responding to organ and tissue donation requests
• Working with a medical examiner or funeral director
• Addressing workers’ compensation, law enforcement, and other government requests
• Responding to lawsuits and legal actions

For more information on these situations, please visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Our Responsibilities

• 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 must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
• 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 and on our website.

For more information, please visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.