Notice of Privacy Practices

Treatment

Practice will use your health information in the provision and coordination of your healthcare. We may disclose all or any portion of your medical record information to your physician, consulting physician(s), nurses and other healthcare providers who have a legitimate need for such information in the care and continued treatment of the patient. For example, a healthcare provider treating you for an injury can ask another healthcare provider about your overall health condition.

Payment

Practice may release medical information about you for the purposes of determining coverage, billing, claims management, medical data processing and reimbursement. The information may be released to an insurance company, third-party payor or other entity (or their authorized representatives) involved in the payment of your medical bill and may include copies or excerpts of your medical record that are necessary for payment of your account. For example, to the extent Practice bills for services it provides to you, a bill sent to a third-party payor may include information that identifies you, your diagnosis, the procedures and supplies used.

Routine Healthcare Operations

Practice may use and disclose your medical information during routine health care operations to run our practice, improve your care, and contact you when necessary. For example, we can use your health information to manage your treatment and services.

Business Associates

Practice may use and disclose certain health information about you to its business associates. A business associate is an individual or entity under contract with Practice to perform or assist Practice in a function or activity that necessitates the use or disclosure of medical information. Examples of business associates include but are not limited to, a copy service used by the Clinic to copy medical records, consultants, independent contractors, accountants, lawyers, medical transcriptionists and third-party billing companies. Practice requires the business associate to protect the confidentiality of your medical information. In addition, Practice requires any subcontractor of Practice's business associate to protect the confidentiality of your medical information.

Regulatory Agencies

Practice may disclose your medical information to public health or legal authorities charged with preventing or controlling disease, injury or disability. For example, billing practices may be audited by the State Auditor and records are subject to review by the Secretary of Health and Human Services and his/her authorized representatives.

Workers' Compensation

Practice may release medical information about you for workers' compensation or similar programs that provide benefits for work-related injuries or illnesses.

Military Veterans

Practice may disclose your medical information as required by military command authorities if you are a member of the armed forces.

Inmates

If you are an inmate of a correctional institution or under the custody of a law enforcement officer, Practice may release your medical information to the correctional institution or law enforcement official.

Organ and Tissue Donation Requests

Medical information can be shared with organ procurement organizations.

Medical Examiner or Funeral Director

Medical information can be shared with a coroner, medical examiner, or funeral director when an individual dies.

Required by Law

Practice will disclose medical information about you when required to do so by law, for example, responding to lawsuits and legal actions.

Other Uses:

• We will obtain your written authorization before using or disclosing your protected health information when required by law.
• Additional protections apply to substance use disorder treatment records under 42 C.F.R. Part 2.
• You may revoke your authorization in writing at any time, except to the extent we have already relied upon it.

Right to Confidential Communications

You have the right to receive confidential communications of your medical information by alternative means or at alternative locations. For example, you may request that Practice contact you only at work or by mail.

Right to Inspect and Copy

You have the right to inspect and copy your medical information.

Right to Amend

You have the right to amend your medical information. Any request for amendment should be submitted to Practice in writing, stating a reason in support of the amendment.

Right to an Accounting

You have the right to obtain an accounting of the disclosures of your medical information made during the preceding six (6) year period.

Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your medical information. Practice is not required to honor your request except where: (i) the disclosure is for the purpose of carrying out payment or healthcare operations and is not otherwise required by law, and (ii) the medical information pertains solely to a healthcare item or service for which you, or person other than the health plan on your behalf, has paid Practice in full.

Right to Receive a Paper Copy

You have the right to receive a paper copy of this Notice.

Right to Receive Electronic Copies

You have the right to receive electronic copies of your medical information.

Right to Choose Someone to Act For You

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Right to Revoke Authorization

You have the right to revoke your authorization to use or disclose your medical information, except to the extent that action has already been taken in reliance on your authorization. A request to exercise any of these rights must be submitted, in writing, to Practice at 15 8th St. N, St Petersburg, FL 33701, or by contacting Practice at 727-409-0332.

Redisclosure Notice

Information disclosed pursuant to the HIPAA Privacy Rule may be subject to redisclosure by the recipient and may no longer be protected by federal privacy laws. However, substance use disorder records disclosed pursuant to 42 C.F.R. Part 2 remain subject to federal confidentiality protections and generally may not be redisclosed unless permitted by law.