HIPAA

NOTICE OF PRIVACY PRACTICES. THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

OUR RESPONSIBILITIES

We respect our legal obligation to maintain the privacy of your Protected Health Information (“PHI”). We are obligated by law to give you notice of our privacy practices regarding your PHI. This notice explains our privacy practices, our legal duties, and your rights concerning your PHI. We are required to follow the privacy practices that are described in this notice while it is in effect.

We reserve the right to change our privacy practices and the terms of this notice at anytime, provided such changes are permitted by applicable law. Before we make a material change in our privacy practices, we will revise this notice and make the new notice available upon request. You may request a copy of our notice at anytime. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.

USES & DISCLOSURES OF PROTECTED HEALTH INFORMATION

We will not disclose your PHI unless we are allowed or required by law to make the disclosure, or you (or your authorized representative) give us permission. Following are examples of the types of uses and disclosures of your PHI that we are permitted to make:

Treatment: We may use or disclose your PHI to doctors, nurses, and other healthcare providers who are involved in providing your healthcare. For example, your PHI may be shared among the members of your healthcare treatment team.

Payment: We may use and disclose your PHI in order to bill and collect payment for your healthcare services. For Example, we may contact your employer to verify employment status and/or you insurance provider to get paid for the services that we provided to you. We may also release information to collection agencies for the purpose of payment on outstanding accounts

Healthcare Operations: We may use and disclose, as needed, your PHI in order to support the business activities of our practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, accreditation, certification, licensing or credentialing activities, and conducting or arranging for other business activities.

Your health information may be used or disclosed, unless you ask for restrictions on a specific use or disclosure, for the following purposes:

• Family members or close friends. We may disclose your PHI to family members or friends who are authorized to consent to your treatment or who are involved in the payment for your treatment.
• Appointment reminders. We may use or disclose your PHI to provide you with appointment reminders, such as voice-mail messages, postcards or letters.
• As required by law. We may use or disclose your PHI to the extent that such use or disclosure is mandated by state or federal law.
• Public health activities. We may use or disclose your PHI for public health activities, including disease prevention; reporting deaths; reporting child abuse or neglect; reporting reactions to medications or product problems; notification of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect or domestic violence (as required by state law).
• Health oversight activities. We may use or disclose your PHI for health oversight activities, including audits, inspections, investigations, and licensure.
• Legal proceedings & law enforcement. We may disclose your PHI in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal, and, under certain circumstances, in response to a subpoena, discovery request or other law process. We may also disclose your PHI, so long as applicable legal requirements are met, for law enforcement purposes.
• To coroners or medical examiners; organ and tissue donation. We may disclose health information to a coroner or medical examiner for identification purposes, to determine the cause of death, or for the coroner or medical examiner to perform other duties authorized by law. We may disclose such information in reasonable anticipation of death. Health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.
• Certain research projects approved by an Institutional Review Board. We may disclose your PHI to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.
• Military and national security. We may disclose the PHI of Armed Forces personnel to military authorities under certain circumstances.
• Workers’ Compensation. We may disclose your PHI as it relates to benefits for work-related illnesses, as appropriate.
• Business Associates. We may disclose your PHI to third-party business associates who perform health care operations for us and who commit to respect the privacy of your PHI.

Your authorization is required for other disclosures. Except as described above, we will not use or disclose your PHI unless you authorize us to do so in writing. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while such authorization was in effect.

YOUR RIGHTS REGARDING YOUR PHI

Following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights:

Right to inspect and copy: You have the right to review and receive a copy of your PHI, with limited exceptions. By law, we may charge you a nominal fee for providing you with copies of your PHI that is in our possession. You do not have the right to obtain copies of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; PHI that is subject to other state or federal laws that prohibit us to release such information. We may also limit your access to your PHI if we determine that providing the information could possibly harm you or another person. If we limit access based on the belief that access could harm you or another person, you have the right to request a review of that decision.

Right to request amendment: You have the right to request that we amend your PHI. Your request must be in writing, and it must identify the information that you think is incorrect and explain why the information should be amended. We may decline your request for certain reasons, including asking us to change information that we did not create. If we decline your request to amend your records, we will provide you with a written explanation. You may respond with a statement of disagreement to be appended to the information you want amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you have authorized, of the amendment and to include the changes in any future disclosures of that information.

Right to accounting of disclosures: You have the right to receive a report of when, to whom, for what purposes, and what content of your PHI has been released other than instances of disclosure:

• for treatment, payment, or health care operations;
• to you or your authorized representatives; or
• pursuant to your written authorization.

We will respond to your written request for such a list within sixty (60) days of receiving it. You are entitled to such an accounting for the six (6) years prior to your request, though not for disclosures made prior to April 14, 2003. If you request this accounting more than once in a twelve (12) month period, we may charge you a reasonable fee for creating and sending these additional reports.

Right to request restriction: You have the right to ask that we limit how we use or disclose your PHI. We will consider your request, but are not legally bound to agree to the requested restrictions. To the extent that we do agree to any restriction on our use or disclosure of your PHI, we will put the agreement in writing and abide by it except in emergency situations. We cannot agree to limit uses or disclosures that are required by law.

Right to confidential communications: You may request that we contact you in a certain way or at a certain location, but you must specify how or where you wish to be contacted (e.g. by sending materials to a P.O. Box instead of your home address). We will make all efforts to accommodate reasonable requests made in writing.

Right to a copy of this notice: If you receive this notice on our website or by electronic mail (e-mail), you are entitled to receive this notice in written form. Please contact us using the information listed at the end of this notice to obtain this notice in written form.

Effective Date and Updates

This Notice is effective January 31, 2022.

QUESTIONS & COMPLAINTS

If you want more information about our privacy practices or have questions or concerns please contact us using the information listed below.

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to submit a complaint to us, send a written complaint to the address listed below, or, if you prefer, you can also discuss your complaint in person or by phone.

PathAdvantage Associated
5327 North Central Expwy, Suite 300
Dallas, Texas 75205
Ph: 214-219-5880