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.
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OUR COMMITMENT TO YOUR PRIVACY
We are dedicated to maintaining the privacy of your protected health information (PHI). This Notice explains how we may use and disclose your PHI and your rights regarding your health information under the Health Insurance Portability and Accountability Act (HIPAA) and Texas state law.
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HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use and disclose your PHI for the following purposes:
1. Treatment
To provide, coordinate, or manage your healthcare and related services (e.g., sharing information with other providers involved in your care).
2. Payment
To obtain payment for services we provide (e.g., billing your insurance company or a third-party payer).
3. Healthcare Operations
To run our practice efficiently and ensure quality care (e.g., quality assessments, audits, administrative processes).
4. Appointment Reminders and Health-Related Services
We may contact you about appointments, treatment alternatives, or health-related benefits and services.
5. As Required by Law
We will disclose your PHI when required to do so by federal, state, or local law.
6. Public Health and Safety
We may disclose PHI to public health authorities for preventing or controlling disease, reporting adverse events, or protecting against serious threats to health and safety.
7. Legal and Administrative Proceedings
We may disclose your PHI in response to a court order, subpoena, or other legal process.
8. Law Enforcement
We may disclose PHI for law enforcement purposes, including locating suspects or missing persons, or reporting a crime.
9. Workers’ Compensation
We may disclose your PHI for workers’ compensation or similar programs.
10. Other Uses with Authorization
Any other use or disclosure of your PHI not described in this notice will only be made with your written authorization. You may revoke this authorization at any time.
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YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding your PHI:
1. Right to Access
You have the right to inspect and receive a copy of your medical records (with some exceptions). A reasonable fee may apply.
2. Right to Amend
If you feel your PHI is incorrect or incomplete, you may request an amendment in writing.
3. Right to an Accounting of Disclosures
You have the right to request a list of disclosures made of your PHI (excluding disclosures for treatment, payment, and healthcare operations).
4. Right to Request Restrictions
You may request restrictions on how we use or disclose your PHI. We are not required to agree, but if we do, we will comply except in emergencies or as required by law.
5. Right to Request Confidential Communications
You can request we contact you in a specific way (e.g., only by phone or email).
6. Right to a Paper Copy
You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.
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OUR DUTIES
We are required by law to maintain the privacy of your PHI.
We must provide you with this Notice of our legal duties and privacy practices.
We will notify you if a breach of your unsecured PHI occurs.
We must follow the terms of this Notice currently in effect.
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CHANGES TO THIS NOTICE
We reserve the right to change this Notice. Any changes will apply to all PHI we maintain. A current copy will be available at our office and on our website [insert website if applicable].
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QUESTIONS AND COMPLAINTS
If you have questions about this Notice or believe your privacy rights have been violated, you may contact:
Privacy Officer: Marivel Alvarez, MSN, APRN, FNP-C
Phone: 956-966-3003
You may also file a complaint with the U.S. Department of Health and Human Services. Filing a complaint will not affect your care or services.
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ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES
You will be asked to sign an acknowledgment form confirming that you have received this notice.