Notice of Privacy Practices

For Treatment

We will use and disclose your health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example:

• Consultation with other physicians about your surgical care
• Communication with your primary care physician or specialists
• Pre-operative and post-operative care coordination
• Referrals to other healthcare providers when necessary
• Sharing surgical photos and records with consulting specialists

For Payment

We may use and disclose your health information to obtain payment for services we provide to you. For example:

• Submitting claims to your insurance company
• Verifying insurance benefits and coverage
• Determining eligibility for payment
• Collecting payment for services rendered
• Working with collection agencies if necessary

For Health Care Operations

We may use and disclose your health information for our health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of care. For example:

• Quality assessment and improvement activities
• Training medical students, residents, or other healthcare providers
• Compliance with regulatory requirements
• Business planning and development
• Internal auditing and risk management

Appointment Reminders

We may use and disclose your health information to contact you to remind you of appointments. We may leave messages with callback numbers on your voicemail or with individuals who answer your phone unless you instruct us otherwise.

Treatment Alternatives and Health-Related Benefits

We may use and disclose your health information to tell you about treatment options or alternatives, or health-related benefits and services that may be of interest to you.

As Required by Law

We will disclose your health information when required to do so by federal, state, or local law.

Public Health Activities

We may disclose your health information for public health activities, including:

• Reporting disease, injury, or vital events to public health authorities
• Reporting suspected abuse, neglect, or domestic violence
• Reporting adverse reactions to medications or problems with medical devices
• Notifying people about potential exposure to communicable diseases
• Notifying authorities about potential threats to public health or safety

Health Oversight Activities

We may disclose your health information to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, licensure, or disciplinary actions.

Lawsuits and Disputes

If you are involved in a lawsuit or a dispute, we may disclose your health information in response to a court or administrative order. We may also disclose information in response to a subpoena, discovery request, or other lawful process.

Law Enforcement

We may release health information if asked to do so by a law enforcement official:

• In response to a court order, subpoena, warrant, or similar process
• To identify or locate a suspect, fugitive, material witness, or missing person
• About the victim of a crime if certain limited circumstances are met
• About a death we believe may be the result of criminal conduct
• About criminal conduct at our office
• In emergency circumstances to report a crime

Workers' Compensation

We may release your health information for workers' compensation or similar programs that provide benefits for work-related injuries or illness.

Marketing

We will not use or disclose your health information for marketing purposes without your written authorization. We do not sell patient information.

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your health information that may be used to make decisions about your care. This typically includes medical and billing records. To inspect and copy your health information, you must submit your request in writing. We may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.

Right to Amend

If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. You must provide a reason that supports your request.

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures of your health information. This is a list of certain disclosures we made of your health information for purposes other than treatment, payment, and healthcare operations. To request this accounting, you must submit your request in writing. Your request must state a time period, which may not be longer than six years.

Right to Request Restrictions

You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care. We are not required to agree to your request unless you are asking us to restrict disclosures to your health plan for services you paid for in full out-of-pocket.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time, even if you have agreed to receive the notice electronically. You may obtain a copy of this notice at our website or by contacting our office.

Right to be Notified of a Breach

You have the right to be notified in the event that we (or one of our Business Associates) discover a breach of your unsecured protected health information.