SOUTH TEXAS SPINE CLINIC
NOTICE OF PRIVACY PRACTICE
NOTICE: UNDERSTANDING THE USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION
Effective Date: April 14, 2003 – Revised Date: September 1, 2013
For inquiries or additional information regarding this notice, please contact our Privacy Officer:
Privacy Officer: Angela Szymblowski Mailing Address: 9150 Huebner Rd., Suite 290 San Antonio, TX 78240 Telephone: 210-614-6432 Fax: 210-293-3920
Overview: By law, we are obligated to safeguard the privacy of Protected Health Information and provide you with this notice explaining our privacy practices. This notice outlines your rights and our legal responsibilities concerning the privacy of your health information. We are bound by the terms of the current version of this notice.
Protected Health Information (PHI): “Protected Health Information” includes individually identifiable information obtained from you, another healthcare provider, health plan, employer, or health care clearinghouse. It pertains to your past, present, or future physical or mental health, the provision of healthcare, or the payment for your healthcare.
How We Use and Disclose Your PHI: We may use and disclose your PHI in the following situations:
Treatment:
- Providing medical treatment or services and managing your medical care.
- Sharing information with healthcare providers involved in your treatment.
Payment:
- Billing for the treatment and services you receive.
- Coordinating payment with health plans or third parties.
Health Care Operations:
- Internally reviewing the quality of treatment and services.
- Evaluating the performance of our team members.
- Disclosing information for educational and learning purposes.
Appointment Reminders/Treatment Alternatives/Health-Related Benefits and Services:
- Contacting you regarding appointments, treatment options, or health-related benefits.
Minors:
- Disclosing PHI of minor children to parents or guardians unless prohibited by law.
Research:
- Using and disclosing PHI for approved research purposes with privacy safeguards.
Required by Law:
- Disclosing PHI as mandated by international, federal, state, or local law.
Serious Threat to Health or Safety:
- Using and disclosing PHI to prevent a serious threat to your or others’ health or safety.
Business Associates:
- Disclosing PHI to business associates who perform functions on our behalf.
Organ and Tissue Donation:
- Sharing PHI with organizations facilitating organ or tissue donation.
Military and Veterans:
- Disclosing PHI as required by military command authorities.
Workman’s Compensation:
- Using or disclosing PHI for workman’s compensation or similar programs.
Public Health Risks:
- Disclosing PHI for public health activities as allowed by law.
Abuse, Neglect, or Domestic Violence:
- Disclosing PHI to the appropriate government authority if abuse is suspected.
Health Oversight Activities:
- Disclosing PHI to a health oversight agency for authorized activities.
Data Breach Notification Purposes:
- Using or disclosing PHI for legally required notices of unauthorized access.
Lawsuits and Disputes:
- Disclosing PHI in response to court orders or legal processes.
Law Enforcement:
- Disclosing PHI for law enforcement purposes if legal requirements are met.
Military Activity and National Security:
- Disclosing PHI for military, national security, or intelligence activities.
Coroners, Medical Examiners, and Funeral Directors:
- Disclosing PHI to facilitate their duties.
Inmates:
- Disclosing PHI to correctional institutions for healthcare, safety, or security.
Opportunity to Object and Opt-Out: You have the right to object or opt-out of certain disclosures, including:
- Disclosures to individuals involved in your care or payment.
- Disclosures to disaster relief organizations coordinating your care in a disaster.
Authorization for Other Uses and Disclosures: Certain uses and disclosures require your written authorization, including marketing purposes and the sale of PHI.
Your Rights Regarding Your PHI: You have specific rights concerning your PHI:
Right to Inspect and Copy:
- Inspect and copy PHI within 30 days, with potential fees.
Right to Summary or Explanation:
- Request a summary or explanation of your PHI.
Right to an Electronic Copy:
- Request an electronic copy of your electronic medical records.
Right to Get Notice of a Breach:
- Be notified in case of a breach of unsecured PHI.
Right to Request Amendments:
- Request amendments to incorrect or incomplete PHI.
Right to an Accounting of Disclosures:
- Request a list of disclosures made, subject to certain conditions and fees.
Right to Request Restrictions:
- Request restrictions on certain uses or disclosures of your PHI.
Out of Pocket-Payments:
- Request that PHI not be disclosed to a health plan if you paid out-of-pocket.
Right to Request Confidential Communication:
- Request communication preferences in writing.
Right to a Paper Copy of This Notice:
- Request a paper copy of this notice.
How to Exercise Your Rights: To exercise your rights, send a written request to our Privacy Officer at the provided address. For inspection and copying, you may also contact your physician directly. For a paper copy of this notice, contact our Privacy Officer by phone or mail.
Changes to This Notice: We reserve the right to change this notice, effective for existing and future PHI. The current notice is posted in our office and on our website.
Complaints: File complaints with us or the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. No retaliation will occur for filing a complaint.
Foreign Language Version: If you struggle with English, request a Spanish version of this notice.