Effective Date (Last Edited On): February 24, 2023.
These are the categories of information collected from you on the Site:
We may use your personal information to contact you, improve the Site and the services provided to you, provide you with information that you have requested, or provide you with additional information that we believe may be of interest to you.
We use the information you submit to us to schedule your appointment, and to provide information you request or respond to inquiries. We may also use information, including usage data, to troubleshoot or make improvements to the Site.
We may combine your information with other information about you that is available to us, including information from other sources. Use for any other purpose will be with your express consent.
We do not sell your data to any third parties for marketing purposes.
Other third-party web sites may provide information to us about which web site referred you to the Site. This data is aggregated.
We may further need to share your personal information in the following situations: (1) Business Transfers – in connection with, or during negotiations of, any merger, sale of Company assets, financing or acquisition of all or a portion of our business to another company; (2) Business Partners – to offer you certain products, services or promotions; and (3) Law Enforcement or Public Authorities – we may be required to disclose if required by law or in response to valid requests by public authorities, such as a court or law enforcement.
We implement a variety of security measures to maintain the safety of your personal information. Your personal information is contained behind secured networks and is only accessible by a limited number of persons who have special access rights to such systems. Despite these precautions, no security system is impenetrable. As such, we do not guarantee the absolute safety of your information. You should only access the Sites and use our services within a secure environment.
We do not knowingly solicit data from, or market to, children under 18 years of age. By using the Site and/or our services, you represent that you are at least 18 years of age or that you are the parent or guardian of such a minor and consent to such minor dependent’s use of the Sites and/or our services. If you become aware of any data we may have collected from children under 18 years of age, please contact us at firstname.lastname@example.org.
If you wish to delete your personal information, send a request via email to email@example.com. Please note aggregated data collected from your visit will not be deleted, you must also contact any third-party web sites with a similar request.
We do not knowingly collect information from children under 5 years of age. If we learn that a child under 5 years of age has submitted information to the Company, we will immediately delete it.
We are required by law to:
We reserve the right to change the terms of this Notice at any time. We also reserve the right to make the changes apply to your PHI we already have. Before we make a material change to this Notice, we will post a notice of such change in a clear and prominent manner on the Site along with the new Notice.
“Protected Health Information” or “PHI” is information, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. Any information about you (including PHI) that has been de-identified in accordance with standards established under HIPAA (“De-Identified Data”) is not considered PHI. De-Identified Data is not subject to this Notice and we may use and disclose De-Identified Data for any lawful purpose.
We may use and/or disclose your PHI without your consent or authorization for the following purposes:
Treatment. We may use and disclose your PHI in order to provide health care services and treatment for you. For example, information obtained by a nurse, physician or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his/her expectations of the members of your healthcare team. Members of your healthcare team will then record the actions they took and their observations. In that way the physician will know how you are responding to treatment. We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him/her in treating you once you’re done with our services. Additionally, we may disclose your PHI to an electronic prescribing network, to ensure you can obtain the medications you need for your treatment cycle, if applicable.
Payment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to your health plan to get paid for the health care services we provided to you. We may also disclose your PHI to your health plan to permit it to make a determination of eligibility or coverage for insurance benefits, to review the services we provided to you for medical necessity, and to perform utilization review activities. We also disclose your PHI to the responsible party of your account. If you are listed as a dependent on another person’s insurance policy, financial information regarding medical care provided may be mailed to that responsible party. In addition, if you do not timely pay us for the health care services we provided to you, we may also disclose limited PHI to a collection agency.
Health Care Operations. We may use and disclose your PHI in order to support our business activities, such as quality assessment activities, employee review activities, and conducting or arranging for our other business activities. For example, we may use PHI to review our treatment and services and to evaluate the performance of our staff in providing services. We may also use your PHI to evaluate and improve services provided by our business associates. In addition, we may use and disclose your PHI to other health care providers, health plans or health care clearinghouses for their limited health care operations, such as quality assessment activities, licensing and other health care compliance activities.
Business Associates. We may disclose your PHI to our business associates that assist us in our delivery of health care and related services. For example, we contract with a management services organization, which provides non- clinical, administrative and business support services on behalf of the Company, including without limitation, billing and collection services and technology and technology support services. Other business associates may include software providers, lawyers, accountants and other persons or entities who provide us with items or services used in our business. Before we disclose your PHI to a business associate, we will have a written contract with the business associate that will require the business associate to maintain the privacy of your PHI in accordance with HIPAA.
Research. We may use and disclose your PHI to conduct medical research as permitted under HIPAA. Under HIPAA, we may use or disclose PHI for research purposes if:
An applicable Institutional Review Board or Privacy Board determines that (1) the use or disclosure involves no more than minimal risk to the privacy of the individual’s information, (2) the research could not practicably be conducted if individual authorization was required, and (3) the research could not practicably be conducted without access to the PHI;
The use or disclosure is solely in preparation for research, for example, to design a research study, and we obtain representations from the researcher that your PHI will be used only for this purpose, will not be removed and is necessary for research purposes;
The PHI is from decedents; or
We use only a limited data set (i.e., excluding certain direct identifiers) and enter into data set agreement with the researcher.
Uses and Disclosures Required by Law. We may use or disclose your PHI as required by law but must limit such use or disclosure to relevant information and otherwise comply with applicable legal requirements.
Public Health Activities. We may use or disclose your PHI for public health activities. For example, we may use or disclose your PHI to public health authorities responsible for collecting information for purposes of preventing or controlling disease and certain disclosures related to regulatory activities of the Food and Drug Administration.
Abuse, Neglect, or Domestic Violence. We may use or disclose your PHI in some instances if we reasonably believe that you are a victim of abuse, neglect, or domestic violence.
Health Oversight Activities. We may use or disclose your PHI for certain health oversight activities, including, for example, inspections and licensure of health care facilities.
Judicial and Administrative Proceedings. We may use or disclose your PHI under some circumstances in response to a subpoena or order by a court or administrative tribunal.
Law Enforcement Purposes. We may use or disclose your PHI for certain law enforcement purposes. For example, we may use or disclose your PHI to law enforcement officials for identification of suspects or where a crime has been committed on our premises.
Decedents. We may use or disclose PHI of decedents to coroners, medical examiners, and funeral directors. Serious Safety Threat. We may use or disclose your PHI where we believe it is necessary to prevent or lessen a serious threat to the safety of a person or the public.
Specialized Government Functions. We may use or disclose your PHI under some circumstances for specialized government functions, including those related to the armed forces, national security, and intelligence.
Scheduling Appointments, Appointment Reminders and Health Related Benefits or Services. We may use and disclose your PHI to schedule appointments, give you appointment reminders, and give you information about treatment alternatives or other health care related services or benefits we offer.
Personal Representatives. We may disclose your PHI to your personal representatives that are appointed by you or authorized by applicable law.
Uses and Disclosures for which you Have an Opportunity to Agree or Object:
Spouse/Significant Other. We may disclose your PHI to your spouse or significant other, unless you object in whole or in part. For example, although PHI in your medical record belongs to you, it will contain some information pertaining to your spouse/significant other. PHI will only be disclosed to individuals provided for on a Company Consent Form signed by you.
Individuals Involved in Your Care. We may disclose your PHI to a family member, friend or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity for you to agree or object may be given retroactively in emergency situations. PHI will only be disclosed to individuals provided for on a Company Consent Form signed by you.
The Right to Inspect and Copy Your PHI:
For so long as we maintain your PHI, you have the right to request to inspect or obtain a copy of your PHI maintained by us. In order to inspect and/or obtain a copy of your PHI, you must email us at firstname.lastname@example.org for further instructions. Because your PHI may include a significant amount of underlying data generated as part of our testing and monitoring, when providing you with access to or a copy of your PHI, we may provide a summary of certain of your records in lieu of providing access to all data generated as part of the services we provide. In using our services, you are agreeing to receive this summary in lieu of all PHI. Additionally, if you would like to have access to and/or receive a copy of your informed consent documents, you must specifically request that such documents be provided to you. To request inspection or a copy of your PHI, you must email us at email@example.com for further instructions. Please note that in certain circumstances, we are not required to agree to your request.
Note: HIV-related information, genetic information, mental health records and other specially protected health information may be subject to certain special confidentiality protections under applicable State and Federal law. Any disclosures of these types of records will be subject to these special protections.
You have the right to request a list of certain disclosures that we and our business associates made for certain purposes for the last six (6) years
We welcome your questions, comments, and concerns about privacy. Please send us any and all feedback pertaining to privacy to firstname.lastname@example.org.