HIPAA Notice of Privacy Practices

How We May Use and Disclose Health Information About You

We may use and disclose your health information for treatment, payment, and healthcare operations, and in several other circumstances described below. Some information, such as HIV-related information, genetic information, and substance use or mental health records, may be entitled to special confidentiality protections under applicable law, which we will honor.

• Treatment: we may share your protected health information with other healthcare providers, business associates, and their subcontractors involved in your treatment, billing, or administrative support, all of whom are bound by federal law to protect your information.
• Payment: we may use and disclose your health information to obtain reimbursement for treatment and services, including billing, collections, and claims management.
• Healthcare operations: we use and disclose health information to keep our practice operable, including records staff and insurance operations.
• Individuals involved in your care: we may disclose information to family, friends, or a patient representative involved in your care or payment.
• Required by law: we may use or disclose your information when required by court order, subpoena, or other lawful process, or when requested by national security or law enforcement officials.
• Substance use disorder (SUD) records: records subject to 42 C.F.R. Part 2 receive additional protections and may not be disclosed in legal proceedings without your written consent or a qualifying court order.
• Abuse or neglect: we may disclose information to appropriate authorities if we reasonably believe you are a possible victim of abuse, neglect, or domestic violence.
• Public health activities: including reporting to prevent or control disease, report child abuse or neglect, or notify of a product recall.
• National security, worker’s compensation, law enforcement, health oversight, judicial proceedings, research, and coroners/medical examiners as permitted or required by applicable law.
• Marketing and fundraising: we will not use your health information for marketing purposes without your written authorization. We may use limited contact information for fundraising, and you may opt out of any such communication at any time.
• Appointment reminders: we may use your health records to remind you of recommended services, treatment, or scheduled appointments.

Your Health Information Rights

• Access: you have the right to look at or get copies of your health information, with limited exceptions, by submitting a request in writing.
• Disclosure accounting: you have the right to receive an accounting of certain disclosures of your health information.
• Right to request a restriction on our use or disclosure of your protected health information.
• Alternative communication: you may request that we communicate with you by alternative means or at alternative locations.
• Amendment: you may request that we amend your health information in writing.
• Right to notification of a breach of unsecured protected health information.
• Electronic notice: you may receive a paper copy of this Notice upon request, even if you agreed to receive it electronically.

Questions and Complaints

If you want more information about our privacy practices, have questions or concerns, or believe we may have violated your privacy rights, please contact us or call (817) 754-4858. You may also submit a written complaint to the U.S. Department of Health and Human Services; we will provide the address to file that complaint upon request. We will not retaliate in any way if you choose to file a complaint.

Our Privacy Officer: Owner / Office Manager
Address: 12652 Timberland Boulevard, Suite 130, Fort Worth, TX 76244