This notice describes how medical information about you may be used and disclosed, and how you can gain access to this information. Please review it carefully.
My Doctor, LLC is committed to protecting the privacy and security of your health information. Protected health information, often called PHI, includes information that may identify you and relates to your past, present, or future physical or mental health condition, the health care services you receive, or payment for those services. This may include information such as your name, address, phone number, medical history, medications, test results, insurance information, and other information related to your care.
We are required by law to maintain the privacy and security of your protected health information. We are also required to provide you with this Notice of Privacy Practices and follow the terms of the Notice currently in effect. This Notice explains your rights, our responsibilities, and how we may use or disclose your health information for treatment, payment, health care operations, and other purposes permitted or required by law.
We may update this Notice from time to time. If we make changes, the updated Notice will apply to all protected health information we maintain. A current copy will be available upon request, posted in our office, and made available on our website.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities.
You have the right to receive a copy of this Notice of Privacy Practices. You may ask us for a paper copy at any time, even if you have agreed to receive the Notice electronically.
You have the right to inspect or request a copy of your medical record and other health information we maintain about you. You may also ask us to send a copy of your health information to another person or entity.
If your health record is maintained electronically, you may request an electronic copy. We may charge a reasonable, cost-based fee for copies, as permitted by federal law. We will respond to your request within the timeframe required by law. If additional time is needed, we will notify you of the reason for the delay and the expected date of completion.
You have the right to ask us to correct health information about you that you believe is incorrect or incomplete. Your request must be submitted in writing. We may deny your request in certain circumstances, but we will explain the reason in writing.
You have the right to ask us to contact you in a specific way or at a specific location. For example, you may ask that we contact you by phone, email, mail, or at an alternative address or phone number.
Requests for alternative communication must be made in writing. We will accommodate all reasonable requests.
You have the right to ask us not to use or disclose certain health information for treatment, payment, or health care operations. Your request must be made in writing.
We are not required to agree to all requested restrictions. If we do agree, we will follow the restriction unless the information is needed to provide emergency treatment.
You also have the right to request that we not share information with your health plan about a specific service if you, or someone on your behalf, paid for that service in full out-of-pocket. We are required to honor this type of request unless disclosure is otherwise required by law.
You have the right to request a list, also called an accounting, of certain disclosures we have made of your health information. This list will not include disclosures made for treatment, payment, health care operations, disclosures made to you or at your request, or certain other disclosures excluded by law.
We will provide one accounting in a 12-month period at no charge. We may charge a reasonable fee for additional requests within the same 12-month period.
You have the right to receive written notice if we discover a breach of your unsecured protected health information and determine that notification is required by law.
We will not use or disclose your protected health information for purposes not described in this Notice unless you give us written authorization.
For example, written authorization is generally required for most uses and disclosures of psychotherapy notes, certain marketing purposes, or the sale of protected health information.
You may revoke an authorization at any time in writing, except to the extent that we have already acted in reliance on the authorization.
The following are examples of ways we may use or disclose your protected health information. These examples are not meant to include every possible use or disclosure, but they describe common ways your information may be used or shared.
We may use and disclose your health information to provide, coordinate, or manage your health care and related services.
For example, we may share information with pharmacies, laboratories, imaging centers, hospitals, specialists, or other health care providers involved in your care. This helps support continuity of care and allows your health care team to make informed decisions.
We may use and disclose your health information to bill and obtain payment for the health care services we provide.
For example, we may share information with your health insurance plan to confirm eligibility, obtain prior authorization, submit claims, determine coverage, or receive payment for services.
We may use and disclose your health information to support the business and clinical operations of our practice.
This may include quality assessment and improvement, care coordination, patient safety activities, staff training, medical review, auditing, legal services, business planning, and other activities necessary to operate our practice.
We may use or disclose your health information to contact you about appointments, test results, treatment options, prescription-related information, health-related benefits, or services offered by our office.
We may contact you by phone, mail, secure portal, email, text message, or other communication methods, depending on your preferences and the communication options available through our practice.
We may participate in a health information organization or health information exchange to support the secure electronic exchange of health information for treatment, payment, or health care operations.
This may allow health care providers involved in your care to access important medical information when needed for your treatment or coordination of care.
Unless you object, we may share relevant health information with a family member, relative, close friend, caregiver, personal representative, or another person you identify who is involved in your care or payment for your care.
If you are unable to agree or object, we may use our professional judgment to determine whether sharing information is in your best interest. In these situations, we will only disclose the information that is directly relevant to that person’s involvement in your care.
We may also use or disclose health information to notify or assist in notifying a family member, personal representative, or another person responsible for your care about your general condition, location, or death.
We may use or disclose your health information for certain public health and safety purposes, including:
Reporting certain diseases, injuries, or health conditions
Helping with product recalls
Reporting adverse reactions to medications
Preventing or controlling disease
Reporting suspected abuse, neglect, or domestic violence when required or permitted by law
Preventing or reducing a serious threat to anyone’s health or safety
We may disclose health information to health oversight agencies for activities authorized by law. These may include audits, investigations, inspections, licensure, certification, and other oversight activities.
We may disclose your health information in response to a court or administrative order, subpoena, discovery request, or other lawful process, when the applicable legal requirements are met.
We may also disclose health information for certain law enforcement purposes when permitted or required by law.
We may disclose health information to coroners, medical examiners, funeral directors, or organ and tissue donation organizations as permitted or required by law.
We may disclose health information as authorized by and necessary to comply with workers’ compensation laws or similar programs.
We may disclose health information for certain specialized government functions, such as military, national security, protective services, or correctional institution purposes, when permitted or required by law.
We may use or disclose health information for research purposes when the research has been approved through a process required by law or when another legal requirement has been met.
We will disclose your health information when required to do so by federal, state, or local law.
We may disclose your health information to the U.S. Department of Health and Human Services if requested as part of an investigation or review of our compliance with federal privacy laws.
Federal privacy law includes specific protections for certain health information related to reproductive health care.
When required by law, we will not use or disclose protected health information for a prohibited purpose, including to investigate or impose liability on a person for seeking, obtaining, providing, or facilitating reproductive health care that is lawful under the circumstances in which it was provided.
In certain situations involving requests for protected health information potentially related to reproductive health care, we may be required to obtain a signed attestation that the request is not for a prohibited purpose before disclosing the information.
We are required by law to:
Maintain the privacy and security of your protected health information
Provide you with this Notice of Privacy Practices
Follow the terms of the Notice currently in effect
Notify you if a breach occurs that may have compromised the privacy or security of your protected health information
Not use or disclose your health information except as described in this Notice or as permitted or required by law
We reserve the right to change this Notice and make the updated Notice effective for all protected health information we maintain. The updated Notice will be available upon request, posted in our office, and available on our website.
You have the right to file a complaint if you believe your privacy rights have been violated.
You may file a complaint with us by contacting:
My Doctor, LLC
Attn: Privacy Manager
9050 Montgomery Road
Cincinnati, OH 45242
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
We will not retaliate against you for filing a complaint.
If you have questions about this Notice, your privacy rights, or how to submit a written request regarding your protected health information, please contact our Privacy Manager.