Full Circle Dermatology

NOTICE OF PRIVACY PRACTICES

(Effective April 1, 2024)

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We understand that health information about you and your healthcare is personal, and we are committed to protecting it. Your personal health information is protected by the Health Insurance Portability and Accountability Act ("HIPAA") and other privacy laws and regulations. This notice will tell you how we may use and disclose protected health information about you. Protected health information means any health information about you that identifies you or for which there is a reasonable basis to believe the information can be used to identify you. In this notice, we refer to all of that protected health information ("PHI") as "medical information." This notice also explains your rights and our duties regarding medical information about you. Additionally, it provides information on how to file a complaint with us and the Department of Health and Human Services if you believe we have violated your privacy rights.

How We May Use and Disclose Medical Information About You

We use and disclose medical information about you for various purposes, as described below.

For Treatment

We may use medical information about you to provide, coordinate, or manage your healthcare and related services. We may disclose medical information about you to doctors, nurses, hospitals, and other healthcare facilities involved in your care. For example, if we refer you to a specialist, we will share your medical information with that specialist to ensure you receive the necessary care.

For Payment

We may use and disclose medical information about you to receive payment for the services we provide. This can include billing you, your insurance company, or a third-party payor. For example, we may need to provide your insurance company with information about the healthcare services we provide to you so they will pay us or reimburse you.

For Health Care Operations

We may use and disclose medical information about you for our healthcare operations, which are necessary to maintain quality care. For example, we may use medical information about you to review the services we provide and the performance of our staff. We may also use the information to study ways to more efficiently manage our organization.

How We Will Contact You

Unless you tell us otherwise in writing, we may contact you by telephone or mail at your home or workplace. We may leave messages for you on an answering machine or voicemail. If you want us to communicate with you in a specific way or at a certain location, see the section "Right to Receive Confidential Communications" in this notice.

Treatment Alternatives

We may use and disclose medical information about you to contact you about treatment alternatives that may be of interest to you.

Health-Related Benefits and Services

We may use and disclose medical information about you to contact you about health-related benefits and services that may be of interest to you.

Marketing Communications

We may use and disclose medical information about you only to communicate directly with you about services provided through our office. This includes describing services we provide, treatments we offer, or recommending alternative treatments or healthcare providers. Any marketing of our services to you utilizing your medical information will be done only with your written authorization and consent.

Individuals Involved in Your Care

We may disclose to a family member, other relative, a close personal friend, or any other person identified by you, medical information about you that is directly relevant to that person's involvement with your care or payment related to your care. If there is someone to whom you do not want us to disclose medical information, please notify Full Circle Dermatology or inform our staff.

Required by Law

We may use or disclose medical information about you when required by law.

Public Health Activities

We may disclose medical information about you for public health activities, such as reporting diseases or injuries, and for public health surveillance and interventions.

Victims of Abuse, Neglect, or Domestic Violence

We may disclose medical information about you to a government authority authorized to receive reports of abuse, neglect, or domestic violence if we believe you are a victim.

Health Oversight Activities

We may disclose medical information about you to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.

Judicial and Administrative Proceedings

We may disclose medical information about you in response to a court order or other lawful process.

Disclosures for Law Enforcement Purposes

Under certain circumstances, we may disclose medical information about you to law enforcement officials.

Coroners and Medical Examiners

We may disclose medical information about you to coroners or medical examiners for identification purposes or determining cause of death.

Funeral Directors

We may disclose medical information about you to funeral directors as necessary for them to carry out their duties.

Organ, Eye, or Tissue Donation

To facilitate organ, eye, or tissue donation, we may disclose medical information to relevant organizations.

Research (if applicable)

Under certain circumstances, we may use or disclose medical information for research purposes.

To Avert Serious Threat to Health or Safety

We may use or disclose medical information if necessary to prevent a serious threat to health or safety.

Specialized Government Functions

We may disclose medical information to authorized federal officials for national security purposes.

Workers' Compensation

We may disclose medical information to comply with workers' compensation laws.

Other Uses and Disclosures

Your written authorization will be obtained for certain uses and disclosures, such as for marketing purposes or disclosures that constitute a sale of your medical information. You may revoke such authorization at any time.

Your Rights with Respect to Medical Information About You

You have the following rights regarding your medical information:

Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your medical information. You can request restrictions on disclosures to a health plan if you have paid for the service in full out of pocket. Requests must be made in writing to Full Circle Dermatology.

Right to Receive Confidential Communications

You have the right to request that we communicate with you in a certain way or at a specific location. Requests must be made in writing to Full Circle Dermatology.

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your medical information. Requests must be made in writing to Full Circle Dermatology.

Right to Amend

You have the right to request an amendment of your medical information. Requests must be made in writing to Full Circle Dermatology and must state the reason for the amendment.

Right to an Accounting of Disclosures

You have the right to receive an accounting of certain disclosures of your medical information. Requests must be made in writing to Full Circle Dermatology.

Right to Copy of this Notice

You have the right to obtain a paper copy of this notice upon request. You may also obtain a copy from our website.

Our Duties

Generally

We are required by law to maintain the privacy of your medical information and provide this notice of our legal duties and privacy practices. You have the right to receive notifications of any breaches of your unsecured medical information.

Our Right to Change Notice of Privacy Practices

We reserve the right to change this notice. Any changes will apply to all medical information we maintain.

Availability of Notice of Privacy Practices

A copy of our current notice will be posted in our office and on our website. You can request a copy at any time.

Complaints

You may complain to us and the United States Secretary of Health and Human Services if you believe your privacy rights have been violated. To file a complaint with us, contact Full Circle Dermatology in writing or by phone. To file a complaint with the United States Secretary of Health and Human Services, use the contact information provided in this notice. You will not be retaliated against for filing a complaint.

Questions and Information

If you have any questions or want more information, contact Full Circle Dermatology in writing or by calling 281-645-5013.