HIPAA
SynergenX Physician Services, PLLC, it subsidiaries and affiliates, HIPAA Notice of Privacy Practice
SynergenX Physician Services, PLLC is a group medical practice and reference to “SyenrgenX” in this policy shall incorporate its subsidiaries and affiliates. 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 are required by law to maintain the privacy of your health information. This notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, and healthcare operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Protected Health Information, or PHI, is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related healthcare services. By executing, these documents, you acknowledge that, SynergenX shall also include its subsidiaries and affiliated practice entities.
Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff, and others outside of our office that are involved in your care and treatment for the purposes of providing health care services to you, to pay your health care bills, to support the operations of the physicians practice, and any other use required by law. We are also obligated to notify you following a Breach of unsecured PHI. When we use or disclose your PHI, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).
Treatment
We will only use and disclose your protected health information to provide, coordinate, or manage your health care and related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you or provide it to a physician whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
Payment
Your protected health information will be used as needed to obtain payment for your health care services.
Healthcare Operations
We may use or disclose, as needed, your protected health information in order to support the business activities of your physician’s practice. These activities include but are not limited to quality assessment, employee review, training of medical students, and licensing. For example, we may call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointments.
We may use or disclose your protected health information in the following situations without your authorization: as required by law, public health issues, communicable diseases, health oversight, abuse or neglect, food and drug administration requirements, legal proceedings, law enforcement, coroners, funeral directors, organ donation, research, criminal activity, military activity, and national security. Under the law, we must also make disclosures to you, and when required by the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.
Other Permitted & Required Uses and Disclosures
Disclosures will be made only with your authorization or opportunity to object unless required by law. You may revoke this authorization at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.
We may use or disclose your PHI to a family member, relative, close friend or acquaintance, or such other person or persons identified by you if we: 1) obtain your agreement; 2) allow you the opportunity to object to disclosure and you do not object; or 3) reasonably infer that you have no objection to disclosure. If you are not present or we cannot reasonably secure your agreement or objection because of your incapacity or in an emergency, we may exercise professional judgment in determining whether disclosure is warranted and appropriate, particularly in notifying others of your whereabouts, general condition or hospitalization.
Disclosure Due to Regulatory Requirements or as a Matter of Law
We may disclose your PHI to a governmental agency that oversees the health care system and ensures compliance with that system, such as Medicare and Medicaid. We may disclose your PHI if required through a judicial or administrative proceeding. We may also disclose your PHI to law enforcement authorities in compliance with a court order, grandy jury or administrative subpoena. We may also disclose your PHI as authorized by the HIPAA rule and any other law, beyond the categories referenced here.
Disclosure of PHI After Written Authorization
In some circumstances your written authorization is required for the disclosure of your PHI. One such example is disclosure of your PHI to your life insurance company or to another medical provider. You may revoke such authorization or any other written authorization you provided for the disclosure of your PHI by delivering a written statement to the privacy officer referenced below.
Your Individual Rights:
You have the right to inspect and receive a copy of your PHI. Our practice will accept such requests in writing. Under federal law, however, you may not inspect or receive a copy of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information.
You have the right to request a restriction on the disclosure of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment, or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Your physician is not required to agree to a restriction that you may request. If a physician believes it is in your best interest to permit use and disclosure of our protected health information, your health information will not be restricted. You then have the right to use another healthcare professional.
You have the right to request that we amend your PHI contained in your medical records or billing records. We will make every effort to comply with your request for amendment unless we believe the information you are asking be amended is accurate, complete or in the even that other circumstance exist that would prohibit amendment.
You have the right to request to receive confidential communications from us by an alternative means or at an alternative location.
You have the right to obtain a paper copy of this notice from us.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. We reserve the right to change the terms of this notice and will post any changes in our waiting areas and online. You then have the right to object as provided in this notice.
Complaints
You may file any complaints with our Privacy Officer, Paula Childs, at (281) 713-4384, or with the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. We will not retaliate against you for filing a complaint.