Vita Bella Medical Group, P.A. of Florida
NOTICE OF PRIVACY PRACTICES
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.
Our Uses and Disclosures
- Treatment. We can use your health information and share it with other professionals who are treating you (e.g. your pharmacy) or supervising your treating professional.
- Run our organization. We can use and share your health information to onboard you as a patient, run our practice, improve your care, and contact you when necessary.
- Obtain payment and bill for our services. We can use and share your health information to bill and obtain payment from you for services we provided.
- To help with public health and safety issues. We can share health information about you for certain situations, including, but not limited to, preventing disease, reporting suspected abuse, neglect, or domestic violence, and/or preventing or reducing a serious threat to anyone’s health or safety.
- To conduct research. We can use or share your information for health research.
- To comply with the law. We will share information about you if state or federal laws require it.
- Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.
- Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
- Address workers’ compensation, law enforcement, and other government requests.
- To respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.
- We are required by law to maintain the privacy and security of your health records.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
- We are required by law to ask you sign a written authorization form should we need to release your health records.
- A paper or electronic copy of your medical record. You can ask to see or get a paper or electronic copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, as expeditiously as possible.
- Ask us to correct your medical record. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we will tell you why in writing within 60 days.
- Confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
- Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. Additionally, if you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of our operations with your health insurer.
- A list of those with whom we have shared information. You can ask for a list (accounting) of the times we have shared your health information for 5 years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
- A copy of this privacy notice. You can ask for a paper copy of this notice at any time. We will provide you with a paper copy promptly.
- Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
- File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information below:
- For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have the choice to tell us to: (i) Share information with your family, close friends, or others involved in your care; (ii) Share information in a disaster relief situation; and/or (iii) Include your information in a hospital directory.
- In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.
Notice of Retention and Destruction of Health Records
Changes to the Terms of this Notice