Notice of Privacy Practices
Effective Date: 6/30/2024This 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: make sure that health-related information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; follow the terms of the notice that is currently in effect and notify you following a breach of unsecured protected health information.
OUR PLEDGE REGARDING your MEDICAL INFORMATION
We understand that information about you and your health is personal. We are committed to protecting that medical information. We create a record of the care and services you receive to provide you with quality care and to comply with certain legal requirements.
This notice applies to all the records of your care generated by Hormone & Health Medical Center, whether made by our employees or your provider. This notice tells you about how we may use and disclose information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information. This Notice of Privacy Practices is not an authorization; rather it describes how we may use and disclose your Protected Health Information to carry out treatment, payment, or health care operations, and for other purposes as permitted or required by law.
This notice describes Hormone & Health Medical Center’s practices regarding the use and disclosure of your medical information by (a) any healthcare professional authorized to enter information into your medical record, (b) volunteers/students we allow to help you while you are in the facility, (c) all contracted individuals, entities, and facilities, and (d) all members of Hormone & Health Medical Center’s workforce. These individuals, entities, and facilities may share medical information with each other for treatment, payment or operations purposes described in this notice.
If you have any questions about this notice, please refer to our website, www.hormoneandhealthfl.com or you may contact the Chief Privacy Officer by telephone at (407) 205-9777, email to info@hormoneandhealthfl.com or mail: 225 West Canton Avenue #200, Winter Park, FL 32789
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe the ways that we can use and disclose health-related information. For each category of use or disclosure, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed.
For Treatment
We may use and disclose your information to provide you with medical treatment and to coordinate or manage your healthcare and related services. We may use and disclose medical information about you when you need a prescription, lab work, X-rays or other healthcare services, or when referring you to another medical provider. If you participate in a virtual visit (telehealth), your information will be shared electronically via a secure transmission to facilitate the virtual visit.
For Payment
We may use and disclose information about you so the treatment and services you receive can be billed to and payment may be collected from you, a family member, an insurance company, or a third party. We may also disclose your information to a collection agency to obtain overdue payment or to a regulatory agency or insurance company to determine whether the services we provided were medically necessary or appropriately billed.
For Healthcare Operations
We may use and disclose information about you for normal clinic operations. These uses and disclosures are necessary to run the facility and make sure that all our patients receive quality care. We may disclose medical information to business associates who provide contracted services such as accounting, legal representation, claims processing, quality assurance, accreditation, and consulting. We may also combine medical information about patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to physicians, nurses, technicians, medical students, and other personnel for review and learning purposes. We may also use and disclose your protected health information for marketing activities. For example, we may send you a thank you card with a coupon for specialized services or products. We may also send you information about products or services that might be of interest to you. You can contact us at any point to stop receiving this information. In addition, We may also record your visit to facilitate the documentation of your care by your provider via a scribe or virtual scribe service.
Appointment Reminders and Check-in
We may use and disclose your information for appointment reminders. We may use a sign-in sheet at the registration desk and call you by name in the waiting room when your provider is ready to see you.
Follow-Up Phone Calls
As part of your treatment plan, there may be times that you will be contacted by staff after you have had service in our facility. Such phone calls will be limited in number and are meant to ensure optimum recovery, patient satisfaction, and education. We may use and disclose information to contact you about test results. We may leave a message regarding the results of certain tests but will leave the minimum amount of information necessary to communicate this information.
Treatment Alternatives and Health-Related Benefits and Services
We may use and disclose information to recommend or tell you about treatment alternatives and health-related benefits or services that may be of interest to you. We may also use and disclose your information to provide options about payment for such products, benefits or services, including payment that might be available to you through your benefit plan.
Individuals Involved in Your Care or Payment for Your Care
Unless you object, we may release information about you to a friend or family member who is involved in or helps pay for your medical care. If you are incapacitated, we may disclose your PHI to the person named in your Durable Power of Attorney for Health Care or your personal representative (the individual authorized by law to make health-related decisions for you). In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Disclosures as Required by Law
We will disclose information about you when required to do so by federal, state or local law. To Prevent a Serious Threat to Health or Safety. We may use and disclose information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures would only be to someone able to help prevent the threat. For example, We may disclose information to comply with child and elder abuse reporting laws or to report certain diseases, injuries or deaths to state or federal agencies.
SPECIAL SITUATIONS
Workers’ Compensation
We may release information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Public Health Risks
We will disclose information about you for public health activities as required by law. These activities generally include the following: (a) to prevent or control disease, injury or disability; (b) to report births and deaths; (c) to report child abuse or neglect; (d) to report reactions to medications or problems with products; (e) to notify people of recalls of products they may be using; (f) to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and (g) to notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence.
Health Oversight Activities
We will disclose information to a health oversight agency for activities authorized by law. These oversight activities include: audits, investigations, inspections, and licensure that are necessary for the government to monitor the healthcare system, government programs, and compliance with applicable laws.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose information about you in response to a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if we are assured that reasonable efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement
We may release information if asked to do so by a law enforcement official: (a) in response to a court order, subpoena, warrant, summons, or similar process; (b) to identify or locate a suspect, fugitive, material witness, or missing person; (c) about the victim of a crime if, under certain limited circumstances, we are unable to obtain the patient agreement; (d) about a death we believe may be the result of criminal conduct; (e) about criminal conduct in the facility; and (f) in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Organ and Tissue Donation, Coroners, Medical Examiners and Funeral Directors
If you are an organ donor, we may release information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank to facilitate organ or tissue donation and transplantation. We will release information to a coroner or medical examiner to identify a deceased person or determine the cause of death. We will also release information to funeral directors as necessary to fulfill their responsibilities.
Military, National Security, and other Specialized Government Functions
We may release information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law. We may disclose information about you to authorized Federal officials so they may conduct special investigations and provide protection to the President or other officials and dignitaries.
Research
We may use and disclose your information to researchers for the purpose of conducting research with your written authorization or when the research has been approved by an Institutional Review Board and is in compliance with law governing research. In certain situations, the need for your individual consent may be waived by a Privacy Board.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding the medical information we maintain about you:
Right to Inspect and Copy
You have the right to inspect and obtain copies of medical information that may be used to make decisions about your care. To inspect and obtain a copy of medical information that may be used to make decisions about you, submit your request in writing to: 225 West Canton Avenue #200, Winter Park, FL 32789 or email to info@hormoneandhealthfl.com. You can also request copies of your records through Hormone & Health Medical Center patient portal. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, labor, electronic media, or other supplies associated with your request. We may deny your request to inspect and obtain a copy of your medical information in certain limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Depending on the reason for the decision to deny a request, we may ask another licensed provider chosen by us to conduct a review of your request and its denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to Amend
If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for Hormone & Health Medical Center. To request an amendment, your request must be made in writing and submitted to 225 West Canton Avenue #200, Winter Park, FL 32789 or email to info@hormoneandhealthfl.com. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: (a) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (b) is not part of the medical information kept by or for Hormone & Health Medical Center; (c) is not part of the information which you would be permitted to inspect and copy; or (d) is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request an accounting (list) of certain types of disclosures we have made of information about you. We are not required to account for certain disclosures such as: (a) disclosures you authorize; (b) disclosures to carry out treatment, payment, and healthcare operations; and (c) disclosures to persons involved in your care. To request an accounting of disclosures, you must submit your request in writing to: 225 West Canton Avenue #200, Winter Park, FL 32789 or email info@hormoneandhealthfl.com. This information may not be longer than (STATUTE OF LIMITATIONS) years ago prior to the date the accounting is requested. We reserve the right to charge a reasonable fee for this process.
Right to Request Restrictions
You have the right to request a restriction or limitation on our use or disclosure of information about you for treatment, payment or healthcare operations. You also have the right to request a limit on the information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. (For example, you could ask that we not use or disclose information about a surgery you had to a particular family member.) If you pay for a service or health care item out-of-pocket in full, you may ask us not to share that information for the purpose of payment or our operations with your health insurer. In that case, we will approve your request unless a law specifically requires us to share that information.
Right to Request Confidential Communications
You may request, in writing, that we communicate with you in a specific way or send mail to a different address. For example, you may request that we contact you at home, rather than work or by mail. You do not need to give a reason for your request. We will comply with your request if we are reasonably able to do so. You must submit your request in writing to: 225 West Canton Avenue #200, Winter Park, FL 32789, or email info@hormoneandhealthfl.com.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this notice at any time even if you have agreed to receive the notice electronically. You may also obtain a copy of this notice at our website -- hormoneandhealthfl.com/privacy.
CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time. We reserve the right to make the revised or changed notice effective for medical information we already have about you, as well as any information we receive in the future. We will post a copy of the current notice in various locations indicating the effective date. Revised copies of this notice will be provided upon request.
COMPLAINTS
If you believe your privacy rights have been violated, or you disagree with a decision we made about your health information, you may file a complaint with the facility. Contact us by telephone at (407) 205-9777, email to info@hormoneandhealthfl.com, or mail: 225 West Canton Avenue #200, Winter Park, FL 32789. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services by mail to 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, DC 20201 or online at https://ocrportal.hhs.gov/. You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of information not covered by this notice or the laws that apply to us will be made only with your written permission. These include most uses and disclosures of psychotherapy notes, most uses and disclosures for marketing purposes, and disclosures for which we receive remuneration in exchange for your information. If you provide us permission to use or disclose information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
Patient Portal and Other Patient Electronic Correspondence
Hormone & Health Medical Center may use and disclose your information through various secure patient portals that allow you to view, download, and transmit certain medical and billing information and communicate with certain healthcare providers securely. For more information on the patient portal, please visit our website at www.hormoneandhealthfl.com.
Your Contact Information: Home and Email Addresses/Phone Numbers
If you provide us with a home or email address, home/work/cell telephone number, or other contact information during any registration or administrative process we will assume that the information you provided us is accurate and that you consent to our use of this information to communicate with you about your treatment, payment for service and health care operations. You are responsible to notify us of any change of this information. We reserve the right to utilize third parties to update this information for our records as needed.
Email or Downloading Information
If you email us medical or billing information from a private email address (such as a Yahoo, Gmail, etc. account), your information may not be secure in transmission. We therefore recommend you use your patient portal to communicate with us regarding your care and/or billing issues. Hormone & Health Medical Center is not responsible for the privacy or security of your information if you request that we send it to you in an unsecured manner. In addition, Hormone & Health Medical Center is not responsible if your information is redisclosed, damaged, altered, or otherwise misused by an authorized recipient.
Incidental Disclosures
Despite our efforts to protect your privacy, your information may be overheard or seen by people not involved in your care. For example, other individuals at your provider’s office could overhear a conversation about you or see you getting treatment. Such incidental disclosures are not a violation of HIPAA.
Business Associates
Your information may be disclosed to individuals or entities who provide services to or on behalf of Hormone & Health Medical Center. Pursuant to HIPAA, We require these companies sign business associate or confidentiality agreements before we disclose your PHI to them. However, we generally do not control the business, privacy, or security operations of our business associates.
HEALTH INFORMATION EXCHANGE
Hormone & Health Medical Center participates in a Health Information Exchange (HIE) to share your health information with other providers who deliver healthcare services to you. Health Information Exchange (HIE) enables your healthcare providers to quickly and securely share your health information electronically among a network of healthcare providers, including physicians, hospitals, laboratories, and pharmacies. Your health information is transmitted securely and only authorized healthcare providers with a valid reason may access your information. Access to information about your health history and medical care gives your healthcare provider a more complete picture of your overall health. This can help your provider make better decisions about your care. The information may also prevent you from having repeat tests, saving you time, money, and worry.
Hormone & Health Medical Center recognizes you have certain rights related to how we share your information. By signing the form "Authorization and Consent to Treat form", you have granted us permission to share your health information to HIE. You may opt-out of the HIE by doing one of the following: Send your request via email to info@hormoneandhealthfl.com; OR mail your written request, signed and dated to Hormone & Health Medical Center, 225 West Canton Avenue #200, Winter Park, FL 32789. Include your full name and date of birth with your request. You may opt back into the HIE at any time. You do not have to participate in the HIE to receive care.