Solvion Health | Notice of Privacy Practices

Solvion Health Notice of Privacy Practices

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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.

This Notice of Privacy Practices (the “Notice”) describes how Solvion Health Medical Group, PLLC and any other affiliated professional entities that are part of the Solvion Health affiliated covered entity (collectively, “we,” “us,” or “our”) may use and disclose your protected health information and how you can access that information.

An Affiliated Covered Entity is a group of health care providers under common ownership or control that designates itself as a single entity for purposes of complying with the Health Insurance Portability and Accountability Act (“HIPAA”). When our professional entities are acting as covered entities under HIPAA, they may choose to operate together as an Affiliated Covered Entity. Members of the Solvion Health Affiliated Covered Entity may share protected health information with each other for treatment, payment, and health care operations, and as otherwise permitted by HIPAA and this Notice.

Protected health information (“PHI”) is information about you, including demographic data, that can be used to identify you and that relates to your past, present, or future physical or mental health or condition, the provision of health care services to you, or payment for those services.

This Notice also explains your rights regarding your PHI and our duties to protect it.

Uses and Disclosures of Protected Health Information

Your PHI may be used and disclosed by your health care providers, our clinical and administrative staff, and others involved in your care and in the operation of our practices, for purposes such as treatment, payment, health care operations, and other uses permitted or required by law.

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and related services. This includes sharing information with other health care providers involved in your care.

For example, we may disclose PHI to another physician, a specialist, a laboratory, or a pharmacy to help diagnose or treat you, or to facilitate referrals and coordination of care.

Payment

We may use and disclose your PHI as needed to obtain payment for the health care services we provide to you. This can include activities such as:

  • Determining eligibility or coverage for benefits
  • Billing you or your health plan for services
  • Obtaining prior authorization for services
  • Reviewing services for medical necessity or utilization management

Health Care Operations

We may use and disclose your PHI as needed to support our day to day health care operations. These activities allow us to run our practices and improve the quality and efficiency of the services we provide. Examples include:

  • Quality assessment and improvement activities
  • Reviewing the performance and qualifications of health care professionals
  • Training and education of health care professionals
  • Conducting audits, compliance programs, and fraud, waste, or abuse investigations
  • Maintaining, operating, and improving computer systems and telehealth platforms
  • Obtaining legal, accounting, consulting, or other professional services
  • Contacting you with information about treatment alternatives or other health related benefits and services that may interest you

When possible, we will remove direct identifiers or use limited data sets, in line with HIPAA requirements.

Uses and Disclosures That Do Not Require Your Authorization

There are situations where we may use or disclose your PHI without your written authorization, as allowed or required by law. These may include:

  • As required by law
    When a law requires that we disclose information, for example to report certain injuries, conditions, or vital statistics.
  • Public health activities
    For reporting diseases, injuries, births, and deaths, and for reporting to public health authorities to help prevent or control disease.
  • Health oversight activities
    To health oversight agencies for activities such as inspections, audits, investigations, licensure, or disciplinary actions.
  • Abuse, neglect, or domestic violence
    To appropriate government authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence, as authorized or required by law.
  • Food and Drug Administration (FDA)
    To report adverse events, product defects, or to enable product recalls, repairs, or replacements.
  • Legal proceedings
    In response to court orders, subpoenas, discovery requests, or other lawful processes, when certain conditions are met.
  • Law enforcement
    To law enforcement officials in limited circumstances, such as to respond to certain warrants, subpoenas, or to locate a missing person or suspect.
  • Coroners, medical examiners, and funeral directors
    To identify a deceased person, determine cause of death, or as needed for funeral or burial arrangements.
  • Organ and tissue donation
    To organizations that handle organ, eye, or tissue procurement and transplantation, as permitted by law.
  • Research
    For certain approved research purposes when an institutional review board or privacy board has reviewed the research proposal and established protocols to protect your privacy, or when you have provided authorization.
  • To avert a serious threat to health or safety
    To prevent or lessen a serious and imminent threat to the health or safety of a person or the public, consistent with applicable law.
  • Specialized government functions
    For certain military, national security, intelligence, protective services, or correctional institution activities, when authorized by law.
  • Workers’ compensation
    As needed to comply with workers’ compensation or similar programs that provide benefits for work related injuries or illness.
  • Inmates and correctional institutions
    If you are an inmate or in lawful custody, we may disclose PHI to the correctional institution or law enforcement officials when necessary for the institution to provide you with health care, protect your health and safety or that of others, or for the safety and security of the facility.
  • Required disclosures
    We must disclose your PHI to you when you request access, as described in this Notice, and to the Secretary of the U.S. Department of Health and Human Services when requested to investigate our compliance with HIPAA.

State laws may provide additional protections for certain types of information, such as mental health, substance use disorder, genetic information, or HIV related information. When state law is more protective, we will follow that law.

Uses and Disclosures That Require Your Authorization

Other uses and disclosures of PHI that are not described in this Notice will be made only with your written authorization, unless otherwise permitted or required by law.

In particular, without your authorization:

  • We will not use or disclose your PHI for most marketing purposes.
  • We will not sell your PHI.
  • We will not use or disclose psychotherapy notes except as specifically permitted by HIPAA.
  • We will not use your PHI for fundraising activities.

If you sign an authorization to use or disclose your PHI, you may revoke that authorization at any time, in writing, except to the extent we have already acted in reliance on it.

Your Rights With Respect to Your Protected Health Information

You have several important rights regarding your PHI. To exercise any of these rights, please contact us using the information in the “Contacting Us” section below.

Right to Inspect and Obtain a Copy

You have the right to request access to and obtain a copy of your PHI that we maintain in a designated record set, which generally includes medical and billing records. We may provide your PHI in paper or electronic form, as appropriate and as permitted by law.

We may charge a reasonable cost based fee as permitted by law for copies, mailing, or other supplies associated with your request. In limited circumstances, we may deny your request, and you may have the right to have the denial reviewed.

Right to Request an Amendment

If you believe that information in your record is inaccurate or incomplete, you have the right to request that we amend your PHI. Your request must be in writing and must explain why you believe the amendment is needed.

We may deny your request in certain situations, for example if the information is accurate and complete, or if we did not create the information. If we deny your request, you have the right to submit a statement of disagreement, and we may prepare a rebuttal. We will keep both in your record and include them in certain future disclosures.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations. You may also request restrictions on disclosures to family members, friends, or others involved in your care.

We are not required to agree to most requested restrictions. If we agree to a restriction, we will comply with it except in an emergency or as otherwise permitted by law.

However, we are required to agree to a requested restriction on disclosure of PHI to a health plan if:

  • The disclosure is for the purpose of payment or health care operations and is not otherwise required by law, and
  • You have paid for the relevant service out of pocket in full.

Right to Request Confidential Communications

You have the right to request that we contact you about medical matters in a specific way or at a certain location, such as sending mail to a different address or calling you at a different phone number. We will accommodate reasonable requests and will not require you to explain the reason for your request.

Right to an Accounting of Disclosures

You have the right to request an accounting of certain disclosures of your PHI that we have made in the six years before your request. The accounting will not include all disclosures, such as those made for treatment, payment, health care operations, or disclosures you authorized.

The first accounting in a twelve month period will be provided at no charge. We may charge a reasonable fee for additional accountings within the same period, as permitted by law.

Right to a Copy of This Notice

You have the right to receive a paper copy of this Notice upon request, even if you have agreed to receive it electronically. You may also view and print a current copy at any time on our website.

Right to Be Notified of a Breach

If a breach of unsecured PHI occurs, we will notify you as required by law. The notice will include general information about what happened, the types of information involved, steps you can take to protect yourself, and what we are doing to investigate, mitigate, and prevent future occurrences.

Our Duties

We are required by law to:

  • Maintain the privacy and security of your PHI
  • Provide you with this Notice of our legal duties and privacy practices
  • Follow the terms of the Notice that is currently in effect
  • Notify you following a breach of your unsecured PHI, as required by law

We will not retaliate against you for exercising your rights under HIPAA or this Notice, including filing a complaint.

Revisions to This Notice

We reserve the right to change the terms of this Notice and to make the revised Notice effective for all PHI we maintain, including information created or received before the change. When we make a significant change, we will update the “Last updated” date at the top of the Notice and post the revised Notice on our website. You are entitled to a copy of the Notice that is currently in effect.

Complaints

If you believe your privacy rights have been violated, or if you disagree with a decision we made about access to your PHI, you may file a complaint with us using the contact information below.

You also have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll free: 1 877 696 6775
Website: hhs.gov/ocr/privacy/hipaa/complaints

We will not retaliate against you for filing a complaint.

Contacting Us

If you have any questions about this Notice, or if you want to exercise your privacy rights, please contact:

Solvion Health Medical Group, PLLC
Attn: HIPAA Privacy Officer
[Street Address]
Houston, Texas [ZIP Code]
Phone: [XXX XXX XXXX]
Email: privacy@solvionhealth.com

Important Disclaimer

This Notice is a template for discussion and planning only. It is not legal advice and does not create an attorney client relationship. Before you use this as your official Notice of Privacy Practices, it needs to be reviewed, customized, and approved by a qualified health care attorney familiar with HIPAA, Texas law, and your exact management and medical group structure.

Notice of Privacy Practices