This Notice of Privacy Practices summarizes how we may use and disclose your protected health information to carry out treatment, payment or health care 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 and related health care services. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. Any new notice will be effective for all PHI that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. The full version of this notice, which includes more specific examples of uses and disclosures, is available upon request.

1. Uses and Disclosures of Protected Health Information

Uses and Disclosures of Protected Health Information Based Upon Your Written Consent: You will be asked by your physician to sign a consent form, which allows your physician to use or disclose your protected health information as described in this Section 1. Your PHI 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 purpose of providing health care services to you. Your PHI may also be used and disclosed to facilitate the reimbursement of your health care bills and to support the operation of the physician’s practice. Treatment: For example, we will disclose your PHI, as necessary, to a specialist to whom you have been referred or to other physicians who may be treating you to ensure that the physician has the necessary information to diagnose or treat you, as well as service providers that have become involved in your care (e.g. laboratories or radiologists).

Payment: This may include certain activities that your health insurance plan may undertake before it approves or reimburses for the health care services we have provided or recommend for you. For example, obtaining approval for a hospital stay may require that your relevant PHI be disclosed to the health plan to obtain approval for the hospital admission.

Healthcare Operations: These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, marketing, and conducting or arranging for other business activities which we may outsource to third-party “business associates” who will be asked to sign a confidentiality statement. In addition, we may also call you by name in the waiting room when your physician is ready to see you, or we may contact you to remind you of your appointment at which time a voice message may be necessary to facilitate the reminder. We may use or disclose your PHI, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Opportunity to Object Uses and Disclosures: You have the opportunity to agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use or disclosure of the PHI as a result of an emergency, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. All other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law as described below. 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.

Communication Barriers: We may use and disclose your PHI if your physician or another physician in the practice attempts to obtain consent from you but is unable to do so due to substantial communication barriers and the physician determines, using professional judgment, that you intend to consent to use or disclosure under the circumstances.

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Consent: We may use or disclose your PHI in the following situations or to the following authoritative entities without your consent or authorization to the extent that the use or disclosure is required by law. You will be notified, as required by law, of any such uses or disclosures. These situations or entities include: Public Health, Disaster Relief, Abuse or Neglect, Food and Drug Administration, Legal Proceedings, Law Enforcement, Coroners, Funeral Directors, Organ Donation, Research, Military Activity and National Security, Workers’ Compensation, or a Correctional Institution while an Inmate is Incarcerated. Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.

2. Your Rights

You have the right to inspect and copy your protected health information: You may inspect and obtain a copy of PHI about you that is contained in a designated record set for as long as we maintain the protected health information. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and PHI that is subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable, and you may have a right to have this decision reviewed.

You have the right to request a restriction of your protected health information: You may request that we not use or disclose any part of your PHI for the purposes of treatment, reimbursement or healthcare operations, which must state the specific restriction and to whom you want the restriction to apply. If physician believes it is in your best interest to permit use and disclosure of your PHI, your PHI will not be restricted. If your physician does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment.

In addition, you have the right to request in writing the following: You may request to receive confidential communications from us by alternative means or at an alternative location. You may request that your physician amend your PHI in a designated record set for as long as we maintain this information. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. In addition, you may request an accounting of certain disclosures we have made of any of your PHI other than the general disclosures for purposes such treatment, payment or healthcare operations as described in this Notice of Privacy Practices.

3. Inquiries, Restrictions or Complaints

You may contact our Privacy Officer, Nicole Stroud at 843.853.8870, or in person at 235 Calhoun Street, Charleston, SC 29401 or anonymously by mail at this same address for further inquires, requested restrictions of your PHI, or information about the complaint process. You may also file a complaint with the Secretary of Health and Human Services if you believe your privacy rights have been violated by us, at which time there will be no retaliation against you for filing a complaint


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