Effective Date: November 1, 2024
STRIDE FORWARD MEDICAL GROUP
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.
You have the right to obtain a paper copy of this Notice upon request.
Your Rights
You have the following rights regarding your health information:
- Request Restrictions: You may request limits on how we use or share your health information for treatment, payment, or operations. While we are not required to agree, if we do, we will honor your request.
- Confidential Communications: You may request that we contact you in specific ways (e.g., only at a certain address or phone number).
- Inspect and Obtain Copies: You have the right to view or request copies of your health information. A small fee may apply for copies.
- Amend Information: If you believe your health record is incorrect or incomplete, you can request a correction or add missing information.
- Accounting of Disclosures: You may request a list of instances where your health information was shared for purposes other than treatment, payment, or operations.
- Obtain a Copy of this Notice: You may request a paper or electronic copy of this Notice at any time.
- File a Complaint: If you feel your rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint.
How We Use Your Health Information
We use and disclose your health information in the following ways:
Treatment:
We use your health information to provide medical care. For example:
- Physicians, nurses, and other health care providers will record and use your health information to determine your course of treatment.
- We may share your information with other healthcare providers, pharmacies, or family members involved in your care.
Payment:
We use your health information to bill and receive payment for the services provided. For example:
- We may contact your insurance company to verify coverage or obtain preauthorization for specific treatments.
- We will maintain records of payments received and billed.
Health Care Operations:
We use your health information to conduct administrative tasks, evaluate care quality, and improve services. For example:
- Reviewing care outcomes and ensuring compliance with regulatory requirements.
Special Uses:
We may use your information to:
- Send appointment reminders.
- Inform you about treatment alternatives or health-related benefits and services.
Other Permitted Uses and Disclosures
Your health information may also be used or disclosed without your consent under the following circumstances:
- Required by Law: Reporting gunshot wounds, suspected abuse, or similar incidents.
- Research: For approved medical research projects.
- Public Health Activities: Reporting diseases, vital statistics, and product recalls.
- Health Oversight: Assisting in audits, investigations, or compliance activities.
- Judicial and Administrative Proceedings: Responding to court orders or subpoenas.
- Law Enforcement: Sharing information as required by law enforcement.
- Deaths: Providing information to coroners, medical examiners, funeral directors, and organ donation agencies.
- Threats to Health or Safety: Acting to prevent serious threats to health or public safety.
- Military and Government Functions: Complying with requirements for armed forces personnel or correctional institutions.
- Workers’ Compensation: Sharing information for work-related injury claims.
In all other situations, we will request your written authorization before using or disclosing your health information. You may revoke your authorization at any time to stop future uses and disclosures.
Our Legal Duties
We are required by law to:
- Maintain the privacy and security of your protected health information (PHI).
- Provide this Notice and abide by the practices described within it.
- Notify you promptly if a breach occurs that may compromise the privacy or security of your information.
- Follow HIPAA regulations to safeguard your PHI.
Changes to Our Privacy Practices
We reserve the right to change this Notice at any time. Any changes will apply to all information we maintain. The updated Notice will be:
- Posted in our office and on our website.
- Made available upon request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint by contacting:
Address: 7284 W. Palmetto Park Road, Suite 104N. Boca Raton FL 33433
Phone: 561-401-0422
Fax: 561-401-0477
Website: www.strideforwardpodiatry.com
