Notice of Privacy Practices.

01

Your rights

You have the following rights regarding health information we maintain about you.

Get an electronic or paper copy of your record

You may inspect or obtain an electronic or paper copy of health and billing information about you, usually within 30 days of a written request. We may charge a reasonable, cost-based fee. In limited circumstances the law allows us to deny access; if review of a denial is available, we will explain how to request it.

Ask us to correct your record

You may ask us in writing to correct health information you believe is inaccurate or incomplete. We may deny the request, but we will explain the reason in writing within the time required by law and tell you how to submit a statement of disagreement.

Request confidential communications

You may ask us to contact you in a specific way, such as at a particular phone number, or to send mail to a different address. We will accommodate reasonable requests.

Ask us to limit what we use or disclose

You may ask us not to use or disclose certain information for treatment, payment, or healthcare operations, or not to share information with someone involved in your care. We are not required to agree unless the law says otherwise. If you pay in full out of pocket for an item or service and ask us not to disclose it to your health plan for payment or operations, we will agree unless disclosure is required by law.

Get a list of certain disclosures

You may request an accounting of certain disclosures made during the six years before your request. The accounting does not include every disclosure, such as most disclosures for treatment, payment, and healthcare operations. One accounting in any 12-month period is free; we may charge a reasonable cost-based fee for another.

Get a copy of this notice

You may request a paper copy at any time, even if you agreed to receive it electronically. We will provide one promptly.

Choose someone to act for you

If you have given someone medical power of attorney or someone is your legal guardian or personal representative, that person may exercise your rights and make choices about your health information. We will verify the person's authority before acting.

Receive notice of a breach

We will notify you as required by law if a breach may have compromised the privacy or security of your unsecured protected health information.

02

Your choices

For certain information, you may tell us what you prefer. If you cannot communicate a preference, we may act in your best interest when the law allows.

People involved in your care

You may tell us whether to share relevant information with family, close friends, or others involved in your care or payment for care. We may also share information for disaster relief or when needed to reduce a serious and imminent threat to health or safety, as the law permits.

Marketing, sale, and psychotherapy notes

We will obtain your written authorization for most uses of psychotherapy notes, for marketing uses not otherwise permitted by law, and before selling protected health information. Other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we already relied on it.

Fundraising

We do not currently use protected health information for fundraising. If that changes, any fundraising communication will explain how to opt out, and we will honor your choice.

03

How we may use and disclose information

The law permits or requires us to use or disclose protected health information in the following ways without a separate written authorization.

Treatment

We may use and disclose information to provide, coordinate, or manage your care. For example, we may share information with a specialist, pharmacy, laboratory, hospital, or other clinician involved in your treatment.

Payment

We may use and disclose information to obtain or process payment for services. For example, we may provide information needed to process a membership fee, laboratory charge, or other authorized payment, or to answer a billing question.

Healthcare operations

We may use and disclose information to run the practice and improve care. Examples include quality review, care coordination, training, credentialing, compliance, auditing, legal services, security, and business planning. Vendors that handle protected health information for us must enter required agreements and safeguard it.

Appointment reminders and care information

We may contact you about appointments, treatment alternatives, care coordination, health-related benefits, or services that may interest you. Tell us if you need a different communication method.

Public health and safety

We may disclose information for legally permitted public-health activities, including reporting certain diseases, adverse events, births, deaths, abuse, neglect, or domestic violence; preventing or controlling disease; product recalls; and reducing a serious and imminent threat to health or safety.

Research

We may use or disclose information for research when an institutional review board or privacy board approves a waiver, when information has been appropriately de-identified or limited, when preparing for research as the law allows, or when you authorize it.

Law, oversight, and legal proceedings

We may disclose information when required by law; for health-oversight activities; in response to a valid court or administrative order, subpoena, discovery request, or other lawful process; for certain law-enforcement purposes; to correctional institutions when applicable; for military, veterans, national-security, protective, and other specialized government functions; or for workers' compensation and similar programs. We disclose only what the law permits or requires.

Coroners, medical examiners, funeral directors, and donation

We may disclose information to coroners, medical examiners, funeral directors, and organ or tissue donation organizations as permitted by law.

Sensitive health information

Reproductive-health, mental-health, genetic, and minor records may receive additional protection under federal or state law. We use or disclose this information only as HIPAA and other applicable law permit or require. When an authorization, court order, or other special legal process is required, we will obtain or verify it before acting.

Substance-use-disorder records

Records protected by 42 C.F.R. Part 2 receive additional protection. Such records, or testimony describing them, will not be used or disclosed in a civil, criminal, administrative, or legislative proceeding against you unless permitted by your written consent or a qualifying court order and accompanying legal process, as applicable.

Redisclosure

Information lawfully disclosed under HIPAA may be redisclosed by the recipient and may no longer be protected by HIPAA. Other federal or state confidentiality laws may still apply, including special protections for certain substance-use-disorder, mental-health, genetic, reproductive-health, and minor records.

04

Our responsibilities

• We are required by law to maintain the privacy and security of protected health information.
• We must give you this notice of our legal duties and privacy practices.
• We must follow the notice currently in effect.
• We will notify affected people following a breach of unsecured protected health information when required by law.
• We will not use or disclose information other than as described here unless you authorize it in writing or the law otherwise permits or requires it.

We may change this notice and make the revised terms effective for all protected health information we maintain, including information created or received before the change. A current notice will be posted on our website and available at the practice. You may request a paper copy at any time.

Questions or concerns

Contact or file a complaint

If you have questions, want to exercise a right, or believe your privacy rights were violated, contact:

Privacy Officer, Jhūma Medicine PLLC
500 S Main St, Ste 113
Mooresville, NC 28115
Phone: (980) 357-4879
Email: joy@jhumamedicine.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, through the OCR Complaint Portal, by mail at 200 Independence Avenue SW, Washington, DC 20201, or by calling 1-800-368-1019 (TDD: 1-800-537-7697).

Jhūma Medicine will not retaliate against you for asking a question, exercising a privacy right, or filing a complaint.