This notice describes how medical information regarding you may be used and disclosed, and how you can get access to this information. Please read and review it carefully.

Health Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is created to manage the care you receive. Wheatland Internal Medicine Clinic understands that the medical information that is recorded about you and your health is personal. The confidentiality of your health information is also protected under both state and federal law. This Notice of Privacy Practice describes how Wheatland Internal Medicine Clinic may use and disclose your information and the rights that you have regarding your health information. The facilities use an electronic health record and will not use or disclose your health information without written authorization, except as described in this notice. Use or disclosures pursuant to this notice may include electronic transfer of your health information.

Your Health Information Rights

Although your health information is the physical property of the facility or practitioner that compiled it, the information belongs to you, and you have certain rights over that information. You have the right to:

1. Request in writing, a restriction on certain uses and disclosures of your information. However, agreement with the request is not required by law, such as when it is determined that compliance with the restriction cannot be guaranteed.
2. Request, in writing, to inspect or obtain a copy of your health record as provided by law.
3. Request in writing that your health record be amended as provided by law, if you feel the health information, we have about you is incorrect or incomplete. You will be notified if the request cannot be granted.
4. Request in writing to obtain an accounting disclosure or report of who has accessed your health information as provided by law. The access report will only be available after federal regulations become effective.
5. Obtain a paper copy of this notice of privacy practices on request.

You may exercise these rights by directing a request to the privacy office (practice manager) @ WIMC. (972) 634-8110.

Our Responsibility

The clinic has certain responsibilities regarding your health information, including the requirement to:

1. Maintain the privacy of your health information.
2. Provider you with this notice that describes the legal duties and privacy practices regarding the information that we maintain about you.
3. Abide by the terms of the notice currently in effect.
4. Inform you that the clinic must keep your medical records for the time required by law and then may dispose of them as permitted by law.

The clinic reserves the right to change these information privacy policies and practices and to make changes applicable to any health information that we maintain. If changes are made, the revised notice of privacy practices will be made available at the clinic and supplied upon request.

Disclosures and Uses of Health Information without Authorization

1. Disclosures of medical information may be made to doctors, medical assistants, technicians, medical students, or others who are involved in taking care of you at the clinic. This information may also be disclosed to other physicians that are treating you lor to other healthcare facilities involved in your care. Information may be shared with pharmacies, laboratories, or radiology centers in the coordination of your treatment or care.
2. Health information may be disclosed so that services provided to you may be billed to an insurance company of a third party. Information may be provided by your health plan about the treatment you are going to receive to obtain prior approval or to determine if your health plan will cover the treatment.
3. Students and trainees may have access to your health information for training and treatment purposes as they participate in continuing education, training, and internships.
4. HIE-Health Information exchange- The clinic participates in electronic health exchanges and may share your health information as described in this notice. Participation is voluntary. You will be given the opportunity to opt in to the electronic health information exchanges at the time of registration.
5. To provide continuity of care once you are discharged from a facility your information may be shared with other healthcare providers such as home health agencies. Information about you may be disclosed to community agencies to obtain their services on your behalf.

Verbal Agreement Disclosures

Unless you give notice of an objection, and in accordance with your agreement, medical information may be released to a family member or other person who is involved in your medical care or who helps may for your care. Information about you may be disclosed to notify a family member, legally authorized representative, or other person responsible for your care about your location or in general condition. This may also include an organization that may be assisting in disaster relief effort, such as the American Red Cross, so that your family can be notified about your condition. You will be given an opportunity to agree or object to these disclosures except as due to incapacity or in emergency circumstances.

Disclosures Required by Law or allowed without Authorization or Notification.

The following disclosures of health information may be made according to state and federal laws without your written authorization or verbal agreement.

1. A disclosure required by federal, state, or local law, judicial or administrative proceedings, on or for law enforcement. An example would be reporting gunshot wounds, or abuse or responding to court orders.
2. Public health purposes, such as reporting various diseases, or disclosures to the FDA regarding adverse events related to medication or devices.
3. Health oversight activities, such as audits, inspections, or licensure investigations.
4. To organ procurement organizations for the purpose of tissue donation and transplant.
5. For research purposes, when the research has been approved by an institutional review board that has reviewed the research proposal and established guidelines to provide for the privacy of your health information, or the disclosure is that of limited data set, where personal identifiers have been removed.
6. To funeral directors and coroners for the purpose of identification, the determination of the cause of death, or to perform their duties as authorized by law.
7. To avoid a serious threat to the health or safety of a person or the public.
8. To correctional institutions or law enforcement officials concerning the health information of inmates, as authorized by law.

Other Disclosures or Allowable Uses without Authorization.

1. Contacting you to provide appointment reminders for treatment or medial care, as well as to recommend treatment alternatives.
2. To notify you of health-related benefits and services that may be of interest to you.
3. Contacting you about disease management programs, wellness programs, or other community initiatives that the clinic participates in.

Breach Notification

In certain instances, you have the right to be notified if we, or one of our business associates, discover an inappropriate use of disclosure of your health information. Notice of any such use or disclosure will be made as required by state and federal law.

Required Uses and Disclosures

Under the law we must make disclosures when required by the Secretary of the Department of Health and human Services to investigate or determine our compliance with federal privacy law.

Uses and Disclosures Requiring Authorization

Any other uses or disclosures of your health information not addressed in these notices or otherwise required by law will be made only with your written authorization. You may revoke such an authorization at any time. An example of uses and disclosures requiring authorization include use of psychotherapy notes, marketing activities, and some types of sale of your health information.

Privacy Complaints

You have the right to file a complaint if you believe your privacy rights have been violated. This complaint may be addressed to the Privacy Officer (practice manager), or to the Secretary of the Department of health and Human Services. There will be no retaliation for registering a complaint.

Privacy Contact

You can address any questions about these notices or how to exercise your privacy rights to the practice manager at Wheatland Internal Medicine Clinic. EFFECTIVE DATE: MARCH 25, 2024