Notice of Privacy Practices

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 (this “Notice”) describes how The Peds MD PLLC (“Peds MD”, “we”, “us”, or “our”) may use and disclose protected health information (“PHI”) about you or your child to carry out treatment, payment, or health care operations, and for other purposes permitted or required by law. “Protected health information” means information about you or your child, including demographic information, that may identify you or your child and that relates to past, present, or future physical or mental health or condition, treatment, or payment for health care services. This Notice also describes your rights regarding PHI and how to exercise them.

Uses and Disclosures of Protected Health Information

PHI about you or your child may be used and disclosed by your Care Team, our staff, and others outside of our practice who are involved in care and treatment, in order to provide health care services, support our business operations, obtain payment for care, and for any other use authorized or required by law.

Treatment

We use and disclose PHI to provide, coordinate, or manage health care and related services, including coordinating care with other providers. For example, PHI may be shared with another health care provider who has an existing treatment relationship with you or your child so that the information needed to diagnose or treat is available.

Payment

We may use and disclose PHI to bill or obtain payment for health care services, including in connection with processing membership fees or other charges for services provided to you or your child.

Health Care Operations

We may use or disclose PHI as needed to support our business activities, including improving quality of care, training and credentialing, legal services, and conducting audits and compliance activities, including fraud, waste, and abuse investigations. We may deidentify PHI so that it no longer identifies you or your child and may use that deidentified information for any lawful purpose, including analytics, research, and education. We do not sell PHI and do not use PHI for marketing without your authorization.

Uses and Disclosures That Do Not Require Your Authorization

In addition to the uses and disclosures described above for treatment, payment, and health care operations, we may use or disclose PHI without authorization:

• as required by law;
• for public health activities;
• for health oversight activities;
• to report suspected abuse or neglect;
• pursuant to Food and Drug Administration requirements;
• in connection with judicial or administrative proceedings;
• for law enforcement purposes;
• to coroners, medical examiners, or funeral directors;
• for certain research purposes;
• to avert a serious threat to health or safety;
• for specified government functions;
• for workers’ compensation purposes; and
• as otherwise required or permitted by law.

We must also disclose PHI to you upon request and to the Secretary of the U.S. Department of Health and Human Services when required to investigate or determine our compliance with HIPAA. State law may further restrict these disclosures.

Uses and Disclosures That Require Your Authorization

Other uses and disclosures not described above, including most uses and disclosures of psychotherapy notes (if applicable) and any use or disclosure that constitutes a sale of PHI or is for marketing purposes, will be made only with your written authorization. You may revoke an authorization at any time by contacting us, except to the extent we have already relied on it.

Your Rights Regarding Your PHI

You have the right to:

• inspect and obtain a copy of PHI in a designated record set;
• request corrections to PHI that you believe is incomplete or inaccurate;
• receive an accounting of certain disclosures of PHI we have made, other than disclosures for treatment, payment, or health care operations, or those made pursuant to your authorization;
• request restrictions on certain uses or disclosures of PHI, which we are not required to agree to except in limited circumstances required by law;
• request confidential communications by alternative means or at alternative locations; and
• obtain a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

To exercise any of these rights, please contact us using the information below.

Revisions to This Notice

We reserve the right to revise this Notice and to make the revised Notice effective for PHI we already have as well as for information we receive in the future. You are entitled to a copy of the Notice currently in effect. We will post any significant changes on our website, and you have the right to obtain a paper copy upon request.

Breach of Protected Health Information

We will notify you if a reportable breach of your unsecured PHI is discovered, consistent with applicable law. Notification will include a brief description of how the breach occurred, the PHI involved, and contact information for you to ask questions.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us at privacy@thepedsmd.com, or with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights, by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Contact

Peds MD PLLC
1515 Mockingbird Lane, Suite 4111, Charlotte, NC 28209
Email: privacy@thepedsmd.com

For how we handle information collected through this website (which is not medical-record information), see our Privacy Policy.