Notice of privacy practice

Notice of Privacy Practices

This notice describes how medical information may be used and disclosed and how to obtain this information. Please read carefully. You have the right to obtain a copy of this notice upon request. 

Personal Health Information

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a federal program that requires strict confidentiality for all your personal health information (PHI). Personal health information includes information about your symptoms, test results, diagnosis, treatment, and related medical information. Your health information also includes payment, billing, and insurance information.

How we use your PHI

We are permitted by law to use and disclose PHI for treatment, payment, and healthcare operations and use it to determine the most appropriate course of care. We may also disclose health information to other health care providers who are participating in your treatment, to pharmacists who are filling your prescriptions and to family members who are assisting in your care. 

Healthcare Operations

We may use or disclose your PHI to support our business activities. These activities may include quality assessment, employee review and conducting or arranging other business activities. We may also use a sign-in sheet at the registration desk where you will be asked to sign your name. We may call you by name in our reception area when your provider is ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment. We may phone your home/cell and leave a message to remind you of an upcoming appointment, the need to schedule a new appointment or to call our office. We may also mail a postcard reminder or letter to your home address. Please tell us if you prefer that we call or contact you at another phone number or location.

We may use or disclose your PHI under the following circumstances without your authorization. These include, as required by law:

public health issues, communicable diseases, health oversight, abuse or neglect, Food and Drug Administration requirements, legal proceedings, law enforcement, coroners, funeral directors and organ donation, medical research, criminal activity, military activity and national security, worker’s compensation.

Payment

We will use and disclose your health information for payment purposes We will submit bills and maintain records of payment from your health plan. 

You have the following rights regarding your health information. 

Request restrictions- You may request restrictions on certain uses and disclosures of your health information. We are not required to agree to such restrictions, but if we agree, we must comply with them.

Inspect and obtain copies- You have the right to look at or obtain a copy of your health information. There may be a charge for the copies. 

Amend information- If you believe that information in your record is incorrect or that important information is missing, you have the right to request that we correct the existing information or add the missing information. We are not required to agree to such amendment but must let you know our reasons. 

Accounting of Disclosures- You may request a list of instances where we have disclosed health information about you for reasons other than treatment, payment, or health care operations. 

Our legal duty

We are required by law to protect and maintain the privacy of your health information, to provide this Notice about our legal duties and privacy practices regarding protected health information, and to abide by the terms of the notice currently in effect. Upon request, you may receive a copy of this notice.

Complaints

If you are concerned that we have violated your privacy rights or if you disagree with a decision we have made about your records, please contact the privacy officer. You may also send a written complaint to the U.S Department of Health and Human Services. You will not be penalized for filing a complaint. 

Contact Person

Jenny Fredrickson, DNP, NP 

3964 Goodman Rd E, Suite 131

Southaven, MS 38672

662-856-8440

This notice was published and effective 1/29/2022.