Notice of Privacy Practices

Your rights

You have the right to:

• Inspect or obtain an electronic or paper copy of your medical record
• Ask us to correct information in your medical record
• Request that we communicate with you in a confidential way
• Ask us to limit certain uses or disclosures
• Receive a list of certain disclosures we have made
• Obtain a paper copy of this notice
• Choose someone legally authorized to act for you
• File a complaint without retaliation

Get an electronic or paper copy of your medical record

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. Ask us how to make the request. We will generally provide a copy or summary within 30 days, as required by law. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

You may ask us to correct health information you believe is incorrect or incomplete. We may deny the request in certain circumstances, but we will explain the reason in writing, generally within 60 days.

Request confidential communications

You may ask us to contact you in a particular way—for example, only at a certain telephone 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 health information for treatment, payment, or healthcare operations. We are not always required to agree and may deny a request if, for example, it could affect your care. If we agree, we may still disclose information needed for emergency treatment.

If you pay for a healthcare item or service in full out of pocket, you may ask us not to disclose information about that item or service to your health plan for payment or healthcare operations. We will agree unless a law requires disclosure.

Receive an accounting of disclosures

You may request a list of certain times we disclosed your health information during the six years before your request, including who received it and why. The accounting does not include disclosures for treatment, payment, or healthcare operations and certain other disclosures excluded by law. One accounting in a 12-month period is free; we may charge a reasonable, cost-based fee for additional accountings during that period.

Receive a copy of this notice

You may request a paper copy of this notice 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 if someone is your legal guardian or otherwise legally authorized to act for you, that person may exercise your rights and make choices about your health information. We will verify the person’s authority before taking action.

Your choices

For certain health information, you may tell us your preferences about what we disclose. Tell us what you want us to do, and we will follow your instructions when the law gives you that choice.

You may tell us whether to:

• Disclose information to family, close friends, or others involved in your care or payment for your care
• Disclose information in a disaster-relief situation

If you cannot tell us your preference—for example, if you are unconscious—we may disclose information if we believe it is in your best interest. We may also disclose information when necessary to lessen a serious and imminent threat to health or safety.

We will obtain your written authorization before using or disclosing health information for marketing, selling your health information, or most uses and disclosures of psychotherapy notes. Tennessee Foot Care Center LLC does not maintain a hospital directory and does not currently conduct fundraising.

How we typically use or disclose your health information

Treat you

We may use your health information and disclose it to other professionals who are treating you. For example, we may share relevant information with your primary care clinician, a specialist, a hospital, a home-health provider, or a facility involved in your care.

Run our practice

We may use and disclose health information to operate the practice, improve care, coordinate services, train staff, conduct quality activities, and contact you when necessary.

Bill for services

We may use and disclose health information to bill and obtain payment from health plans, government programs, patients, or other responsible parties. For example, we may provide information to your health plan so it can determine coverage or pay a claim.

Other uses and disclosures permitted or required by law

We may use or disclose health information in other circumstances permitted or required by law. These activities are subject to legal conditions and limitations.

Public health and safety

We may disclose information for activities such as:

• Preventing or controlling disease
• Reporting adverse reactions to medications or product problems
• Supporting product recalls
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to health or safety

Health research

We may use or disclose information for health research when the research meets applicable legal approval and privacy requirements.

Comply with the law and health oversight

We will disclose information when federal or state law requires it, including to the U.S. Department of Health and Human Services to demonstrate our compliance with federal privacy law. We may also disclose information to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure actions.

Organ and tissue donation

We may disclose health information to organ procurement organizations or other entities involved in organ, eye, or tissue donation and transplantation.

Medical examiners and funeral directors

We may disclose health information to a coroner, medical examiner, or funeral director when permitted by law.

Workers’ compensation, law enforcement, and government functions

We may use or disclose health information:

• For workers’ compensation claims
• For lawful law-enforcement purposes
• For health oversight activities authorized by law
• For special government functions, including military, national security, and protective-service activities

Lawsuits and legal proceedings

We may disclose health information in response to a court or administrative order, or in response to a subpoena or other lawful process when applicable requirements are met.

Substance use disorder records

To the extent we maintain substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records in a civil, criminal, administrative, or legislative investigation or proceeding against you unless you provide written consent or a court order and subpoena satisfy the applicable legal requirements.

Additional protections under other laws

Some categories of health information may receive additional protection under Tennessee or federal law. When another law imposes stricter limits than HIPAA, we will follow the stricter requirement, including obtaining written permission when required.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in the notice currently in effect and provide you a copy.
• We will not use or disclose your information other than as described in this notice unless you authorize us in writing. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Changes to this notice

We may change the terms of this notice, and the changes may apply to all health information we maintain, including information created or received before the change. A revised notice will be available upon request, posted in our office, and posted on our website.

Practice Privacy Officer

Please do not include sensitive medical information in ordinary email. Contact the office to arrange a more appropriate communication method.