Terms and Conditions

Terms and Conditions

Last updated: 07/01/2024

Physicians NOW Management LLC (“Physicians NOW”) operates a management services company, the website thephysiciansnow.com and the content associated therewith (the “Service”), which is used to provide the delivery of healthcare services via telehealth to patients of third-party Physician Groups, Physicians NOW FL, LLC, Physicians NOW Medical PC, and Physicians NOW PC (the “Physician Groups”). Physicians NOW does not engage in the practice of medicine. The Physician Groups, physicians and other licensed health professionals are solely responsible for the delivery of healthcare services to patients through the Physicians NOW Service. The Physician Groups are third-party beneficiaries of these Terms and Conditions.

These Terms and Conditions constitute a binding agreement between the user (“you” or “your”) and Physicians NOW, its subsidiaries, affiliates, associates, officers, directors, agents and subcontractors (collectively, “Physicians NOW,” “we”, “us”, or “our”).

IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, GO TO THE NEAREST HOSPITAL EMERGENCY ROOM OR DIAL 911. THE SERVICE IS NOT INTENDED TO PROVIDE ACCESS TO URGENT CARE OR EMERGENCY CARE.

PLEASE CAREFULLY REVIEW THE TERMS AND CONDITIONS BEFORE CLICKING THE “AGREE” BOX AND USING THE SERVICE. BY CLICKING THE “AGREE” BUTTON DISPLAYED, YOU ARE INDICATING YOUR ACCEPTANCE OF ALL THE TERMS AND CONDITIONS.

IF YOU DO NOT AGREE WITH THESE TERMS AND CONDITIONS AND THE PRIVACY POLICY INCORPORATED HEREIN, REFRAIN FROM SELECTING THE “AGREE” BUTTON AND DO NOT ACCESS THE PORTAL OR ESTABLISH A PORTAL CONNECTION. PHYSICIANS NOW’S ACCEPTANCE OF THESE TERMS AND CONDITIONS IS EXPLICITLY DEPENDENT ON YOUR AGREEMENT TO ALL

THE TERMS AND CONDITIONS OF THIS AGREEMENT.

CONSENT TO TELEHEALTH SERVICES

Physicians NOW FL, LLC a Delaware limited liability company, Physicians NOW Medical PC, a New York professional services corporation, and Physicians NOW PC, a California professional services corporation (each a “Medical Group,” and together, the “Physician Groups”) provide medical and mental health care services via telehealth (“Telehealth Services”). By agreeing to the terms set forth herein (this “Telehealth Consent”), you consent to the applicable Medical Group providing services to you pursuant to these terms.

The terms “you” and “yours” refer to the person using the Telehealth Services. The purpose of this form is to obtain your consent to participate in the applicable Medical Group’s Telehealth Services.

Telehealth refers to the use of electronic communication technologies, such as computers, smartphones, and other digital devices to provide healthcare services remotely. It enables physicians and other healthcare professionals to interact with patients who are not physically present at the same location. Telehealth encompasses a range of services, including consultations, diagnoses, treatments, monitoring, and health education, all delivered through audio, video, data transmission, or other means.

The electronic systems employed in Telehealth Services will include network and software security protocols to ensure the privacy and security of health information and imaging data. Additionally, measures will be taken to safeguard the data, protecting its integrity from any intentional or unintentional corruption.

You may discuss the potential risks and benefits of telehealth services with your Medical Group Provider and may also ask any questions you may have regarding these services.

Possible Benefits of Telehealth

Accessing medical care and treatment can be more convenient and efficient for you.
You have the flexibility to receive medical care and treatment at your preferred location
Interacting with healthcare providers no longer requires in-office appointments, offering greater accessibility and convenience.

Possible Risks of Telehealth

The information transmitted to your Provider(s) may not always be sufficient for them to make appropriate medical decisions.
In some cases, your Provider(s) may be unable to conduct certain tests or assess vital signs in person, potentially hindering their ability to provide a diagnosis, treatment, or identify the need for emergency care.
Your specific condition may not be treatable via telehealth, and you might need to seek alternative care.
Technical failures may lead to delays in medical evaluation or treatment. Although every effort is made to provide uninterrupted services, errors or interruptions cannot be completely guaranteed.

While security measures are used, privacy breaches could occur due to the failure of security protocols or safeguards. Information transmitted over external media may not always be secure, such as email, text, or telephone communications, which are inherently unsecured and subject to disclosure to third parties.
In certain jurisdictions, regulatory requirements may limit your Provider(s) in their treatment options, particularly concerning certain prescriptions.

Will my telehealth visit be private?

Visits with your provider will not be recorded for privacy reasons.
It’s essential to be in a private location during your telehealth session to prevent others from overhearing sensitive information.
Your provider will inform you if anyone else from their office may have access to hearing or seeing your session.
Our telehealth technology is specifically designed to prioritize and protect your privacy.
When using the Internet for telehealth, ensure you are on a private and secure network.
While highly unlikely, there exists a minimal risk that technology could potentially be misused to access or view your telehealth visit.

Your Rights

You have the right to withhold or withdraw your consent for a telemedicine consultation at any time before or during the consultation. Doing so will not affect your entitlement to future care, treatment, or program benefits.

By accepting this Consent to Telehealth Services, you acknowledge and agree to the following terms:

I agree to utilize the Telehealth Services provided by the Physician Groups, which involve the delivery of healthcare services using interactive audio, video, and data communications, encompassing assessment, treatment, diagnosis, and education.
I have carefully read and understood this Consent to Telehealth Services, including the risks and benefits associated with telehealth services provided by “Providers” on Physicians NOW’s platform.
I grant my informed consent to the use of telehealth by providers affiliated with Physicians NOW.
I acknowledge that telehealth is an evolving field, and my medical care and treatment through telehealth may involve technologies not explicitly mentioned in this consent.
While telehealth may offer potential benefits, I understand that no specific results or improvements are guaranteed, and my condition may not always be cured or improved, and in some instances, it may worsen.
I am aware that the level of care provided to me through telehealth is expected to be equivalent to in-person medical visits. However, “Providers” may decide at their

discretion that my condition is not suitable for telehealth treatment, requiring me to seek in-person care or an alternative source.

I understand that the confidentiality and privacy protections applicable to my other healthcare services also extend to telehealth services.
I have access to all my health and wellness information related to telehealth services as per applicable laws and regulations.
I can withdraw or withhold this consent at any time by emailing Physicians NOW with my instructions. Otherwise, this consent will be considered renewed for each new telehealth consultation with “Providers.”
I expressly assume the risk of any unauthorized disclosure, intentional intrusion, delay, failure, interruption, or corruption of data or information transmitted during the use of any Telehealth Services.
I authorize my healthcare provider to share information regarding the telehealth exam for treatment, payment, and healthcare operations purposes with other individuals.
I understand that my consent is not mandatory for telehealth services, and it is only required if I choose to utilize telehealth services offered by Physicians NOW.
In case of an emergency, I will call 911 or go directly to the nearest hospital emergency room.
I authorize my healthcare provider to release information regarding the telehealth exam to Physicians NOW and its affiliates.

I HAVE HAD AN OPPORTUNITY TO ASK QUESTIONS ABOUT THIS INFORMATION AND ALL OF MY QUESTIONS HAVE BEEN ANSWERED. I HAVE READ AND AGREED TO A TELEMEDICINE CONSULTATION.

By clicking the acceptance box, I consent to receive telehealth services, or in the case of a use of the service by or on behalf of a minor, I am the parent or legal guardian of said minor and provide consent on behalf of said minor. I understand and agree that I am signing this Consent electronically and that (a) I have read this Telehealth Consent carefully, (b) I understand the risks and benefits of the Service and the use of telehealth in the medical care and treatment provided to me by Provider(s) using the Service, and (c) I have the legal capacity and authority to provide this consent for myself and/or the minor for which I am consenting under applicable federal and state laws, including laws relating to the age of majority and/or parental/guardian consent.

INFORMED CONSENT FOR CONTROLLED SUBSTANCE MEDICATIONS

If your Provider has recommended the use of a medication classified as a controlled substance, you are required to provide informed consent (“Informed Consent”). Controlled medications can be hazardous and potentially addictive, and it is crucial to take them only as prescribed by your Provider. Please carefully read and understand this consent and agreement. If you have any questions, do not hesitate to ask.

I am aware that I have the right to discuss the risks, benefits, and available alternatives for all proposed procedures and treatment plans with my healthcare Provider(s).
The Medical Group will provide care consistent with the prevailing medical practice standards, but no assurances or guarantees are made regarding treatment outcomes.
Before prescribing any controlled substance, my Provider may review information from the Prescription Drug Monitoring Program in my state of residence or other similar databases to assess my prior use of controlled substances.
I understand that the prescribed medication may carry the risk of addiction, but my provider deems it necessary for my condition. My Provider has explained to me the potential risks, short- and long-term side effects, the possibility of drug interactions, as well as the risk of misuse and overdose. I accept these risks.
I agree to take the prescribed medication only as directed by my Provider.
I commit to attending all scheduled appointments with my Provider.
I understand that refills will not be issued ahead of schedule and the provider will not request early refills if your pharmacist determines you are re-filling a medication ahead of their established schedule.
I will not obtain the same or similar controlled substances from any other providers unless authorized by my primary provider.
I acknowledge that these medications are for my personal use only and I am aware that it is illegal and reportable to the police to give or sell my medication to others.
I agree not to use any illegal substances, including but not limited to cocaine, fentanyl or any other street drugs.
I understand that using medications not prescribed to me is illegal.
I will take responsibility for securing my medication and understand that lost or stolen medication will not be replaced.
I waive privacy protections concerning my prescription for controlled substances. My Provider or their staff may communicate with other physicians, pharmacists, or family members to ensure appropriate medication use.
I understand that these medications may impair my ability to drive and operate heavy machinery.

I HAVE CAREFULLY REVIEWED THIS INFORMED CONSENT AND TREATMENT AGREEMENT FOR CONTROLLED SUBSTANCES. I UNDERSTAND ITS CONTENTS AND AGREE TO COMPLY WITH THE AGREEMENT. I UNDERSTAND THAT

FAILURE TO DO SO MAY RESULT IN MY DISCHARGE FROM THIS MEDICAL PRACTICE.

By clicking the acceptance box, I acknowledge and agree that I am electronically signing this Informed Consent. I confirm that (a) I have carefully read and understood this Informed Consent,

(b) I comprehend the risks and benefits of the Service and the use of telehealth in the medical care and treatment provided by Provider(s) using the Service, including prescribing controlled substances, and (c) I have the legal capacity and authority to provide this consent for myself and/or the minor under applicable federal and state laws, including laws concerning the age of majority and/or parental/guardian consent.

YOUR FINANCIAL RESPONSIBILITY

You agree to pay the Physicians NOW for all applicable charges at the prices then in effect for the Telehealth Services provided to you or in the case of a use of the Service by or on behalf of a minor (“Covered Minor”) on whose behalf you are accepting these Telehealth Services terms and/or payment responsibility. You authorize Physicians NOW to charge your chosen payment method (“Payment Method”) for the Telehealth Services provided to you or the Covered Minor.

If your Payment Method is invalid at the time payment is due, you agree to pay all amounts due upon demand. Physicians NOW may accumulate charges that you have incurred for the Telehealth Services and submit them as one or more aggregate charges during or at the end of each billing cycle. We reserve the right to correct any billing errors or mistakes even if payment has already been requested or received.

When using a payment card, you hereby acknowledge and agrees that:

The payment card used for transactions is solely in your name, or if not in your name you have been duly authorized to use the payment card for the specific transactions.
You accept full responsibility for any outstanding balance resulting from the use of the payment card for each transactions made.
In the event of a chargeback initiated by the cardholder or the cardholder’s bank, you agree to assume full liability for any disputed amount and any associated chargeback fees.

All purchases are final and once paid, all fees are non-refundable regardless of whether Services are utilized, except as prohibited by applicable law. We reserve the right to issue refunds or credits at our sole discretion. If we issue a refund or credit in one instance, we are under no obligation to issue the same refund or credit in the future. Should there be a payment dispute, you agree to contact [email protected] prior to taking any further action or requesting additional services.

PROHIBITED ACTIVITIES

You may not access or use the Service for any purpose other than that for which we make the Service available. The Service may not be used in connection with any commercial endeavors except those that are specifically endorsed or approved by us.

As a user of the Service, you agree not to:

Obtain data or content from the Site in a systematic manner to create collections, compilations, databases, or directories without written permission from us.
Engage in unauthorized use of the Service, including gathering usernames and/or email addresses of users through electronic or other means for unsolicited email purposes or creating user accounts through automated means or false pretenses.
Utilize a buying agent or purchasing agent to make purchases on the Site.
Advertise or offer to sell goods and services using the Site.
Attempt to bypass, disable, or interfere with security-related features of the Service, including those that restrict the use or copying of content or enforce usage limitations.
Engage in unauthorized framing or linking to the Site.
Attempt to deceive, defraud, or mislead us or other users, especially in trying to access sensitive account information such as user passwords.
Misuse our support services or submit false reports of abuse or misconduct.
Employ any automated use of the system, such as using scripts to send comments or messages, data mining, robots, or similar data gathering tools.
Disrupt, interfere with, or place an undue burden on the Site or connected networks and services.
Try to impersonate another user or use another user’s username.
Sell or transfer your profile to others.
Use any information obtained from the Service to harass, abuse, or harm another person.
Utilize the Service to compete with us or use the Site, App, or their content for any commercial or revenue-generating purpose.
Attempt to decipher, decompile, disassemble, or reverse engineer any software used in the Service.
Try to bypass measures of the Service intended to prevent or restrict access.
Harass, annoy, intimidate, or threaten our employees or agents providing the Service.
Remove copyright or proprietary rights notices from any content.
Copy or adapt the Site’s or App’s software, including but not limited to Flash, PHP, HTML, JavaScript, or other code.
Upload or transmit viruses, Trojan horses, or other disruptive material that interferes with others’ use of the Site or Service or alters their operation.
Upload or transmit any material acting as an information collection or transmission mechanism, such as gifs, 1×1 pixels, web bugs, cookies, or similar devices (also known as “spyware” or “passive collection mechanisms”).

Use, launch, develop, or distribute any automated system, including spiders, robots, cheat utilities, scrapers, or offline readers accessing the Site without authorization or using unauthorized scripts or software.
Disparage, tarnish, or otherwise harm us and/or the Site, App, or Service in our opinion.
Use the Site or App in violation of applicable laws or regulations.
Solicit and/or contact providers of the Physician Groups outside of the Service.

THIRD-PARTY SERVICES

Third-party entities, such as laboratories, pharmacies, payment services, and the Medical Group’s clinicians, may offer services and medications directly to you through the support of the Service (“Third-Parties”). Any engagement with Third-Party services, including payment and delivery of goods or services, as well as any associated terms, conditions, warranties, or representations, are solely between you and these Third-Parties. It is advisable to conduct any necessary investigations before proceeding with online or offline transactions involving Third-Parties or their goods and services. As the user, you assume full responsibility and should exercise caution, discretion, common sense, and judgment when using the Service and disclosing personal information.

You acknowledge that Physicians NOW shall not be held responsible or liable for any losses or damages resulting from your use of the Service, including any interactions with Third-Party goods and services. Should any disputes arise between you and any Third-Party, another User, or any other entity or individual, Physicians NOW is not obligated to intervene in such matters.

Consequently, you hereby release and indemnify Physicians NOW, the Physician Groups, and their respective subsidiaries and affiliates, along with all their contractors, directors, officers, employees, representatives, partners, shareholders, agents, predecessors, successors, assigns, accountants, and attorneys (collectively referred to as “Physicians NOW Parties”), from any claims or damages, whether actual or consequential, known or unknown, suspected or unsuspected, disclosed or undisclosed, related to such disputes or the Service, its features, and services.

IF YOU ARE A CALIFORNIA RESIDENT, YOU WAIVE CALIFORNIA CIVIL CODE SECTION 1542, WHICH STATES: “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.”

INDEMNIFICATION

You shall undertake to defend, indemnify, and hold harmless the Physicians NOW Parties, as well as any Third Parties providing products or services through the Service, including the Physician Groups, from any and all suits, actions, claims, proceedings, damages, settlements, judgments, injuries, liabilities, obligations, losses, risks, costs, and expenses (including, but not limited to, attorneys’ fees and litigation expenses) that may arise from or be related to your use of the Service, fraudulent activities, violation of laws, willful misconduct, any breach of this Agreement, or infringement upon the rights of any other individual or entity. In the event of a third-party claim for which we are entitled to indemnification, we reserve the right to control the defense, and you agree to provide reasonable cooperation as requested by us.

TERM AND TERMINATION

These Terms and Conditions will remain in effect during your use of the Service. We reserve the sole discretion to deny access to and use of the Service, including the blocking of certain IP addresses, to any individual for any reason or no reason, without notice or liability. This may include instances of breaching any representation, warranty, or covenant outlined in these Terms and Conditions or violating any applicable law or regulation. At our sole discretion and without prior warning, we may terminate your use or participation in the Service, delete your account, and remove any content or information you have posted.

If your account is terminated or suspended for any reason, you are strictly prohibited from registering or creating a new account under your name, a fictitious name, or any third-party name, even if you are acting on behalf of the third party. In addition to the termination or suspension of your account, we reserve the right to pursue appropriate legal action, including civil, criminal, and injunctive measures.

MODIFICATIONS AND INTERRUPTIONS

We retain the right to alter, amend, or remove any content within the Service at our sole discretion and without prior notice, for any reason. However, we are not obligated to update any information on the Service. Additionally, we reserve the right to modify or discontinue the Service, in whole or in part, without prior notice.

We shall not be held liable to you or any third party for any changes in content, price adjustments, suspensions, or discontinuations of the Service. Please note that we cannot guarantee uninterrupted availability of the Service. From time to time, we may encounter hardware, software, or other issues that require maintenance, leading to interruptions, delays, or errors. We reserve the right to change, revise, update, suspend, discontinue, or otherwise modify the Service without notice.

During any downtime or discontinuance of the Service, you acknowledge and agree that we bear no liability for any loss, damage, or inconvenience you may experience due to your inability to access or use the Service. Nothing in these Terms and Conditions obligates us to maintain, support, or provide corrections, updates, or releases for the Service.

DISCLAIMER

THE SERVICE IS PROVIDED ON AN “AS-IS” AND “AS-AVAILABLE” BASIS. BY USING THE SERVICE, YOU AGREE THAT YOU DO SO AT YOUR SOLE RISK. TO THE MAXIMUM EXTENT PERMITTED BY LAW, WE DISCLAIM ALL WARRANTIES, EXPRESS OR IMPLIED, IN CONNECTION WITH THE SERVICE AND ITS USE, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES

OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON- INFRINGEMENT.

WE DO NOT MAKE ANY WARRANTIES OR REPRESENTATIONS REGARDING THE ACCURACY OR COMPLETENESS OF THE CONTENT WITHIN THE SERVICE OR THE CONTENT OF ANY WEBSITES LINKED TO THE SITE OR APP. FURTHERMORE, WE ASSUME NO LIABILITY OR RESPONSIBILITY FOR THE FOLLOWING:

ERRORS, MISTAKES, OR INACCURACIES OF CONTENT AND MATERIALS.
PERSONAL INJURY OR PROPERTY DAMAGE RESULTING FROM YOUR ACCESS TO AND USE OF THE SERVICE.
ANY UNAUTHORIZED ACCESS TO OR USE OF OUR SECURE SERVERS AND/OR ANY PERSONAL OR FINANCIAL INFORMATION STORED THEREIN.
INTERRUPTION OR CESSATION OF TRANSMISSION TO OR FROM THE SERVICE.
BUGS, VIRUSES, TROJAN HORSES, OR SIMILAR HARMFUL ELEMENTS TRANSMITTED TO OR THROUGH THE SERVICE BY ANY THIRD PARTY.
ERRORS OR OMISSIONS IN ANY CONTENT AND MATERIALS OR ANY LOSS OR DAMAGE RESULTING FROM THE USE OF ANY CONTENT POSTED, TRANSMITTED, OR MADE AVAILABLE VIA THE SERVICE.

WE DO NOT WARRANT, ENDORSE, GUARANTEE, OR ASSUME RESPONSIBILITY FOR ANY PRODUCTS OR SERVICES ADVERTISED OR OFFERED BY THIRD PARTIES THROUGH THE SITE, APP, OR ANY LINKED WEBSITES OR MOBILE APPLICATIONS FEATURED IN BANNERS OR OTHER ADVERTISING. WE ARE NOT LIABLE FOR MONITORING ANY TRANSACTION BETWEEN YOU AND THIRD-PARTY PROVIDERS OF PRODUCTS OR SERVICES. AS WITH ANY PRODUCT OR SERVICE PURCHASE THROUGH ANY MEDIUM OR ENVIRONMENT, YOU SHOULD EXERCISE CAUTION AND USE YOUR BEST JUDGMENT.

LIMITATIONS OF LIABILITY

WE AND OUR AFFILIATES, DIRECTORS, EMPLOYEES, OR AGENTS WILL NOT BE LIABLE TO YOU OR ANY THIRD PARTY FOR ANY DIRECT, INDIRECT, CONSEQUENTIAL, EXEMPLARY, INCIDENTAL, SPECIAL, OR PUNITIVE DAMAGES ARISING FROM YOUR USE OF THE SERVICE, INCLUDING BUT NOT LIMITED TO LOST PROFITS, LOST REVENUE, LOSS OF DATA, OR OTHER DAMAGES, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. DESPITE ANYTHING STATED TO THE CONTRARY IN THIS

AGREEMENT, OUR LIABILITY TO YOU FOR ANY CAUSE WHATSOEVER, REGARDLESS OF THE FORM OF ACTION, WILL ALWAYS BE LIMITED TO THE LESSER OF THE AMOUNT PAID, IF ANY, BY YOU TO US DURING THE SIX (6) MONTH PERIOD PRECEDING THE CAUSE OF ACTION OR $1,000.00.

PLEASE NOTE THAT CERTAIN US STATE LAWS AND INTERNATIONAL LAWS MAY NOT ALLOW LIMITATIONS ON IMPLIED WARRANTIES OR THE EXCLUSION OR LIMITATION OF CERTAIN DAMAGES. IF THESE LAWS APPLY TO YOU, SOME OR ALL OF THE ABOVE DISCLAIMERS OR LIMITATIONS MAY NOT APPLY, AND YOU MAY HAVE ADDITIONAL RIGHTS.

ARBITRATION

Any dispute or claim arising from or related to this contract, including any breaches thereof, shall be resolved through arbitration under the administration of Judicial Administration and Arbitration Services (“JAMS”) as per their prevailing rules. The arbitration will be conducted by a single arbitrator, chosen through mutual agreement of both parties. If an agreement on the arbitrator’s selection is not reached within thirty (30) days after the respondent receives the claim, JAMS will appoint an arbitrator. The arbitration proceedings will be held in Tampa, FL.

The arbitration award provided by the arbitrator will constitute a final and binding resolution of the dispute, enforceable in any court of competent jurisdiction. Both parties and the arbitrator(s) shall keep the existence, content, and results of the arbitration confidential, except when required by law or in a proceeding to enforce the arbitration results, unless both parties have given prior written consent to disclosure.

Any judgment based on the arbitrator(s)’ award may be entered in any court having jurisdiction. The costs of arbitration will be divided equally between you and Physicians NOW.

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 (the “Notice”) describes how your information is used. Specifically, how Physicians NOW and its Physician Groups may use and disclose your protected health information to carry out treatment, payment, or business operations and for other legally permissible purposes.

“Protected health information” or “PHI” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical health or condition, treatment, or payment for health care services. This Notice also describes your rights to access and control your protected health information.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION:

Your protected health information may be used and disclosed by our health care providers, our staff, and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you, to support our business operations, to obtain payment for your care, and any other use authorized or required by law.

TREATMENT:

We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your protected health information may be provided to a health care provider to whom you have been referred to ensure the necessary information is accessible to diagnose or treat you.

PAYMENT:

Your protected health information may be used to bill or obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for your services, such as: making a determination of eligibility or coverage for insurance benefits and reviewing services provided to you for medical necessity.

HEALTH CARE OPERATIONS:

We may use or disclose, as needed, your protected health information in order to support our business activities. These activities include, but are not limited to, improving quality of care, providing information about treatment alternatives or other health-related benefits and services, development or maintaining and supporting computer systems, legal services, and conducting audits and compliance programs, including fraud, waste and abuse investigations.

USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION:

To comply with applicable law, we may use or disclose your protected health information in the following situations without the need to obtain your authorization. These situations include the following uses and disclosures: as required by law; for public health activities; for health care oversight activities; pursuant to Food and Drug Administration requirements; for abuse, neglect, or domestic violence reporting; for judicial and administrative proceedings; for law enforcement purposes; to coroners and medical examiners, funeral directors and organ donation agencies; for certain research purposes; to avert serious threat to health or safety; for specialized government functions; for certain criminal activities; for workers’ compensation reporting; relating to certain inmate reporting; and other required uses and disclosures. Under the law, we must make certain disclosures to you upon your request, and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of the Health Insurance Portability and Accountability Act (“HIPAA”). State laws may further restrict these disclosures.

This Notice was originally published and effective on August 16, 2017.

USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION:

Other permitted and required uses and disclosures will be made only with your consent, authorization, or opportunity to object unless permitted or required by law. Without your authorization, we are expressly prohibited from using or disclosing your protected health information for marketing purposes. We may not sell your protected health information without your authorization. Your protected health information will not be used for fundraising. We will not use or disclose your medical notes without your authorization, except as permitted by law. If you provide us with an authorization for certain uses and disclosures of your information, you may revoke such authorization, at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the authorization.

YOUR RIGHTS WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION:

You have the right to inspect and copy your protected health information.
You may request access to or an amendment of your protected health information. Responses to these requests will be timely provided.
You have the right to request a restriction on the use or disclosure of your protected health/personal information. Your request must be in writing and state the specific restriction requested and to whom you want the restriction to apply. We are not required to agree to a restriction that you may request, except if the requested restriction is on a disclosure to a health plan for a payment or health care operations purpose regarding a service that has been paid in full out-of-pocket.
You have the right to request to receive confidential communications from us by alternative means or at an alternate location. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
You have the right to request an amendment of your protected health information. If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to our statement and we will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of certain disclosures of your protected health information that we have made, paper or electronic, except for certain disclosures which were pursuant to an authorization, for purposes of treatment, payment, healthcare operations or for certain other purposes.
You have the right to obtain a paper copy of this Notice, upon request, even if you have previously requested its receipt electronically by e-mail.

REVISIONS TO THIS NOTICE:

We reserve the right to revise this Notice and to make the revised Notice effective for protected health information we already have about you as well as any information we receive in the future. You are entitled to a copy of the Notice currently in effect. Any significant changes to this Notice will be posted on our web site. You then have the right to object or withdraw as provided in this Notice.

BREACH OF HEALTH INFORMATION:

We will notify you if a reportable breach of your unsecured protected health information is discovered. Notification will be made to you no later than 60 days from the breach discovery and will include a brief description of how the breach occurred, the protected health information involved and contact information for you to ask questions.

COMPLAINTS:

Complaints about this Notice or how we handle your protected health information should be directed to our HIPAA Privacy Officer. If you are not satisfied with the manner in which a complaint is handled you may submit a formal complaint to the 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.

We must follow the duties and privacy practices described in this Notice. We will maintain the privacy of your protected health information and to notify affected individuals following a breach of unsecured protected health information. If you have any questions about this Notice, please email us at [email protected] or call us at (855) 263-7669 and ask to speak with our HIPAA Privacy Officer.

This notice fulfills the requirements laid out in 45 CFR 164.520(b).