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 (“Notice”) applies to Rosas Medical Center, operated by Advanced Wellness Consultants LLC, and to the health care professionals and workforce members who participate in its organized health care activities, as applicable. It explains our duties and privacy practices concerning your protected health information (“PHI”).

Your Rights

You have the following rights regarding your health information. Certain limits and procedures may apply under law.

Get an electronic or paper copy of your medical record. You may inspect or obtain a copy of health and billing information we maintain about you, usually within the time required by law. We may charge a reasonable, cost-based fee where permitted.

Ask us to correct your medical record. You may request correction of information you believe is incorrect or incomplete. We may deny the request in certain circumstances, but we will explain the reason in writing.

Request confidential communications. You may ask us to contact you in a specific way or at a specific location. We will accommodate reasonable requests.

Ask us to limit what we use or share. You may request restrictions on certain uses or disclosures. We are not required to agree to every request. If you pay for a service in full out of pocket, you may ask us not to disclose information about that service to your health plan for payment or health care operations, unless disclosure is required by law.

Receive a list of certain disclosures. You may request an accounting of certain disclosures of your PHI made during the period allowed by law. The accounting does not include every disclosure, such as many disclosures for treatment, payment or health care operations.

Get a copy of this Notice. You may request a paper copy at any time, even if you agreed to receive it electronically.

Choose someone to act for you. If you have given someone medical power of attorney or another person is your legal representative, that person may exercise your rights as authorized by law.

File a complaint without retaliation. You may complain to us or to the U.S. Department of Health and Human Services if you believe your privacy rights were violated. We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you may tell us your preferences about what we share. If you cannot tell us your preference, for example because you are unconscious, we may share information if we believe it is in your best interest and permitted by law.

Share information with family members, close friends or others involved in your care or payment for your care.

Share information in a disaster-relief situation.

Contact you for fundraising. You may tell us not to contact you again for fundraising.

We generally need your written authorization for uses and disclosures of psychotherapy notes, for marketing purposes and for a sale of PHI, except where law allows otherwise. If you provide an authorization, you may revoke it in writing for future uses and disclosures, subject to actions already taken in reliance on it.

How We May Use and Share Your Health Information

Treatment

We may use and share your PHI to provide, coordinate or manage your health care and related services. For example, we may share information with another provider involved in your care.

Health Care Operations

We may use and share your PHI to operate our practice, improve care, train staff, conduct quality reviews, manage services and contact you when necessary. For example, we may use health information to review the quality of treatment and patient services.

Payment

We may use and share your PHI to bill and obtain payment from health plans or other responsible parties. For example, we may provide information to your health plan to determine coverage or obtain payment.

Business Associates

We may share PHI with vendors that perform services involving PHI on our behalf, such as billing, technology, records management or scheduling, when permitted by law and subject to appropriate written safeguards.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose PHI without your written authorization when permitted or required for purposes including:

Public-health and safety activities, including disease prevention, product recalls, adverse-event reporting and preventing a serious threat to health or safety.

Reporting suspected abuse, neglect or domestic violence as permitted or required by law.

Health oversight activities, audits, inspections, licensing and regulatory investigations.

Judicial and administrative proceedings, subpoenas and lawful process.

Law-enforcement purposes permitted by law.

Workers’ compensation and similar programs.

Coroners, medical examiners, funeral directors and organ or tissue donation organizations.

Research when legal requirements and required approvals are satisfied.

Military, national-security, protective-service and correctional-institution activities authorized by law.

Compliance with other applicable federal, state or local laws.

Substance Use Disorder Records

Records created or maintained by a federally assisted substance use disorder program may receive additional protection under 42 CFR Part 2. When those rules apply, such records generally will not be used or disclosed in civil, criminal, administrative or legislative proceedings against you without your written consent or a qualifying court order, as required by law. Rosas Medical Center will apply these protections when applicable.

Our Responsibilities

We are required by law to maintain the privacy and security of PHI.

We will notify affected individuals following a breach of unsecured PHI when required by law.

We must follow the duties and privacy practices described in the Notice currently in effect.

We will not use or share PHI other than as described here unless you authorize us in writing or law permits or requires it.

We will provide this Notice and make it available electronically and at our facilities as required.

Changes to This Notice

We may change the terms of this Notice, and the changes may apply to all PHI we maintain, including information created or received before the change. A revised Notice will be available upon request, at our facilities and on our website. The Notice will state its effective date.

Questions, Requests and Complaints

Contact our Privacy Officer to exercise your rights, request a copy of this Notice, ask questions or submit a complaint:

Privacy Officer – Rosas Medical Center

Operated by Advanced Wellness Consultants LLC

2822 N University Drive, Sunrise, FL 33322

Phone: (754) 223-2321

Email: info@rosasmedicalcenter.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, without retaliation. Information about filing a complaint is available at:

https://www.hhs.gov/hipaa/filing-a-complaint/

Locations Covered by This Notice