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.

At Third Coast Anesthesia Associates,PLLC we are committed to protecting your privacy and ensuring the confidentiality of your health information. This Notice of Privacy Practices explains how we may use and disclose your Protected Health Information (PHI) and your rights regarding your PHI.

Uses and Disclosures of Protected Health Information

1. Treatment: We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. This includes communication with other healthcare providers regarding your treatment and coordination of your care with other providers.

2. Payment: We may use and disclose your PHI to obtain payment for the healthcare services we provide to you. This may include activities such as billing, claims management, and collection activities.

3. Healthcare Operations: We may use and disclose your PHI for healthcare operations, which include administrative, financial, legal, and quality improvement activities. These activities are necessary to ensure our patients receive quality care.

4. Business Associates: We may disclose your PHI to third-party business associates that perform services on our behalf, such as billing or transcription services. Our business associates are required to protect the privacy of your information.

5. Legal Requirements: We may disclose your PHI as required by law, including in response to a court order, subpoena, or other legal process.

6. Public Health Activities: We may disclose your PHI for public health activities, such as reporting diseases, injuries, or vital events like births or deaths.

7. Health Oversight Activities: We may disclose your PHI to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections.

8. Abuse or Neglect: We may disclose your PHI to appropriate authorities if we believe you are a victim of abuse, neglect, or domestic violence, to the extent required or permitted by law.

9. Research: We may use and disclose your PHI for research purposes, provided that certain conditions are met.

10. Marketing and Fundraising: We will obtain your written authorization before using your PHI for marketing purposes. You have the right to opt-out of receiving fundraising communications from us.

11. Other Uses and Disclosures: We will obtain your written authorization for any other uses and disclosures of your PHI not described in this notice.

Your Rights Regarding Your Protected Health Information

1. Right to Inspect and Copy: You have the right to inspect and copy your PHI, with certain exceptions. To inspect and copy your PHI, you must submit your request in writing.

2. Right to Amend: If you believe your PHI is incorrect or incomplete, you may request an amendment. Your request must be in writing and provide a reason for the amendment.

3. Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures of your PHI made by us, except for disclosures made for treatment, payment, healthcare operations, and certain other purposes.

4. Right to Request Restrictions: You have the right to request restrictions on the use and disclosure of your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, but if we do, we will comply with your restriction unless the information is needed for emergency treatment.

5. Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. Your request must be in writing.

6. Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice upon request, even if you have agreed to receive this notice electronically.

Changes to This Notice

We reserve the right to change this notice at any time. The revised notice will be effective for all PHI we maintain. We will post a copy of the current notice on our website and provide a copy to you upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with 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, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

We will never under any circumstances ask you to waive your rights under this notice or retaliate against you in any manner for filing a complaint.

Contact Information

For further information about this notice or our privacy practices, please contact our Privacy Officer at the address, email, or phone number listed above.

Third Coast Anesthesia Associates, PLLC
105 Oakmont Drive,
Victoria, TX 77904, USA
contact@thirdcoastanesthesia.com
+1(361) 894-1414
www.thirdcoastanesthesia.com

EFFECTIVE DATE:
The effective date of this notice is June 5, 2024.