Notice of Privacy Practices

Our Commitment to Your Privacy

Marron Health and its affiliated healthcare providers are committed to protecting the privacy of your health information. We are required by law to maintain the privacy and security of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices, follow the terms of this Notice currently in effect, and notify you if a breach of your unsecured PHI occurs.

Your Rights Regarding Your Health Information

You have the following rights with respect to your PHI:

Right to Access

You have the right to inspect and obtain a copy of your medical records and other health information. To request access, submit a written request to us. We may charge a reasonable fee for copies.

Right to Amend

You have the right to request an amendment to your health information if you believe it is incorrect or incomplete. Submit your request in writing with the reason for the amendment. We may deny your request in certain circumstances.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we made of your health information for purposes other than treatment, payment, healthcare operations, and certain other activities. The first request within a 12-month period is free.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your health information. We are not required to agree to your request unless you are asking us to restrict disclosure to a health plan for services you paid for out of pocket in full.

Right to Confidential Communications

You have the right to request that we communicate with you in a specific way or at a specific location. For example, you may request that we contact you only by mail or at a specific phone number.

Right to a Paper Copy

You have the right to obtain a paper copy of this Notice upon request, even if you agreed to receive it electronically.

Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your health information to provide, coordinate, or manage your healthcare and related services. This includes consultations with other healthcare providers, pharmacies, and laboratories.

Payment

We may use and disclose your health information to obtain payment for services provided to you. This may include contacting your health insurance company for coverage determinations or claims processing.

Healthcare Operations

We may use and disclose your health information for our healthcare operations, including quality assessment, training, licensing, and accreditation activities.

With Your Authorization

We will obtain your written authorization before using or disclosing your health information for purposes not covered by this Notice or permitted by law. You may revoke your authorization in writing at any time.

As Required by Law

We may use or disclose your health information when required by federal, state, or local law.

Public Health Activities

We may disclose your health information to public health authorities for purposes such as preventing or controlling disease, injury, or disability.

Health Oversight

We may disclose your health information to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections.

Judicial and Administrative Proceedings

We may disclose your health information in response to a court order, subpoena, or other lawful process.

To Avert a Serious Threat

We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of others.

Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI
• We will promptly notify you if a breach occurs that may have compromised the privacy or security of your PHI
• We must follow the duties and privacy practices described in this Notice
• We will not use or share your information other than as described in this Notice unless you tell us we can in writing

Changes to This Notice

We reserve the right to change this Notice and make the new provisions effective for all PHI we maintain. If we make a material change, we will post the revised Notice on our website and make it available upon request.

Contact Information

To exercise any of your rights, request a copy of this Notice, or if you have questions or complaints, please contact our Privacy Officer:

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/ or calling 1-877-696-6775.