Privacy Policy

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.

Our commitment to your privacy

PremCare Family Medical Center is required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this notice describing our legal duties and privacy practices, and to abide by the terms of this notice while it is in effect.

How we may use and disclose your health information

We may use and disclose your PHI for the following purposes without your written authorization:

• Treatment — to provide, coordinate, or manage your medical care, and to consult with other treating providers involved in your care.
• Payment — to bill and collect payment for the services you receive, including submitting claims to your health plan or insurer and confirming coverage.
• Health care operations — for activities such as quality assessment, staff training, licensing, and general practice management.

We may also use or disclose your health information, as permitted or required by law, for purposes such as:

• Appointment reminders and information about treatment alternatives or health-related services that may interest you.
• Public health activities, such as reporting communicable diseases or adverse events, as required by law.
• Health oversight activities, audits, and government inspections.
• Judicial or administrative proceedings, in response to a valid court order or subpoena.
• Law enforcement purposes, as required by law.
• To avert a serious threat to your health or safety, or the health or safety of others.
• Workers' compensation, as authorized by applicable law.

Uses and disclosures not described in this notice — including most uses and disclosures of psychotherapy notes (if applicable) and disclosures for marketing purposes — will be made only with your written authorization, which you may revoke at any time in writing.

Your rights regarding your health information

You have the following rights with respect to your PHI. To exercise any of these rights, please contact us using the information below.

• Right to inspect and copy. You may request to inspect and obtain a copy of your medical and billing records.
• Right to request amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete.
• Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI.
• Right to request restrictions. You may ask us to restrict how we use or disclose your PHI for treatment, payment, or operations.
• Right to request confidential communications. You may ask us to communicate with you about your health matters in a particular way or at a particular location.
• Right to a paper copy of this notice. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Right to file a complaint. You may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. Filing a complaint will not affect your care.

Our duties

We are required by law to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices, and notify you if a breach occurs that may have compromised the privacy or security of your information. We reserve the right to change the terms of this notice and to make the revised notice effective for all PHI we maintain. Any revised notice will be made available at our office and on this website.

How to file a complaint

If you believe your privacy rights have been violated, you may file a complaint with our practice using the contact information below, or directly with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR):

• By mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
• By phone: 1-877-696-6775
• Online: www.hhs.gov/ocr/complaints

You will not be penalized or retaliated against for filing a complaint.

Contact us about your privacy rights

To exercise any of the rights described above, or if you have questions about this notice, please contact our Privacy Officer:

• Privacy Officer: [To be completed by the practice]
• Practice: PremCare Family Medical Center
• Address: 4501 S Semoran Blvd, Orlando, FL 32822
• Phone: (407) 380-1428