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Effective Date: 5.1.25
This notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully.
Your Rights
You have the right to make choices about how we share your information in the following situations:
- Get a copy of your medical records: You may request an electronic or paper copy of your medical records and other health information. We will provide it within 30 days and may charge a reasonable fee.
- Ask us to correct your medical record: If you believe your health information is incorrect or incomplete, you can request a correction. We may deny the request but will inform you in writing within 60 days.
- Request confidential communications: You can ask us to contact you in a specific way (e.g., phone, email, alternate address), and we will accommodate all reasonable requests.
- Ask us to limit what we use or share: You may request limits on the use or disclosure of your information for treatment, payment, or operations. While we are not required to agree, we will consider your request. If you pay in full out-of-pocket for a service, you can ask us not to share related information with your health insurer, and we will comply unless legally required to share.
- Get a list of those with whom we’ve shared information: You can request a list (accounting) of disclosures made in the past six years, excluding those related to treatment, payment, and operations. One request per year is free; additional requests may incur a fee.
- Get a copy of this privacy notice: You can request a paper copy of this notice at any time, even if you’ve received it electronically.
- Choose someone to act for you: If someone has legal authority (medical power of attorney or guardianship), they may exercise your privacy rights.
- File a complaint: If you feel your rights are violated, you may file a complaint with us at info@360mdaustin.com or with the U.S. Department of Health and Human Services at www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you.
Your Choices
You have the right to make choices about how we share your information in the following situations:
- Sharing with family, friends, or others involved in your care
- In disaster relief efforts
- For inclusion in directories (not applicable at 360 MD)
We will follow your preferences whenever possible. If you are unable to express your wishes (e.g., unconscious), we may share information if it is in your best interest or necessary to prevent a serious threat to health or safety.
We will never share your information for:
- Marketing purposes
- The sale of your information
- Most sharing of psychotherapy notes unless you give us written permission.
We may contact you for fundraising efforts, but you can opt out at any time.
How We Use and Share Your Information
We typically use or share your health information for:
- Treatment: To provide and coordinate your care (e.g., consultation between providers).
- Payment: To bill your insurance or process payments.
- Healthcare Operations: To run our practice, improve your care, and manage administrative matters.
Other permitted uses include:
- Public health and safety: Preventing disease, reporting adverse events, abuse, or threats to health/safety.
- Research: Under strict review and approval processes.
- Required by law: Including audits, health oversight, and compliance reviews.
- Organ and tissue donation: To approved organizations.
- Medical examiners or funeral directors: As needed following death.
- Worker's compensation and law enforcement: As allowed by applicable laws.
- Government functions: For national security or protective services.
- Legal proceedings: In response to a court order or subpoena.
We do not sell your information and only disclose PHI as permitted or required by law.
Our Responsibilities
- We are required by law to protect the privacy and security of your protected health information (PHI).
- We will notify you promptly if a breach occurs that may compromise your information.
- We must follow the practices outlined in this notice and provide you with a copy.
- We will not use or disclose your information in ways not described here without your written permission. If you give permission, you may revoke it at any time in writing.
For more information about your rights, visit:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers
Changes to This Notice
We reserve the right to change this notice at any time. Changes will apply to all PHI we maintain. The updated version will be posted on our website and available upon request.
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