Privacy Policy - Total Men's Primary Care

Notification of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

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.

 

Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
  • You can ask to see or get an electronic or paper copy of your medical record and other health information TPC has about you. Ask us how to do this.
  • TPC will provide a copy or a summary of your health information, within 15 days of your request. TPC may charge a reasonable, cost-based fee, for requests that TPC reasonably deems as overly burdensome. More information is available upon request.
Ask us to correct your medical record
  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • TPC may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • TPC will say “yes” to all reasonable requests.
Ask us to limit what we use or share
  • You can ask us not to use or share certain health information for treatment, payment, or our operations. TPC is not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. TPC will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • TPC will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). TPC will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. TPC will provide you with a paper copy promptly.
Choose someone to act for you
  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • TPC will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
  • You can complain if you feel we have violated your rights by contacting us using the information above.
  • You can file a complaint 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, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • TPC will not retaliate against you for filing a complaint.

 

Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. TPC may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:
  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes
In the case of fundraising:
  • TPC may contact you for fundraising efforts, but you can tell us not to contact you again.

 

Our Uses and Disclosures
How do we typically use or share your health information?

TPC typically uses or shares your health information in the following ways.

Treat you TPC can use your health information and share it with other professionals who are treating you.

Example: A provider treating you for an injury asks another provider about your overall health condition.

Run our organization TPC can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: TPC uses health information about you to manage your treatment and services.

Bill for your services TPC can use and share your health information to bill and get payment from health plans or other entities.

Example: TPC gives information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

TPC is allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. TPC has to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues TPC can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
Do research TPC can use or share your information for health research.
Comply with the law TPC will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests TPC can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director TPC can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests TPC can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions TPC can share health information about you in response to a court or administrative order, or in response to a subpoena.

 

Our Responsibilities
  • TPC is required by law to maintain the privacy and security of your protected health information.
  • TPC will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • TPC must follow the duties and privacy practices described in this notice and give you a copy of it.
  • TPC will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

 

Changes to the Terms of this Notice

TPC can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

 

Effective date of this notice: January 1, 2023

 

The Privacy Officer can be contacted via [email protected] or via mail – 

Attn: Privacy Officer

8300 N Lamar Blvd.

Suite 200A

Austin, TX 78753