Privacy Policy

[BLUE LOTUS ENDOCRINE COMPANY, Inc]
HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: September 1st, 2024

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The terms of this Notice of Privacy Practices (“Notice”) apply to [Blue Lotus Endocrine], its affiliates, and its employees. [Blue Lotus Endocrine] will share patients’ protected health information as necessary for treatment, payment, and healthcare operations as the law permits.

We are required by law to maintain the privacy of our patient’s protected health information and to provide patients with notice of our legal duties and privacy practices concerning protected health information. We are required to abide by the terms of this Notice for as long as it remains in effect. We reserve the right to change the terms of this Notice as necessary and to make a new notice of privacy practices effective for all protected health information maintained by [Practice Name]. We are required to notify you in the event of a breach of your unsecured protected health information. We are also required to inform you that there may be a provision of state law related to the privacy of your health information that may be more stringent than a standard or requirement under the Federal Health Insurance Portability and Accountability Act (“HIPAA”). A copy of any revised Notice of Privacy Practices or information about a specific State law may be obtained by mailing a request to the Privacy Officer at the address below.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION:

Authorization and Consent: Unless outlined below, we will not use or disclose your protected health information for any purpose other than treatment, payment, or healthcare operations unless you have signed a form authorizing such use or disclosure. You have the right to revoke such authorization in writing, with such revocation being effective once we receive the writing; however, such revocation shall not be effective to the extent that we have taken any action in reliance on the authorization or if the authorization was obtained as a condition of obtaining insurance coverage, another law provides the insurer with the right to contest a claim under the policy or the policy itself.
Uses and Disclosures for Treatment: We will make uses and disclosures of your protected health information as necessary for your treatment. Doctors, nurses, and other professionals involved in your care will use information in your medical record and information you provide about your symptoms and reactions to your course of treatment, including procedures, medications, tests, medical history, etc.
Uses and Disclosures for Payment: We will make uses and disclosures of your protected health information as necessary for payment purposes. During the normal course of business operations, we may forward information regarding your medical procedures and treatment to your insurance company to arrange payment for the services provided to you. We may also use your information to prepare a bill to send to you or to the person responsible for your payment.
Uses and Disclosures for Health Care Operations: We will use and disclose your protected health information as necessary and as permitted by law for our health care operations, which may include clinical improvement, professional peer review, business management, accreditation and licensing, etc. For instance, we may use and disclose your protected health information to improve clinical treatment and patient care.

Individuals Involved in Your Care: We may, from time to time, disclose your protected health information to designated family, friends, and others who are involved in your care or in payment of your care to facilitate that person’s involvement in caring for you or paying for your care., Suppose you are unavailable, incapacitated, or facing an emergency medical situation, and we determine that a limited disclosure may be in your best interest. We may share limited protected health information with such individuals without your approval. We may also disclose limited protected health information to a public or private entity that is authorized to assist in disaster relief efforts for that entity to locate a family member or other persons who may be involved in some aspect of caring for you.

Business Associates: Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as auditing, accreditation, outcomes data collection, legal services, etc. Sometimes, we may need to provide your protected health information to one or more outside persons or organizations who assist us with our healthcare operations. In all cases, we require these associates to safeguard the privacy of your information appropriately.

Appointments and Services: We may contact you to provide appointment updates, information about your treatment, or other health-related benefits and services that may interest you. You have the right to request, and we will accommodate, reasonable requests by you to receive communications regarding your protected health information from us by alternative means or at alternative locations. For instance, we will accommodate reasonable requests if you wish appointment reminders not to be left on voice mail or sent to a particular address. With such a request, you must provide an appropriate alternative address or method of contact. You also have the right to request that we not send you any future marketing materials, and we will use our best efforts to honor such requests. You must make such requests in writing, including your name and address, and send such writing to the Privacy Officer at the address below.

Research: In limited circumstances, we may use and disclose your protected health information for research purposes. In all cases where your specific authorization is not obtained, your privacy will be protected by strict confidentiality requirements applied by an Institutional Review Board that oversees the research or by representations of the researchers that limit their use and disclosure of your information.
Fundraising: We may use your information to contact you for fundraising purposes. We may disclose this contact information to a related foundation so that the foundation may contact you for similar purposes. If you do not want us or the foundation to contact you for fundraising efforts, you must send a written request to the Privacy Officer at the address below.

Other Uses and Disclosures: We are permitted and/or required by law to make certain other uses and disclosures of your protected health information without your consent or authorization for the following:

Any purpose required by law.
Public health activities include reporting immunizations, disease, injury, birth, death, or those connected with public health investigations.
If we suspect child abuse or neglect, if we believe you to be a victim of abuse, neglect, or domestic violence.
To the Food and Drug Administration to report adverse events, product defects, or to participate in product recalls.
To your employer when we have provided health care to you at your employer’s request.
To a government oversight agency conducting audits, investigations, civil or criminal proceedings.
Court or administrative-ordered subpoena or discovery request.
To law enforcement officials as required by law if we believe you have been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law;
To coroners and/or funeral directors consistent with law.
If necessary, arrange an organ or tissue donation from you or a transplant for you.
If you are a member of the military, we may also release your protected health information for national security or intelligence activities and
To workers’ compensation agencies for workers’ compensation benefit determination.
DISCLOSURES REQUIRING AUTHORIZATION:
Psychotherapy Notes: We must obtain your written authorization before disclosing any psychotherapy notes unless otherwise permitted by law. However, there are certain purposes for which we may disclose psychotherapy notes without obtaining your written authorization, including the following: (1) to carry out certain treatment, payment, or healthcare operations (e.g., use for your treatment, for our training, and to defend ourselves in a legal action or other proceeding brought by you), (2) to the Secretary of the Department of Health and Human Services to determine our compliance with the law, (3) as required by law, (4) for health oversight activities authorized by law, (5) to medical examiners or coroners as permitted by state law, or (6) to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.
Genetic Information: We must obtain your written authorization before using or disclosing your genetic information for treatment, payment, or health care operations. We may use or disclose your genetic information, or the genetic information of your child, without your written authorization, only where it would be permitted by law.

Marketing: We must obtain your authorization for any use or disclosure of your protected health information for marketing, except if the communication is in the form of (1) a face-to-face communication with you or (2) a promotional gift of nominal value.

No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent: this information will not be shared with third parties.

Sale of Protected Information: We must obtain your authorization before receiving direct or indirect remuneration in exchange for your health information; however, such authorization is not required where the purpose of the exchange is for:

Public health activities.
For research purposes, we will receive only a reasonable, cost-based fee to cover the cost of preparing and transmitting the information for research purposes.
Treatment and payment purposes.
Healthcare operations involving the sale, transfer, merger, or consolidation of all or part of our business and for related due diligence.
Payment, we provide to a business associate for activities involving the exchange of protected health information that the business associate undertakes on our behalf (or the subcontractor undertakes on behalf of a business associate), and the only remuneration provided is for the performance of such activities.
Providing you with a copy of your health information or an accounting of disclosures.
Disclosures required by law.
Disclosures of your health information for any other purpose permitted by and per the Privacy Rule of HIPAA, as long as the only remuneration we receive is a reasonable, cost-based fee to cover the cost to prepare and transmit your health information for such purpose or is a fee otherwise expressly permitted by other law; or
Any other exceptions allowed by the Department of Health and Human Services.

RIGHTS THAT YOU HAVE REGARDING YOUR PROTECTED HEALTH INFORMATION:

Access to Your Protected Health Information: You can copy and/or inspect much of the protected health information we retain on your behalf. For protected health information we maintain in any electronic designated record set, you may request a copy in a reasonable electronic format if readily available. Access requests must be made in writing and signed by you or your legal representative. You may obtain a “Patient Access to Health Information Form” from the front office person. You will be charged a reasonable copying fee and actual postage and supply costs for your protected health information. If you request additional copies, you will be charged a fee for copying and postage.

Amendments to Your Protected Health Information: You have the right to request in writing that the protected health information we maintain about you be amended or corrected. We are not obligated to make the requested amendments, but we will carefully consider each request. All amendment requests must be in writing and signed by you or a legal representative. State the reasons for the amendment/correction request. If an amendment or correction request is made, we may notify others who work with us if we believe such notification is necessary. You may obtain an “Amendment Request Form” from the front office person or individual responsible for medical records.

Accounting for Disclosures of Your Protected Health Information: You have the right to receive an accounting of certain disclosures made by us after September 1st,2024. Requests must be made in writing and signed by you or your legal representative. “Accounting Request Forms” are available from the front office person or individual responsible for medical records. The first accounting in any 12-month period is free; you will be charged a fee for each subsequent accounting you request within the same 12-month period. You will be notified of the fee at the time of your request.
Restrictions on Use and Disclosure of Your Protected Health Information: You can request restrictions on uses and disclosures of your protected health information for treatment, payment, or health care operations. We are not required to agree to most restriction requests but will attempt to accommodate reasonable requests when appropriate. However, you have the right to restrict disclosure of your protected health information to a health plan if the disclosure is to carry out payment or health care operations and is not otherwise required by law. The protected health information pertains solely to a health care item or service for which you, or someone other than the health plan on your behalf, has paid [Blue Lotus Endocrine Company, Inc] in full. If we agree to any discretionary restrictions, we reserve the right to remove such restrictions as we appropriate. We will notify you if we remove a restriction imposed per this paragraph. You also have the right to withdraw any restriction in writing or orally by communicating your desire to do so to the individual responsible for medical records.

Right to Notice of Breach: We take the confidentiality of our patients’ information very seriously, and we are required by law to protect the privacy and security of your protected health information through appropriate safeguards. We will notify you if a breach occurs involving or potentially involving your unsecured health information and inform you of what steps you may need to take to protect yourself.

Paper Copy of this Notice: You have a right, even if you have agreed to receive notices electronically, to obtain a paper copy. To do so, please submit a request to the Privacy Officer at the address below.
Complaints: There will be no retaliation for filing a complaint. If you believe your privacy rights have been violated, you can write a complaint with the Privacy Officer at [Blue Lotus Endocrine Company]. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) in writing by mail, fax, email, or via the OCR online portal. Print and mail the completed complaint and consent forms to
Regional Manager, Office for Civil Rights
U.S. Department of Health and Human Services Sam Nunn Atlanta Federal Center, Suite 16T70 61 Forsyth Street, S.W.
Atlanta, GA 30303-8909
Phone (800) 368-1019
Fax: (202) 619-3818
TDD: (800) 537-7697
Email: ocrmail@hhs.gov
For Further Information: If you have questions, need further assistance, or would like to submit a request according to this Notice, you may contact the [Blue Lotus Endocrine Company, Inc] Privacy Officer by phone at (813) 573 0064 or at the following address: 18938 N Dale Mabry Hwy, Ste 101 Lutz, FL 33548.

This Notice of Privacy Practices is also available on our [Blue Lotus Endocrine Company] webpage at https://bluelotusendocrine.com.