OUR LEGAL RESPONSIBILITIES:

We are required by law to give you this notice. It provides information about how we may use and disclose protected health information (PHI) about you, and it describes your rights and our obligations regarding the use and disclosure of that information. We shall maintain the privacy of your protected health information and readily disclose a notice of our legal duties and privacy practices with respect to your protected health information.

We reserve the right to change these policies at any time. If there are any changes to our privacy policy, then all affected patients and clients will be notified. This policy is currently in effect unless stated otherwise. If the policy is changed, it will apply to all your current and past health information.

To request a copy of Medi-Elite Health and Wellness’ Privacy Policy, you may visit our office in person at 2721 Central Drive, Bedford, TX 76021, via email at medicalrecords@medielite.org or print a copy from our website at www.medielite.org

HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION

The following details describe our routine approaches to accessing your protected health information for your treatment, payments, healthcare operations etc., but please be advised that this list is not exhaustive.

Treatment: We may use and disclose your PHI to other members of the healthcare multi- disciplinary team, colleagues and peers, to ensure your treatment plan is optimal. This includes disclosing your protected health information to other medical, such as, providers, trainees, therapists, medical staff, and office staff, which are members of your multi-disciplinary team.

This is done if the healthcare provider at Medi-Elite Health and Wellness finds it necessary or beneficial to consult with a fellow healthcare provider to coordinate your care. Also, Medi-Elite Health and Wellness’ office staff may need to use and disclose your protected health information to other individuals outside of our office such as the pharmacy when a prescription is called in.

Payment: Your protected health information (PHI) may also be used to obtain payment from an insurance company or another third party. This may include sharing your PHI with an insurance company or other payor sources to satisfy pre-authorization requirements for a medication or treatment.

Health Care Operations: We may use or disclose your protected health information (PHI) to operate this medical practice. These activities include training students, reviewing cases with employees, utilizing your information to improve the quality of care, and contacting you by telephone, email, or text to remind you of your appointments.

In the event it is necessary to share your protected health information with third party “business associates” such as a billing service providers, we will only disclose the information that is necessary for them to complete the task that is associated with their scope of work.

We may also use and disclose your protected health information for marketing activities. For example, we might send you a thank you card in the mail with a coupon for specialized services or products. We may also send you information about products or services that might be of interest to you. You may contact us at any point to stop receiving this information.

We will not, without your written consent, use or disclose your protected health information for any purpose other than those identified in this policy. You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. You can revoke this authorization at any time but, in so doing, it will not affect the protected health information that was shared while the authorization was in effect.

Appointment Reminders: We may contact you as a reminder that you have an appointment for your initial visit, follow up visit, or lab work via text, phone or email.

Others Involved in Your Health Care: We may disclose protected health information about you to your approved designated parties if we obtain your written and/ or verbal agreement to do so. If you are unable to agree or object to such a disclosure, we may disclose such information, as necessary, if we determine that it is in your best interest, in the event of an urgent or emergent need.

Research: We may use some elements of your health information for research purposes to improve programs, services offerings and outcomes.

Organ Donation: If you are an organ donor, we may release protected health information to organizations that handle organ procurement or organ, eye or tissue transplantation if it is necessary to facilitate this process.

Public Health Risks: We may disclose your protected health information, if necessary, to prevent or control disease, report adverse events from medications or products, prevent injury, disability or death. This information may be disclosed to healthcare systems, government agencies, or public health authorities. We may have to disclose your protected health information to the Food and Drug Administration to report adverse events, defects, problems, enable recalls etc. if required by FDA regulation.

Health Oversight Activities: We may disclose protected health information to health oversight agencies for audits, investigations, inspections or licensing purposes. These disclosures might be necessary for state and federal agencies to monitor healthcare systems and compliance with civil law.

Required by Law: We will disclose protected health information about you when required to do so by federal, state and/or local law.

Workman’s compensation: We may disclose your protected health information to workman’s comp or similar programs.

Lawsuits: We may disclose your protected health information in response to a court action, administrative action or a subpoena.

Law Enforcement: We may release protected health information to a law enforcement official in response to a court order, subpoena, warrant, subject to all applicable legal requirements.

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

Access to medical records: You have the right to access and receive copies of your protected health information to make decisions about your care. You must submit a written request to obtain your protected health information to the individual listed at the end of this privacy policy. We reserve the right to charge you a fee for the time it takes to obtain and copy the protected health information and provide it to you. Those fees will be disclosed to you in advance of releasing the PHI documents to you.

Amendment: If you believe your protected health information is incorrect or incomplete, then you may request an amendment to information Your request should be submitted in writing and it should include details about the information that is incorrect. We may deny your request to amend PHI if you did not send a written request or provide the reason for the amendment request. If your request is, then a written request will be provided. Your request might also be denied if, in our professional judgement, we determine you medical record and PHI are accurate and complete.

Accounting of Disclosures: You have the right to receive a list of instances in which we disclosed your personal health information unless the disclosure was used for treatment, payment, healthcare operations, was pursuant to a valid authorization and as otherwise provided in applicable federal and state laws and regulations. You must submit a written request to obtain this “accounting of disclosures” to the individual listed at the bottom of this policy. After your request has been approved, then we will provide you the dates of the disclosure, the name of the individual or entity we disclosed the information to, a description of the information that was disclosed, the reason why it was disclosed, and any additional pertinent information. This information may not be longer than (State Specific Statute of Limitations) years prior to the date the accounting is requested. We reserve the right to charge a reasonable fee for this process, which will be disclosed in advance of gathering the requested data.

Restriction Requests: You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment, or healthcare operations. We shall accommodate your request except where the disclosure is required by law. We require this request be submitted in writing.

Paper Copy of this Notice: A hardcopy of the privacy notice is available for download at your discretion. It is publicly accessible on our website at www.medielite.org

Complaints: If you believe your privacy rights have been violated, you may file a complaint with our office by submitting your grievance in writing via certified mail delivery through the United States Postal Service or other reputable mail carrier.

Complaints Notification: Complaints Division 2721 Central Drive Bedford, TX 76021

Requests for PHI or this Privacy Notice should be directed to the following email address:

MedicalRecords@medielite.org