HIPAA · 45 CFR § 164.520
Notice of Privacy Practices
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. This notice applies to all protected health information (PHI) maintained by Valley Family Medicine.
Your rights regarding your protected health information
- Inspect and copy. You may request and inspect or receive copies of your medical and billing records, usually within 30 days of a written request.
- Amend. You may request an amendment to records you believe are incorrect or incomplete.
- Accounting of disclosures. You may request a list of certain disclosures we have made of your PHI for the prior six years.
- Request restrictions. You may ask us to restrict how we use or disclose your PHI for treatment, payment, or health care operations. We are not required to agree to all such requests.
- Confidential communications. You may request that we contact you at a specific address or phone number.
- Receive a paper copy. You may obtain a paper copy of this notice on request, even if you have agreed to receive it electronically.
- Breach notification. You will be notified in the event of a breach affecting your unsecured PHI, as required by law.
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, follow the terms of the notice currently in effect, and notify you in the event of a breach involving your unsecured PHI.
How we use and disclose your information
We may use and disclose your PHI without your written authorization for:
- Treatment — coordinating care with other providers, hospitals, labs, and pharmacies.
- Payment — billing and verifying coverage with your insurance plan.
- Health care operations — quality assessment, training, accreditation, and internal business activities.
- Appointment reminders and notification of treatment alternatives or health-related benefits and services.
- As required by law — including public health activities, abuse or neglect reporting, judicial and law-enforcement proceedings, and other uses required or permitted under HIPAA.
Disclosures requiring your authorization
Most uses and disclosures of psychotherapy notes, uses and disclosures of PHI for marketing, and disclosures that constitute a sale of PHI require your written authorization. You may revoke your authorization at any time in writing, except to the extent we have already taken action in reliance on it.
Complaints and contact
To exercise any of your rights, ask questions about this notice, or file a complaint, please contact Valley Family Medicine using the information on our Contact page. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for all PHI we maintain. The current notice is always available on this page and in the practice waiting area.
This notice is a starting template provided by the website platform. It is intended to assist Valley Family Medicine in meeting the HIPAA Privacy Rule requirement at 45 CFR § 164.520 to provide a Notice of Privacy Practices, but it is not legal advice. Practices should review this content with qualified counsel and tailor it to local operations before relying on it.