ALLERGY & ASTHMA CENTER OF TUSCALOOSA PC.
Adult & Pediatric Allergy, Asthma & Immunology
535 Jack Warner Pkwy NE Ste. C Tuscaloosa, AL. 35404
Phone: 205-553-2252 Fax: 205-553-3326
Required by Law: We may use or disclose your health information when we are required to do so by law. (Court or administrative orders, subpoena, discovery request or other lawful process We will use and disclose your information when requested by national security, intelligence and other State and Federal officials and/or if you are an inmate or otherwise under the custody of law enforcement.
National Security: The health information of Armed Forces personnel may be disclosed to military authorities under certain circumstances. If the information is required for lawful intelligence, counterintelligence, or other national security activities, we may disclose it to authorize federal officials.
Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. This information will be disclosed only to the extent necessary to prevent a serious threat to your health or safety or that of others.
Public Health Responsibilities: We will disclose your health care information to report problems with products, reactions to medications, product recalls, disease/infection exposure and to prevent and control disease, injury and/or disability.
Marketing Health-Related Services: We will not use your health information for marketing purposes unless we have your written authorization to do so. Effective September 1, 2021, we are required to obtain an authorization for marketing purposes if communication about a productof service is provided and we receive financial remuneration (getting paid in exchange for making the communication No authorization is required if communication is made face-to-face or for promotional gifts.
Fundraising: We may use certain information (name, address, telephone number or e-mail information, age, date of birth, gender, health insurance status, dates of service, department of service information, treating physician information or outcome information) to contact you for the purpose of raising money and you will have the right to opt out of receiving such communications with each solicitation. Effective September 1, 2021, PHI that requires a written patient authorization prior to fundraising communication include: diagnosis, nature of services and treatment. If you have elected to opt out we are prohibited from making fundraising communication under the HIPPA Privacy Rule.
Sale of PHI: We are prohibited to disclose PHI without an authorization if it constitutes remuneration (getting paid in exchange for PHI "Sale of PHI" does not include disclosures for public health, certain research purposes, treatment and payment, and for any other purposes permitted by the Privacy Rule, where the only remuneration received is "a reasonable cost based fee" to cover the cost to prepare and transmit the PHI for such purpose or a fee otherwise expressly permitted by law. Corporate transactions (i.e., sale, transfer, merger, consolidation) are also excluded from the definition of "sale".
Appointment Reminders: We may use your health records to remind you of recommended services, treatment, or scheduled appointments.
Access: Upon written request, you have the right to inspect and get your copies of your health information (and that of an individual for whom you are a legal guardian We will provide access to health information in a form/format requested by you. There will be some limited exceptions. If you wish to examine your health information, you will need to complete and submit an appropriate request form. Contact our Privacy Officer for a copy of the request form. You may also request access by sending us a letter to the address at the end of this notice. Once approved, an appointment can be made to review your records. Copies, if requested, will be $1.00 for each page and the staff time charged will be $15.00 per hour including the time required to copy your health information. If you want the copies mailed to you, postage will also be charged. Access to your health information in electronic form if (readily producible) may be obtained with your request. If for some reason we aren't capable of an electronic format, a readable hardcopy will be provided. If you prefer a summary or an explanation of your health information, we will provide it for a fee. Please contact our Privacy Officer for and explanation of our fee schedule.
Amendment: You have the right to amend your healthcare information, if you feel it is inaccurate or incomplete. Your request must be in writing and must include an explanation of why the information should be amended. Under certain circumstances, your request may be denied.
Breach Notification Requirement: It is presumed that any acquisition, access, use or disclosure of PHI not permitted under HIPPA regulations is a breach. We are required to complete a risk assessment, and if necessary, inform HHS and take any other steps required by law. You will be notified of the situation and any steps you should take to protect yourself against harm due to the breach.
Questions and Complaints: You have the right to file a complaint with us if you feel we have not complied with our Privacy Policies. Your complaint should be directed to our Privacy Officer. If you feel we may have violated your privacy rights, or if you disagree with a decision, we made regarding your access to your health information, you can complain to us in writing. Request a Complaint Form from our Privacy Officer. We support your right to the privacy of your information and will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and
Human Services. HOW TO CONTACT US:
Practice name: Allergy & Asthma Center of Tuscaloosa PC
Telephone: 205-553-2252 Email: firstname.lastname@example.org
Address: 535 Jack Warner Pkwy NE Ste. C Tuscaloosa, AL. 35404
Privacy Officer: Bruce Bush
HIPAA Notice of Privacy Practices 2021
This form is intended to comply with all appropriate provisions Of the HIPPA Omnibus Final Rule Revised 09/01/2021