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.

Due to recent changes in State and Federal regulations governing privacy practices and in order to update our records. Please make sure all contact information is current in our system, including your cellphone and work phone numbers and address. This helps ensure we can reach you when needed.

The practice has policies in place to keep your personal and medical information confidential. All physicians and staff will treat your information with the utmost privacy.

To provide appropriate care, operate our practice, and obtain payment, we may share relevant information about your treatment and charges with:

  • Physicians and non-physician providers (e.g., physical therapists, nutrition counselors) outside this practice
  • Hospitals and outpatient centers
  • Laboratories conducting medical tests
  • Pharmacies, medical equipment providers, and ambulance services
  • School health departments and school nurses
  • Insurance companies and third-party administrators
  • State or Federal agencies requiring health-related information

This information may be sent via mail, fax, internet, voicemail, or personal communication.

We may contact you by phone about appointments, test results, referrals, billing, or returning your call. We’ll first try your cellphone number, but if provided, we may also call your work number. If you’re unavailable, we may leave a message to call us back or to remind you of an appointment.

If any balances remain after your visit, we’ll upload a statement to our portal. We may also send letters related to test results, appointment scheduling, or outstanding balances.

We may contact your insurance company to verify your coverage, eligibility, deductible status, and any co-pays or co-insurance.

When you arrive for your appointment, you will be asked to sign in. If you want your records sent to another provider or facility, you must give written authorization. The same applies for release of information to life, disability, or future health insurers.

Your Rights

  • Inspect and Copy: You may review or obtain a copy of your protected health information (PHI) from our designated record set (medical and billing records). Psychotherapy notes may be excluded. Requests must be in writing to our Practice Manager. Fees may apply for copying and mailing. Requests may be denied in certain cases, but you can appeal the decision.
  • Request Restrictions: You can request limits on how your PHI is used or shared, including with family members or friends. Requests must be in writing. The provider may choose not to agree to your request, especially if it may impact care.
  • Request Amendments: You may ask us to correct your PHI in our records. Requests must be in writing. We may deny requests if we believe the information is correct or not created by us. If denied, you may submit a statement of disagreement.

We update our privacy policies as needed to remain in compliance with regulations.

If you have questions about these policies, please contact our Practice Manager.

Thank you for trusting us with your care.

Sincerely,
Premier Pediatrics