Notice Of Privacy Practices

PACS Urgent Care

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.

Our Commitment to Your Privacy

PACS Urgent Care is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI), provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and related services. For example, we may share information with other providers involved in your care, such as specialists or laboratories.

Payment

We may use and disclose your PHI to bill and receive payment for services. For example, we may submit claims to your health insurance company, which may include information about your diagnosis and treatment.

Healthcare Operations

We may use and disclose your PHI for our general healthcare operations, including quality improvement activities, staff training, compliance reviews, and business planning. These activities are necessary to run our practice and ensure quality care.

Other Permitted Uses and Disclosures

We may also use or disclose your PHI without your written authorization in the following circumstances:

As required by law (e.g., court orders, subpoenas)
For public health activities (e.g., reporting communicable diseases to health authorities)
To report suspected abuse, neglect, or domestic violence to government authorities
To health oversight agencies (e.g., audits, investigations, inspections)
For research purposes, subject to applicable privacy protections
To avert a serious threat to health or safety
For workers’ compensation programs
To coroners, medical examiners, and funeral directors
For organ and tissue donation purposes
To the military or veterans’ affairs agencies, if applicable
For national security and intelligence activities

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not described in this notice will be made only with your written authorization, including:

Marketing purposes
Sale of your PHI
Most uses and disclosures of psychotherapy notes

You may revoke a written authorization at any time, in writing, except to the extent that we have already taken action based on it.

Your Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and receive a copy of your PHI that is maintained in a designated record set. To request access, submit a written request to our Privacy Officer. We may charge a reasonable fee for copies.

Right to Amend

If you believe your PHI is incorrect or incomplete, you may request that we amend it. We may deny the request in certain circumstances and will explain our decision in writing.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures of your PHI we have made for purposes other than treatment, payment, and health care operations. Submit your request in writing to our Privacy Officer.

Right to Request Restrictions

You may request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations. We are not required to agree to your request except in limited circumstances (e.g., if you pay out-of-pocket in full for a service and ask us not to share that information with your health plan).

Right to Request Confidential Communications

You may request that we communicate with you in a specific way or at a specific location. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically. Ask any staff member and we will provide one immediately.

Right to Notification of a Breach

If a breach of your unsecured PHI occurs, we will notify you as required by applicable law.

Changes to This Notice

We reserve the right to change this Notice and the terms of our privacy practices at any time. Any revised Notice will be effective for all PHI we maintain, including information created or received prior to the change. We will post the current Notice in our offices and on our website at pacsurgentcare.com and will make it available upon request.

Complaints

If you believe we have violated your privacy rights, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

To file a complaint with PACS Urgent Care, contact our Privacy Officer:

PACS Urgent Care — Privacy Officer

3481 N Beauregard St, Alexandria, VA 22302

17067 Merchants Dr, Ruther Glen, VA 22546

Alexandria: (571) 290-3614 | Ruther Glen: (804) 220-6044

To file a complaint with the U.S. Department of Health and Human Services:

Office for Civil Rights, U.S. Department of Health and Human Services

200 Independence Avenue, S.W., Washington, D.C. 20201

Hotline: 1-800-368-1019 | Website: www.hhs.gov/ocr/privacy/hipaa/complaints

Contact Information

PACS Urgent Care

Alexandria: 3481 N Beauregard St, Alexandria, VA 22302 | Phone: (571) 290-3614

Ruther Glen: 17067 Merchants Dr, Ruther Glen, VA 22546 | Phone: (804) 220-6044

Website: pacsurgentcare.com