Notice of Privacy Practices

Your Rights

You have the following rights regarding your protected health information. To exercise any of these rights, contact our Privacy Officer.

Get a Copy of Your Health Information

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide it within the time allowed by law and may charge a reasonable, cost-based fee.

Ask Us to Correct Your Information

You can ask us to correct health information you believe is wrong or incomplete. We may deny your request in certain cases, but we will explain our decision in writing.

Request Confidential Communications

You can ask us to contact you in a specific way or at a certain location. We will accommodate reasonable requests as required by law.

Ask Us to Limit What We Use or Share

You can ask us not to use or share certain information for treatment, payment, or healthcare operations. We generally do not have to agree. If you pay in full out-of-pocket for a service or item, you can ask us not to share that information with your health plan for payment or healthcare operations. We will agree unless a law requires us to share it.

Get a List of Disclosures

You can ask for an accounting of certain disclosures of your health information made during the six years before your request. The accounting excludes treatment, payment, healthcare operations, and certain other disclosures. We provide one accounting in any 12-month period for free and may charge a reasonable, cost-based fee for additional accountings.

Get a Copy of This Notice

You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

Choose Someone to Act for You

If someone has legal authority to act for you, such as a legal guardian or a person acting under a valid medical power of attorney, that person may exercise your rights after we verify the authority.

File a Complaint

You may complain to AXIS Dermatology or to the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights were violated. We will not retaliate against you for filing a complaint.

Your Choices About Sharing Your Information

You can tell us your preferences about how we share your information.

• You can ask that we not contact you for fundraising. You have the right to opt out, and we will honor your request.
• You can tell us your preferences about sharing information with family, close friends, or others involved in your care or payment for your care. If you cannot tell us your preference, we may share information when permitted by law and when we believe doing so is in your best interest or is needed to lessen a serious and imminent threat to health or safety.

When Authorization Is Required

We will obtain your written authorization before using or sharing your information when authorization is required by law, including:

• Most uses of psychotherapy notes
• Most uses or disclosures for marketing
• The sale of your health information

If we use Part 2-protected information for fundraising, you will receive clear and obvious advance notice and a choice about whether to receive those communications. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Additional Privacy Protections

Some information is protected by additional federal or Georgia confidentiality laws, including certain HIV/AIDS information and substance use disorder records. When an applicable law provides greater privacy protection than HIPAA, AXIS Dermatology will use and disclose that information only as permitted or required by that law. Georgia law provides additional confidentiality protections for certain HIV/AIDS information within the physician-patient relationship, subject to statutory exceptions.

How We May Use and Share Your Information

For Treatment

We can use and share your information to provide, coordinate, or manage your medical care.

Example: We may share information with other healthcare professionals involved in your treatment.

For Payment

We can use and share your information to bill and obtain payment for services.

Example: We may send information to your insurance plan so it can process and pay a claim.

For Healthcare Operations

We can use and share information to run our practice, improve care, train staff, conduct compliance activities, and manage our services.

Example: We may review records for quality improvement, auditing, compliance, or business planning.

Other Uses and Disclosures Permitted or Required by Law

We may use or share your information without your authorization when permitted or required by law, subject to applicable conditions and limits. Examples include:

• Public health and safety activities
• Health oversight activities
• Law enforcement or government requests
• Legal proceedings and subpoenas
• Research when approved as required by law
• Serious threats to health or safety
• Workers’ compensation
• Organ and tissue donation
• Coroners, medical examiners, and funeral directors
• Compliance with federal, state, or local law

Information disclosed as permitted by HIPAA may, in some circumstances, be redisclosed by the recipient and may no longer be protected by HIPAA. Other federal or state privacy laws may continue to apply.

Substance Use Disorder Records (42 CFR Part 2)

To the extent AXIS Dermatology creates or maintains substance use disorder patient records protected by 42 CFR Part 2, those records receive additional protections.

We will not use or disclose Part 2 records, or testimony describing their contents, in civil, criminal, administrative, or legislative investigations or proceedings against you unless permitted by Part 2, including with your written consent or the required court order and subpoena.

Our Responsibilities

• Protect the privacy and security of your protected health information.
• Provide you with this notice of our legal duties and privacy practices.
• Notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
• Follow the duties and privacy practices described in the notice currently in effect.
• Not use or share your information other than as described in this notice unless you authorize us in writing or the law permits or requires it.

Changes to This Notice

We can change the terms of this notice. The new notice may apply to all information we maintain, including information created or received before the change. The current notice will be available upon request, in our office, and on our website.

Questions?

Contact our Privacy Officer:

THIS NOTICE IS AVAILABLE IN OUR OFFICE AND ON OUR WEBSITE. A current copy is available upon request at any time.

This notice applies to protected health information created or maintained by AXIS Dermatology, LLC. It does not create rights or restrictions beyond those required by applicable law.