Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

This Notice of Privacy Practices describes how your medical information may be used and disclosed, along with how you can access to this information. Please review it carefully.

Your Rights

You have the right to:

• Get a copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
• Correct your medical record. You can ask us to correct health information you believe is incorrect or incomplete.
• Request confidential communications. You can ask us to contact you in a specific way (e.g. at a home or office phone) or send mail to a different address.
• Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations.
• Get a list of those with whom we’ve shared information. You can ask for a list of the times we’ve shared your health information, who we shared it with, and why.
• Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time.
• Choose someone to act for you. If you have a medical power of attorney or have a legal guardian, that person can exercise your rights and make choices about your health information.
• File a complaint if you feel your rights are violated. You can file a complaint if you feel we have violated your rights by contacting us directly or the U.S. Department of Health and Human Services.

Your Choices

You can choose how we use and share your information in the following situations:

• Sharing information with your family, close friends, or others involved in your care
• Sharing information in a disaster relief situation
• Including your information in a hospital directory
• Using your information for fundraising purposes (with the option to opt-out)

Our Uses and Disclosures

We may use or share your information for the following purposes:

• Treatment: to provide and coordinate your healthcare services.
• Payment: to bill and receive payment for your healthcare services.
• Healthcare Operations: to improve our services and ensure quality care.
• Research: for health research, with your consent where required.
• Public Health and Safety: to prevent disease, report adverse reactions to medications, or report suspected abuse or neglect.
• Law Enforcement and Legal Requirements: to comply with laws and legal proceedings.
• Organ and Tissue Donation: to support organ or tissue donation requests.
• Worker’s Compensation: to process claims under workers’ compensation programs.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information (PHI).
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We will not use or share your information except as described in this notice unless you tell us we can in writing.

Questions or Complaints?

If you have any questions about this notice or believe your privacy rights have been violated, you may contact:

Privacy Officer
HaloScrips
266 S. Cleveland St. Ste 203, Memphis, TN 38104
800.901.4195
[email protected]

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Filing a complaint will not affect your care.

Visit: HHS.gov for instructions
Call: 1-800-368-1019
Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201