I. MGA Covered by this Notice

This Notice was last revised on August 30, 2022.

A. Right to Access and Review

You may request to access and review a copy of your information. We may deny your request under certain circumstances. You will receive written notice of a denial and can appeal it. We will provide a copy of your information in a format you request if it is readily producible. If not readily producible, we will provide it in a hard copy format or other format that is mutually agreeable.

B. Right to Amend

If you believe that your information is incorrect or incomplete, you may request that we amend it. We may deny your request under certain circumstances. You will receive written notice of a denial and can file a statement of disagreement that will be included with your information that you believe is incorrect or incomplete.

C. Right to Confidential Communications, Alternative Means and Locations

You may request to receive communications of information by alternative means or at an alternative location. We will accommodate a request if it is reasonable and you indicate that communication by regular means could endanger you. When you submit a written request to the Privacy Official listed on the first page of this Notice, you need to provide an alternative method of contact or alternative address and indicate how payment for services will be handled.

D. Right to a Paper Copy of this Notice

You have the right to a paper copy of this Notice. You may ask us to give you a paper copy of the Notice at any time (even if you have agreed to receive the Notice electronically). To obtain a paper copy, ask the Privacy Official.

E. Right to Receive Notification of a Security Breach

We are required by law to notify you if the privacy or security of your information has been breached. The notification will occur by first class mail within sixty (60) days of the event. A breach occurs when there has been an unauthorized use or disclosure under HIPAA that compromises the privacy or security of your health information.

The breach notification will contain the following information: (1) a brief description of what happened, including the date of the breach and the date of the discovery of the breach; (2) the steps you should take to protect yourself from potential harm resulting from the breach; and (3) a brief description of what we are doing to investigate the breach, mitigate losses, and to protect against further breaches.

V. Our Right to Change Our Privacy Practices and This Notice

We reserve the right to change the terms of this Notice at any time. Any change will apply to the health information we have about you or create or receive in the future. We will promptly revise the Notice when there is a material change to the uses or disclosures, individual’s rights, our legal duties, or other privacy practices discussed in this Notice. We will post the revised Notice on our website (if applicable) and in our office and will provide a copy of it to you on request. The effective date of this Notice is 08/30/2022.

VI. How to Make Privacy Complaints

If you have any complaints about your privacy rights or how your information has been used or disclosed, you may file a complaint with us by contacting our Privacy Official listed on the first page of this Notice.