THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

OUR COMMITMENT TO YOUR PRIVACY

Southern Indiana Family Practice Center ("SIFPC") is committed to protecting the privacy and confidentiality 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 Privacy Practices, and follow the terms of this notice currently in effect.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

For Treatment

We may use and disclose your health information to provide, coordinate, and manage your healthcare.

This includes sharing information with physicians, specialists, hospitals, pharmacies, laboratories, and other healthcare providers involved in your care.

For Payment

We may use and disclose your health information to bill and collect payment for services provided. This includes sharing information with insurance companies, health plans, Medicare, Medicaid, and other payers.

For Healthcare Operations

We may use and disclose your information for practice operations, including quality assessment, employee training, credentialing, licensing, audits, compliance activities, and business management functions.

Appointment Reminders

We may contact you by phone, voicemail, text message, patient portal, email, or mail regarding appointments, treatment recommendations, test results, or follow-up care.

Health-Related Services

We may use your information to inform you about treatment options, health-related benefits, wellness services, or preventive care recommendations that may be of interest to you.

Individuals Involved in Your Care

Unless you object, we may share relevant information with family members, caregivers, or other persons involved in your care or payment for your care.

Required by Law

We may disclose health information when required by federal, state, or local law.

Public Health Activities

We may disclose information for public health purposes including disease prevention, reporting communicable diseases, adverse drug events, and other public health activities.

Health Oversight Activities

We may disclose information to government agencies conducting audits, inspections, investigations, and licensing activities.

Law Enforcement and Legal Proceedings

We may disclose information in response to court orders, subpoenas, warrants, or other legal processes when permitted or required by law.

Workers' Compensation

We may disclose information as authorized by workers' compensation laws and similar programs.

Research

Certain disclosures may be made for approved research activities as permitted by law.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the right to:

• Request access to your medical records.

• Request a copy of your medical records.

• Request an amendment to your records if you believe information is incorrect.

• Request restrictions on certain uses or disclosures.

• Request confidential communications by alternative means or locations.

• Receive an accounting of certain disclosures of your health information.

• Obtain a paper copy of this Notice upon request.

• File a complaint if you believe your privacy rights have been violated.

OUR RESPONSIBILITIES

Southern Indiana Family Practice Center is required to:

• Maintain the privacy and security of your protected health information.

• Notify you following a breach of unsecured protected health information when required by law.

• Follow the duties and privacy practices described in this Notice.

• Provide you with a copy of this Notice.

CHANGES TO THIS NOTICE

We reserve the right to revise this Notice at any time. Any revised Notice will apply to all protected health information maintained by our practice. The current version will be available in our office and upon request.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

Privacy Officer

Southern Indiana Family Practice Center

1403 E Atwater Ave

Bloomington, IN 47401

Phone: (812) 339-6744

You may also file a complaint with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

CONTACT INFORMATION

If you have questions regarding this Notice or your privacy rights, please contact: