Notice of Privacy Practices
This Notice is effective January 1, 2025
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.
Contents of Our Notice of Privacy Practices
This Notice will explain:
-
Your rights with respect to medical information about you.
-
How we may use and disclose medical information about you.
-
How and where you may file a privacy-related complaint.
-
Our legal responsibilities as a practice.
If, at any time, you have questions about information in this Notice or about our privacy policies, procedures or practices, you may contact our HIPAA Privacy Officer, Andrew Ting, at (978) 699-3481.
A Brief Summary of the Health Insurance Portability and Accountability Act (HIPAA)
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects your medical information by:
-
Ensuring the confidentiality, integrity, and availability of your health records.
-
Regulating how healthcare providers, insurance companies, and business associates use or disclose your protected health information (PHI).
-
Granting you specific rights to access, amend, and control how your information is shared.
HIPAA also establishes safeguards to secure your PHI, prevent breaches, and requires notification if a breach occurs. Violations can result in fines and penalties.
Your Rights Under HIPAA
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an Electronic or Paper 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.
-
For medical records requests, submit a Medical Records Request through our partner, HealthMark Group, by filling out a form at requestmanager.healthmark-group.com.
-
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask Us to Correct Your Medical Record
-
You can ask us to correct health information about you that you think is incorrect or incomplete by submitting this form.
-
We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request Confidential or Alternative Communications
-
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
-
We will accommodate all reasonable requests.
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. We are not required to agree to your request, and we may say “no” if it would affect your care.
-
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a List of Those with Whom We’ve Shared Information
-
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
-
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a Copy of this Privacy Notice
-
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.
-
We will provide you with a paper copy promptly.
-
Certain document fees may apply. Contact our Medical Records Team or HIPAA officer for more information.
Choose Someone to Act for You
-
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
-
We will make sure the person has this authority and can act for you before we take any action.
File a Complaint if You Feel Your Rights are Violated
If you believe your privacy rights have been violated, you may file a complaint with us or with the federal government.
-
You can file a complaint with our office directly by contacting our HIPAA Officer, Andrew Ting, either by sending a letter Attn: MFM HIPAA Privacy Officer, MFM Health, 147 S Main St, Middleton, MA 01949 or by calling 1-978-624-7129.
-
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
-
We will not retaliate against you for filing a complaint.
Your Choices Under HIPAA
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
-
Share information with your family, close friends, or others involved in your care
-
Share information in a disaster relief situation
-
Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
-
Marketing purposes
-
Sale of your information
-
Most sharing of psychotherapy notes
In the case of fundraising:
-
We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Communication Methods
How do we communicate with you?
To ensure you receive all relevant information and updates about your healthcare and our practice, we will communicate with you in two ways:
-
Patient-Specific Notifications
-
These include appointment reminders, follow-ups, and notifications about gaps in care. These communications are essential to your healthcare and cannot be opted out of. However, you can manage how you receive these notifications by updating your preferences in the patient portal.
-
-
General Newsletters and Update
-
These optional communications provide information about our services, upcoming events, and health-related education. You can opt-out of receiving these messages at any time by clicking the opt-out link included in the email
-
Our Uses and Disclosures
How do we typically use or share your health information?
We use and disclose your medical information in the following ways:
Treatment
We use your information to provide, coordinate, or manage your healthcare and share it with others involved in your care.
-
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Billing and Payments
We use and share your information to bill and receive payment for healthcare services.
-
Example: We give information about you to your health insurance plan so it will pay for your services.
Healthcare Operations
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
-
Example: We use health information about you to manage your treatment and services.
Persons Involved in Your Care
We may share information with family, friends, or caregivers involved in your care with your written consent.
-
Example: Discussing medications with a spouse who assists you.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with Public Health and Safety Issues
We can share health information about you for certain situations such as:
-
Preventing disease
-
Helping with product recalls
-
Reporting adverse reactions to medications
-
Reporting suspected abuse, neglect, or domestic violence
-
Preventing or reducing a serious threat to anyone’s health or safety
Conduct Research
We can use or share your information for health research.
Comply with the Law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to Organ and Tissue Donation Requests
We can share health information about you with organ procurement organizations.
Work with a Medical Examiner or Funeral Director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address Workers’ Compensation, Law Enforcement, and Other Government Requests
We can use or share health information about you:
-
For workers’ compensation claims
-
For law enforcement purposes or with a law enforcement official
-
With health oversight agencies for activities authorized by law
-
For special government functions such as military, national security, and presidential protective services
Respond to Lawsuits and Legal Actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
-
We are required by law to maintain the privacy and security of your protected health information.
-
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
-
We must follow the duties and privacy practices described in this notice and give you a copy of it.
-
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Contact Information
For questions, concerns, or requests about any information contained in this notice, including our privacy policies, procedures or practices, please use the following contact information:
-
HIPAA Privacy Officer: Andrew Ting at 978-624-7129.
For medical records requests, submit a Medical Records Request through our partner, HealthMark Group by filling out a form at requestmanager.healthmark-group.com.
For more information about your care at our practice, please visit our website at www.mfmhealth.com.