Notice of Privacy Practices

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

For purposes of this Notice “us” “we” and “our” refers to the Spruce MD, LLC and “you” or “your” refers to our patients (or their legal representatives as determined by us in accordance with state informed consent law). When you receive healthcare services from us, we will obtain access to your medical information (i.e. your health history). We are committed to maintaining the privacy of your health information and we have implemented numerous procedures to ensure that we do so.

The Health Insurance Portability & Accountability Act of 1996 (“HIPAA”) and its implementing regulations require all health care records and other individually identifiable Protected Health Information (“PHI”) used or disclosed to us in any form, whether electronically, on paper, or orally, be kept confidential. This federal law gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse PHI. As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

Uses and Disclosures of Your Health Information
Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice, and any other use required by law.

Treatment

  • We can use your health information and share it with other professionals to provide, coordinate or manage your health care and any related services. This includes the coordination or management of your health care with a third party.
  • Example: Your health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. Additionally, we may disclose your health information to others who may assist in your care, such as other healthcare providers, your spouse, your children or your parents.

Health Care Operations

  • We may use or disclose, as-needed, your health information in order to support the business activities of your physician’s practice, improve your care and contact you when necessary. These activities include, but are not limited to, quality assessment, employee review, training of medical students, licensing and conducting or arranging for other business activities.
  • Example: We use health information about you to evaluate the quality of care you received from us, to develop protocols and clinical guidelines, to develop training programs, and to aid in credentialing, medical review, legal services and insurance. We will share information about you with such insurers or other business associates as necessary to obtain these services. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you.

Payment & Billing for Services

  • We can use and share your health information to bill and get payment from health plans or other entities.
  • Example: We may use and disclose your IHII to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your IIHI to bill you directly for services and items.

Appointment Reminders

  • We may use and disclose your health information to contact you to remind you of your appointment by phone or email.

Treatment Alternatives

  • We may use and disclose your health information to inform you about possible treatment options and health related benefits and services that may be of interest to you.

Fundraising

  • We may use and disclose your health information to contact you in fundraising efforts for Spruce MD and, in the event you prefer to not receive such communications, you are able to opt out of receiving them.

Uses and Disclosures of Your Health Information Without Your Authorization

We may use or disclose your health information in other situations without your authorization. We may give out health information about you for public health purposes, abuse or neglect reporting, research studies, funeral arrangements and organ donation, workers’ compensation purposes, Food and Drug Administration requirements, and emergencies. We also disclose health information when required by law, such as in response to a request from law enforcement in specific circumstances, or in response to valid judicial or administrative orders.

As Required by Law

  • We may disclose your health information when required to do so under federal, state or local law.

For Public Health Activities

  • We may disclose your health information for certain public health activities such as (i) Preventing disease; (ii) Helping with product recalls; (iii) Reporting adverse reactions to medications; (iv) Reporting suspected abuse, neglect, or domestic violence; or (v) Preventing or reducing a serious threat to anyone’s health or safety.

Abuse and Neglect

  • We may disclose your health information to public officials who are authorized by law to receive reports regarding abuse, neglect and domestic violence.

Health Oversight Activities

  • We may disclose your health information to organizations providing oversight of health care facilities and services, such as governmental agencies and benefit programs.

For Legal Proceedings

  • We may disclose your health information in the course of judicial or administrative proceedings, including in response to a subpoena or an order of the court.

For Law Enforcement Purposes

  • We may disclose your health information to law enforcement officers in certain circumstances where we suspect criminal misconduct or to report a crime on our premises or in emergency situations.

To Coroners, Medical Examiners and Funeral Directors

  • We may disclose your health information to coroners or medical examiners for the purpose of identifying a deceased person, determine the cause of death or as otherwise required. We may also disclose your health information to funeral directors as necessary for them to carry out their duties.

For Organ Donation

  • We may disclose your health information about you with organ procurement organizations.

For Research

  • We may disclose your health information to researchers if an institutional review board has approved such disclosures because adequate safeguards have been taken to ensure the protection of your health information.

To Avert Serious Harm

  • We may disclose your health information when necessary to prevent a serious threat to the safety and health of the public or a person, including yourself.

Government Functions

  • We may disclose your health information to military officials if you are an active member of the military or to determine eligibility and/or benefits for veterans. We may also disclose your health information for national security, intelligence activities, the protection of the President, and to determine officials’ suitability to serve in public office. If you are an inmate of a correctional facility, we may disclose your health information to officials at the correctional facility.

Workers’ Compensation

  • We may disclose your health information as authorized to comply with workers’ compensation laws or similar programs that provide benefits for work related injuries or illness.

Situations Requiring Your Authorization Before Disclosure

In the following situations generally we must obtain your authorization before disclosing your health information:

Sale of Protected Health Information

  • We must obtain your authorization prior to selling your health information. If we will obtain financial remuneration for such sale, we must disclose that to you in the authorization.

Psychotherapy Notes

  • Though unlikely to be part of your health information records, if applicable, most uses and disclosures of your psychotherapy notes require your authorization.

Marketing

  • We must obtain your authorization prior to using or disclosing your health information for marketing purposes in most situations. If we will obtain financial remuneration for such marketing, we must disclose that to you in the authorization.

Other Uses and Disclosures of Your Health Information

  • Other uses and disclosures of your health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission in writing at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization, except to the extent that we have already taken action in reliance on your authorization.

Your Rights Regarding Your Health Information

The following are statements of your rights with respect to your health information:

Right to Inspect and Request a Copy of Your Health Information

  • You have the right to inspect and copy health information that we maintain about you. To inspect or copy your health information, you must submit your request in writing. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. If you request an electronic copy, the health information will be provided in the electronic form you request if it is maintained electronically and is readily producible in such form and format. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Please contact our office at the address or telephone number listed on the last page of this document if you have questions about access to your health information.

Right to Request Spruce MD Amend Your Health Information

  • If you feel that the health information we have about you is incorrect or incomplete, you may ask us in writing to amend the information. You have the right to request an amendment for as long as we maintain the information. In addition, you must provide a reason that supports your request. Any agreed-upon correction to your health information will be included as an addition to, and not a replacement of, already existing records. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that (i) is not part of your health information kept by us; (ii) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (iii) is not part of the health information which you would be permitted to inspect and copy; or (iv) is accurate and complete.

Right to Request Restrictions or Limitations of Your Health Information

  • You have the right to request a restriction or limitation of your health information we use or disclose about you for treatment, payment or health care operations and on uses and disclosures for involvement in care and notification purposes. You may also request that any part of your health information not be disclosed to family members, friends or other individuals who may be involved in your care. We are not required to agree to your request unless your request is to restrict disclosure to a health plan for purposes of payment or health care operations when you or someone on your behalf (but not the health plan) has already made full payment. To request restrictions, you must make your request in writing to our office indicated below. In your request, you must tell us (i) what health information you want to limit; (ii) whether you want to limit our use, disclosure or both; and (iii) to whom you want the limits to apply.

Right to Request Confidential Communications

  • You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. We will accommodate reasonable requests. We will not ask you the reason for your request. Please make this request in writing to our office indicated below.

Right to an Accounting of Disclosures

  • You have the right to request an accounting of disclosures of your health information made by us in the six (6) years prior to the date that the accounting is requested (or shorter period as requested). We will include all disclosures except for those (i) to carry out treatment, payment, or health care operations; (ii) made to you or pursuant to your authorization; (iii) for national security or intelligence purposes; or (iv) to corrections institutions or law enforcement officials.
  • Your first request for an accounting in any twelve (12) month period shall be provided without charge. A reasonable fee shall be imposed for each subsequent request for an accounting within the same twelve (12) month period.

Right to Breach Notification

  • We are required by law to maintain the privacy of your health information and to provide you with notice of our legal duties and privacy practices with respect to your health information. We are also required by law to notify affected individuals following a breach of unsecured health information.

Right to Request a Paper Copy of This Notice

  • You have the right to obtain a paper copy of this notice from us at any time even if you have agreed to receive the notice electronically. You may also obtain a copy of this notice on our website, spruce.md.

Right to File a Complaint

  • You have the right to complain to Spruce MD or to the Secretary of Health and Human Services (“HHS”) if you believe your privacy rights have been violated. You may file a complaint with us by notifying our HIPAA Privacy Officer at the address or phone number below. Filing a complaint will not affect your health care services in any way.

We reserve the right to change the terms of this notice for all records and will inform you by posting the revised notice in the waiting area of our office and on our website, spruce.md.

If you have any questions or complaints, please contact our office at:

Spruce MD
Attn: Privacy Officer
141 Traction Street
Greenville, South Carolina 29611