HIPAA Notice of Privacy Practices

Your Privacy Rights

Under the Health Insurance Portability and Accountability Act (HIPAA), you have the right to:

• Access, inspect, and obtain a copy of your health records
• Request amendments or corrections to your medical records
• Request restrictions on how your health information is used and disclosed
• Request confidential communications of your health information
• Receive an accounting of disclosures of your health information
• Revoke your authorization for use or disclosure of health information
• File a complaint if you believe your privacy rights have been violated

How We Use and Disclose Your Health Information

For Treatment

We use your health information to provide medical care, diagnose conditions, plan treatment, and refer you to specialists. Your information may be shared with other healthcare providers involved in your care, such as hospitals, imaging centers, or laboratories.

For Payment

We use your health information to bill your insurance company or request payment from you. This includes sending your information to your health plan, clearing houses, or other entities involved in payment processing and insurance claims.

For Healthcare Operations

We use your health information for business operations, including:

• Scheduling appointments and managing patient flow
• Communicating with you about appointment reminders and test results
• Evaluating quality of care and provider performance
• Training staff and improving our systems
• Complying with legal and regulatory requirements
• Protecting against fraud and abuse

For Other Uses and Disclosures

We may use or disclose your health information:

• Public Health Activities: Reporting disease, injury, disability, or response to public health emergencies
• Law Enforcement: When legally required by subpoena, court order, or other legal process
• Health and Safety: To prevent or lessen a serious threat to health or safety
• Workers' Compensation: For workers' compensation claims and related proceedings
• Organ Procurement: To organizations engaged in procurement, banking, or transplantation of organs or tissues
• Research: For research purposes with appropriate safeguards and authorization
• Family Members: We may share information with family members or friends involved in your care, unless you object

Our Privacy Practices

Safeguards

Riverstone Urology Specialists maintains physical, technical, and administrative safeguards to protect your health information, including secure electronic systems, limited staff access, and confidentiality agreements with employees and contractors.

Minimum Necessary

We limit our use and disclosure of your health information to the minimum necessary to accomplish the intended purpose. Staff members are trained to access only the information required for their specific job duties.

Business Associates

We may share your health information with business associates (such as billing companies, IT vendors, or medical records storage services) who perform services on our behalf. All business associates are bound by confidentiality agreements to protect your information.

Your Rights and How to Exercise Them

Right to Access

You have the right to access and obtain a copy of your health records. To request access, contact our office in writing. We will respond to your request within 30 days. If we deny your request, we will provide a written explanation and instructions on how to appeal.

Right to Amend

You may request that we amend information in your health record if you believe it is inaccurate or incomplete. Submit your request in writing to our office. We will respond within 60 days and may deny your request only if we did not create the information, or if we determine that the amendment would not be accurate.

Right to Restrict Use

You have the right to request restrictions on how we use or disclose your health information. However, we are not required to agree to all requests. Contact us in writing to request restrictions.

Right to Confidential Communication

You may request that we communicate with you about your health information at a different address or by alternative means. We will accommodate reasonable requests at no cost.

Right to an Accounting

You have the right to request an accounting of disclosures we have made of your health information. We will provide one accounting per year at no charge. Additional requests may incur a reasonable fee.

Right to Revoke Authorization

You may revoke authorization for use or disclosure of your health information at any time by providing written notice. Revocation will not apply to information already used or disclosed in reliance on the authorization.

Changes to This Notice

We reserve the right to modify this notice at any time. Changes become effective as noted in the revised notice. We will provide updated notices to all patients, and the effective date will be documented.

Contact Information & Complaints

For Questions About This Notice

If you have questions about this HIPAA Notice of Privacy Practices, contact:

To File a Privacy Complaint

If you believe your privacy rights have been violated, you have the right to file a complaint with Riverstone Urology Specialists or with the U.S. Department of Health and Human Services Office for Civil Rights (OCR). Filing a complaint will not affect your treatment or benefits. To file a complaint with our office, contact the information provided above. To file a complaint with the OCR, visit www.hhs.gov/ocr/privacy/hipaa/complaints/.

Acknowledgment

By receiving healthcare services at Riverstone Urology Specialists, you acknowledge that you have received a copy of this Notice of Privacy Practices or have been offered one. You are provided with this notice at your first encounter, and you may request a copy at any time.