HIPAA Notice of Privacy Practices

This Notice of Privacy Practices describes how Pittsburgh Physical Medicine ("we," "our," or "the Practice") may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations, and for other purposes permitted or required by law. It also describes your rights regarding your own health information.

Please review this notice carefully. You have the right to request a paper copy of this notice at any time.

Our Responsibilities

We are required by law to:

• Maintain the privacy of your protected health information
• Provide you with this notice of our legal duties and privacy practices
• Notify you following a breach of your unsecured protected health information
• Abide by the terms of this notice currently in effect

How We May Use and Disclose Your Health Information

Treatment

We may use or disclose your PHI to provide, coordinate, or manage your healthcare and related services. For example, we may share your health information with other treating providers (such as specialists or hospitals) to coordinate your care.

Payment

We may use and disclose your PHI to obtain payment for services provided to you. For example, we may share information with your health insurance company (UPMC, Highmark BCBS, Aetna, United Healthcare, or others) to verify coverage and obtain reimbursement for treatment.

Health Care Operations

We may use and disclose your PHI in connection with our healthcare operations, including quality assessment, staff training, business planning, and other administrative functions necessary to run our practice.

Other Permitted Uses and Disclosures

We may also use or disclose your PHI without your specific authorization in the following circumstances:

• As required by law — including court orders, subpoenas, or other legal processes
• Public health activities — to public health authorities for disease prevention and control
• Abuse or neglect reporting — to government authorities authorized to receive reports of abuse or neglect
• Health oversight activities — to government agencies for audits, inspections, and licensure
• Serious threats to health or safety — to prevent or lessen a serious and imminent threat
• Workers' compensation — as authorized by state law for workers' compensation programs

Uses and Disclosures Requiring Your Authorization

Other than the situations described above, we will not use or disclose your PHI without your written authorization. This includes:

• Marketing purposes
• Sale of your health information
• Psychotherapy notes (if applicable)
• Any other uses or disclosures not described in this notice

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Your Rights Regarding Your Health Information

Right to Access

You have the right to inspect and receive a copy of your PHI that is contained in a designated record set. We will respond to your request within 30 days. We may charge a reasonable fee for copies.

Right to Amend

You have the right to request an amendment to your PHI if you believe it is inaccurate or incomplete. We may deny your request under certain circumstances but will provide a written explanation.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures we have made of your PHI (other than for treatment, payment, or operations) within the past 6 years.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to all restrictions, but if we do agree, we will comply with the restriction (except in emergency situations).

Right to Confidential Communications

You have the right to request that we communicate with you in a specific way or at a specific location (for example, only by mail to a certain address). We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice at any time, even if you have received an electronic copy.

Changes to This Notice

We reserve the right to change this notice at any time. If we make material changes, we will post the new notice in our office and on our website. The new notice will apply to all PHI we maintain at that time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized for filing a complaint. To file a complaint with HHS, visit hhs.gov/ocr/privacy or call 1-800-368-1019.