HIPAA Notice of Privacy Practices

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.

Our Commitment to Your Privacy

At AmeriCore Telehealth, we are dedicated to maintaining the privacy and security of your protected health information (PHI). This Notice outlines our legal duties and privacy practices concerning your PHI and explains your rights regarding this information.

Our Responsibilities

We are required by law to:

• Maintain the privacy of your PHI.
• Provide you with this Notice detailing our legal duties and privacy practices.
• Abide by the terms of the Notice currently in effect.
• Notify you in the event of a breach involving your unsecured PHI.

How We May Use and Disclose Your Health Information

The following categories describe different ways we may use and disclose your PHI. Not every use or disclosure in a category is listed, but all are permitted by law:

• Treatment: We may use and share your PHI to provide, coordinate, or manage your healthcare and related services.
• Payment: We may use and disclose your PHI to bill and receive payment for the services we provide to you.
• Healthcare Operations: We may use and disclose your PHI for our healthcare operations, such as quality assessment and improvement activities.

Other Permitted Uses and Disclosures

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

• Public Health and Safety: Reporting disease outbreaks, adverse reactions to medications, or notifying authorities of suspected abuse, neglect, or domestic violence.
• Legal Requirements: Complying with legal proceedings, law enforcement requests, or other lawful processes.

Your Rights Regarding Your Health Information

You have the following rights concerning your PHI:

• Right to Inspect and Copy: You can request to see or obtain a copy of your medical records and other health information we have about you.
• Right to Amend: If you believe the information we have about you is incorrect or incomplete, you can request an amendment.
• Right to an Accounting of Disclosures: You can request a list of certain disclosures we have made of your PHI.
• Right to Request Restrictions: You can ask us to limit the PHI we use or disclose about you for treatment, payment, or healthcare operations.
• Right to Request Confidential Communications: You can request that we communicate with you in a specific way or at a specific location.
• Right to a Paper Copy of This Notice: You can request a paper copy of this Notice at any time.

Changes to This Notice

We reserve the right to change this Notice and make the new provisions effective for all PHI we maintain. The current Notice will be available upon request and on our website at [SITE URL].

Complaints

If you believe your privacy rights have been violated, you can file a complaint with us at:

AmeriCore Telehealth, Privacy Officer
[PRIVACY OFFICER NAME/TITLE]
[BUSINESS ADDRESS]
Email: [PRIVACY EMAIL]
Phone: [PHONE]

You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Contact Information

For questions or more information, please contact:

AmeriCore Telehealth
[BUSINESS ADDRESS]
Email: [SUPPORT EMAIL]
Phone: [PHONE]

External Services Contacts

Our clinical and fulfillment partners maintain their own privacy practices. You may contact them directly:

• Beluga Health (telehealth clinical network / integrations): [email protected]
• Foothills Pharmacy: [CONTACT: CONFIRM IF STILL A PARTNER]
• Promise Pharmacy: [CONTACT: CONFIRM IF STILL A PARTNER]