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.

ClearView Medical Associates-TX, P.C. (the "Practice," "we," "us") is a Texas professional corporation and a virtual medical practice. This Notice explains how we may use and share your protected health information ("health information") and describes your rights under HIPAA and Texas law.

Your rights

Get a 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.
• We will provide a copy or summary within 30 days. Under Texas law, if you request records we maintain electronically, we will provide them within 15 business days of a written request.
• We may charge a reasonable, cost-based fee within the limits set by federal and Texas law.

Ask us to correct your medical record

• You can ask us to correct information you believe is incorrect or incomplete.
• We may say "no," but we will tell you why in writing within 60 days, and you may submit a statement of disagreement to be kept with your record.

Request confidential communications

• You can ask us to contact you in a specific way or at a specific number or address. We will say "yes" to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain information for treatment, payment, or our operations. We are not required to agree, and may say "no" if it would affect your care.
• If you pay for a service in full out of pocket, you can ask us not to share information about it with your health plan. We will say "yes" unless a law requires us to share it.

Get a list of those with whom we have shared your information

• You can ask for an accounting of disclosures we made in the six years before your request.
• It excludes disclosures for treatment, payment, and health care operations and certain others. One accounting per 12 months is free; we may charge a reasonable fee for additional requests.

Other rights

• Get a paper copy of this Notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. If you have given someone a medical power of attorney or someone is your legal guardian, that person can exercise your rights. We will confirm their authority first.
• Be notified promptly if a breach occurs that may have compromised your information.

File a complaint if you believe your rights were violated

• Contact us using the information at the end of this Notice. We will not retaliate against you for filing a complaint.
• You may file with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue S.W., Washington, D.C. 20201, 1-877-696-6775, or www.hhs.gov/ocr/privacy/hipaa/complaints.
• You may also file with the Office of the Texas Attorney General at www.texasattorneygeneral.gov, or the Texas Medical Board at 1-800-201-9353 or www.tmb.state.tx.us.

Your choices

You have both the right and the choice to tell us to share information with your family, close friends, or others involved in your care or payment for your care, or in a disaster relief situation. If you are not able to tell us your preference, for example, if you are unconscious, we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We never share your information for marketing purposes, sell your information, or share psychotherapy notes without your written permission. We do not conduct fundraising.

How we typically use or share your health information

• To treat you - we share information with other professionals treating you. For example, we conduct telemedicine visits, review readings from your home monitoring device, share your care plan with your primary care physician or specialist, send prescriptions to your pharmacy, and communicate with laboratories.
• To run our organization - for quality assessment, care coordination, credentialing, compliance, training, and business management. This includes sharing information with our business associates, who perform administrative, technology, billing, and data services for us under written agreements requiring them to protect it.
• To bill for your services - to submit claims to Medicare or your health plan, provide documentation required for reimbursement, obtain prior authorization, and respond to payer audits.
• To contact you about your care - appointment reminders, care coordination messages, treatment options, and monitoring alerts, by phone, text, email, or portal, consistent with the preferences you give us.

How else we may 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, and only when we meet the conditions in the law:

• Public health and safety - preventing disease, product recalls, adverse drug reactions, reporting suspected abuse, neglect, or domestic violence, and reducing a serious threat to health or safety;
• Health research, under conditions required by law;
• Complying with the law, including with HHS to verify our compliance with federal privacy law;
• Organ and tissue donation requests, and working with a medical examiner or funeral director;
• Workers compensation, law enforcement, health oversight, and special government functions; and
• Responding to a court or administrative order or a subpoena under conditions required by law.

Information with extra protection

Some information has additional protection under federal or Texas law, and we will not disclose it except as those laws allow. This includes substance use disorder treatment records (42 C.F.R. Part 2), mental health records (Texas Health and Safety Code Ch. 611), HIV test results (Texas Health and Safety Code Ch. 81), genetic information, and reproductive health care information.

Electronic disclosure of your health information

As required by Texas law, we are notifying you that your health information is subject to electronic disclosure. We create and maintain your records electronically and use secure electronic systems to deliver telemedicine and remote monitoring.

We may disclose your health information electronically for treatment, payment, and health care operations, and as otherwise authorized or required by law. We will obtain your written authorization before disclosing it electronically for any other purpose. Our systems use access controls, encryption, and audit logging. No electronic system can be guaranteed completely secure.

Our responsibilities

• We are required by law to maintain the privacy and security of your health information.
• We will notify you promptly if a breach occurs that may have compromised it.
• 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 in writing that we may. You can change your mind at any time in writing.

Changes to 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 on request, posted where we deliver services, and posted on our website.

Contact us

Privacy Officer, ClearView Medical Associates-TX, P.C.
206 Wild Basin Road S., Building A, Suite 208, Austin, TX 78746
Phone: (325) 603-3617
Email: privacy@clearviewmedicalassociates.com