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 Duties
Geneva Family Medicine & Aesthetics LLC, doing business as GENEVA Primary Care & Med Spa (“GENEVA,” “we” or “us”), is required by law to maintain the privacy of your protected health information (“health information”), to give you this notice of our legal duties and privacy practices, to notify you if a breach of your unsecured health information occurs, and to follow the terms of the notice currently in effect. This notice applies to all health information created or received by GENEVA, including by our physicians, nurse practitioners, physician assistants, nurses, aestheticians and staff, at our office and through telehealth.
We may change the terms of this notice, and the change will apply to all health information we have about you. The new notice will be available on request, in our office and on our website.
How We May Use and Share Your Health Information
Treatment
We use and share your health information to provide and coordinate your care. For example, a clinician may review your medical history before a treatment, send a prescription to a pharmacy, order laboratory tests, or share information with another provider involved in your care.
Payment
We use and share your health information to bill and collect payment for services. For example, we may use your information to process a payment or prepare an itemized receipt you can submit to an insurer or health savings account. We do not bill health insurance.
Health Care Operations
We use and share your health information to run our practice, improve care and contact you when necessary. For example, we may use information to review the quality of care, train staff, conduct audits, obtain legal or accounting services, and manage our business.
Appointment Reminders and Health-Related Communications
We may contact you by phone, text message, email or mail to remind you of appointments, share results, follow up on care, and tell you about treatment alternatives or health-related services we offer. You may ask us to contact you in a particular way (see “Your Rights” below).
Business Associates
We share health information with vendors that perform services for us, such as our electronic health record, scheduling, payment, laboratory and communication vendors. They must sign a business associate agreement and protect your information as HIPAA requires.
People Involved in Your Care
Unless you object, we may share information with a family member, friend or other person you identify who is involved in your care or in paying for it, or to notify them of your location or condition. If you are not present or cannot agree, for example in an emergency, we may share information if we believe it is in your best interest.
Other Uses and Disclosures Permitted or Required by Law
We may use or share your health information without your written authorization in these situations, subject to the conditions the law sets:
- As required by law, including to the U.S. Department of Health and Human Services to show we comply with HIPAA.
- Public health and safety: to prevent or control disease, report births and deaths, report adverse reactions to medications or products to the FDA, report product recalls, and notify a person who may have been exposed to a communicable disease.
- Abuse, neglect or domestic violence: to report suspected abuse, neglect or domestic violence to the appropriate authorities.
- Health oversight: to agencies for audits, investigations, inspections and licensure, such as the Georgia Composite Medical Board.
- Lawsuits and legal proceedings: in response to a court or administrative order, or a subpoena or other lawful process, subject to legal protections.
- Law enforcement: for certain law enforcement purposes, such as to identify or locate a suspect, fugitive, witness or missing person, or to report a crime on our premises.
- Coroners, medical examiners and funeral directors, and organ and tissue donation organizations.
- Research: under limited circumstances approved by a privacy board or institutional review board.
- Serious threat to health or safety: to prevent or lessen a serious and imminent threat to a person or the public.
- Specialized government functions: for military, national security, intelligence and protective services, and correctional institutions, as authorized by law.
- Workers’ compensation: as authorized by workers’ compensation laws.
Uses and Disclosures That Require Your Written Authorization
We will not do any of the following without your written authorization:
- use or share psychotherapy notes, except as the law permits;
- use or share your health information for marketing, except for face-to-face communications or promotional gifts of nominal value;
- sell your health information;
- use your photographs, name, testimonial or story in advertising, on our website or on social media.
Other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.
Georgia Law
Georgia law gives some types of information extra protection, including information about HIV/AIDS, genetic testing, mental health and substance use treatment. Where Georgia or other federal law is more protective of your privacy than HIPAA, we follow the more protective law. For example, we will disclose AIDS confidential information or genetic testing results only as Georgia law allows.
Fundraising
We do not use your health information for fundraising.
Your Rights
You have the following rights regarding your health information. To exercise them, contact our Privacy Officer using the information at the end of this notice.
- 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 it, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
- Ask us to correct your medical record. You can ask us to correct health information you think is incorrect or incomplete. We may say “no,” but we will tell you why in writing within 60 days.
- Request confidential communications. You can ask us to contact you in a specific way (for example, by mobile phone only) or at a different 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 health information for treatment, payment or our operations. We are not required to agree, and we may say “no” if it would affect your care. If you pay for a service or item out of pocket in full, you can ask us not to share that information with a health plan, and we will agree unless a law requires us to share it.
- Get a list of those with whom we’ve shared information. You can ask for a list (accounting) of the times we’ve shared your health information in the six years before your request, who we shared it with and why. It will not include disclosures for treatment, payment and operations and certain others. We provide one accounting a year free, and may charge a reasonable, cost-based fee for more.
- Get a copy of this notice. You can ask for 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 medical power of attorney or someone is your legal guardian, that person can exercise your rights. We will confirm the person has this authority before we act.
- Be notified of a breach. You will be notified if a breach occurs that may have compromised the privacy or security of your information.
Complaints
If you believe your privacy rights have been violated, you can file a complaint with us by contacting our Privacy Officer below. You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.
Contact Information
Privacy Officer: Megha Jerath
Geneva Family Medicine & Aesthetics LLC
3275 North Point Pkwy, Suite 204
Alpharetta, Georgia 30005
Phone: (470) 704-9687
Email: megha@geneva-med.com
This notice is also available at our front desk. For how we handle information collected through our website, see our Privacy Policy.