Life MD does not replace the primary care physician. Life MD does not guarantee that a prescription will be written. Life MD operates subject to state regulation and may not be available in certain states. Life MD may not prescribe controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Life MD physicians reserve the right to deny care for potential misuse of services.
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 INFORMAITON. PLEASE REVIEW IT CAREFULLY.
Life MD’s Commitment to Your Privacy
Life MD is dedicated to maintaining the privacy of your protected health information (“PHI”). PHI is information about you that may be used to identify you (such as your name, social security number or address), and that relates to (a) your past, present, or future physical or mental condition, (b) the provision of health care to you, or (c) your past, present or future payment for the provision of health care. In conducting its business, Life MD will receive and create records containing your PHI. Life MD is required by law to maintain the privacy of your PHI and to provide with you with notice of its legal duties and privacy practices with respect your PHI.
Life MD must abide by the terms of this Notice while it is in effect. This current Notice takes effect on July 17, 2015 and will remain in effect until Life MD replaces it. Life MD reserves the right to change the terms of this Notice at any time, as long as the changes are in compliance with applicable law. If Life MD changes the terms of this Notice, the new terms will apply to all PHI that it maintains, including PHI that was created or received before such changes were made. If Life MD changes this Notice, it will post the new Notice on its website and will make the Notice available upon request.
USE AND DISCLSOURES OF PHI
Life MD may use and disclose your PHI in the following ways:
1. Treatment, Payment and Health Care Operations. Life MD is permitted to use and disclose your PHI for the purposes of (a) treatment, (b) payment and (c) health care operations. For example:
- Treatment. Life MD may disclose your PHI to another physician or health care provider for purposes of a consult or in connection with the provisions of follow-up treatment.
- Payment. Life MD may use and disclose your PHI to your health insurer or health plan in connection with the processing and payment of claims and other charges.
- Health Care Operations. Life MD may use and disclose your PHI in connection with its health care operations such as providing customer service and conducting quality review assessments. Life MD may engage third parties to provide various services for Life MD. If any such third party to enter an agreement that binds the third party to the use and disclosure restrictions outlined in this Notice.
2. Authorization. Life MD is permitted to use and disclose your PHI upon your written authorization, to the extent such use or disclosure is consistent with your authorization. You may revoke any authorization at any time.
3.As Required by Law. Life MD may use and disclose your PHI to the extent required by law.
The following categories describe unique circumstances in which Life MD may use or disclose your PHI:
- Public Health Activities. Life MD may disclose your PHI to public health authorities or other governmental authorities for purposes including preventing and controlling disease, reporting child abuse or neglect, reporting domestic violence and reporting to the Food and Drug Administration regarding the quality, safety and effectiveness of a regulated product or activity. Life MD may, in certain circumstances disclose PHI to person who have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition.
- Worker’s Compensation. Life MD may disclose your PHI as authorized by, and to the extent necessary to comply with, workers’ compensation programs and other similar programs relating to work-related illnesses or injuries.
- Health Oversight Activities. Life MD may disclose your PHI to a health oversight agency for authorized activities such as audits, investigations, inspections, licensing and disciplinary actions relating to the health care system or government benefits program.
- Judicial and Administrative Proceedings. Life MD may disclose your PHI, in certain circumstances, as permitted by applicable law, in response to an order for a court or administrative agency, or in response to a subpoena or discovery request.
- Law Enforcement. Life MD may, under certain circumstances, disclose your PHI to a law enforcement official, such as for purposes of identifying or locating a suspect, fugitive, material witness or missing person.
- Decedents. Life MD may, under certain circumstances, disclose PHI to coroners, medical examiners and funeral directors for purposes of identification, determining the cause of death and fulfilling duties relating to decedents.
- Organ Procurement. Life MD may, under certain circumstances, use or disclose PHI for the purposes of organ donation and transplantation.
- Research. Life MD may, under certain circumstances, use or disclose PHI that is necessary for research purposes.
- Threat to Health or Safety. Life MD may, under certain circumstances, use or disclose PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- Specialized Government Functions. Life MD, may in certain situations, use and disclose PHI of persons who are, or were, in the Armed Forces for purposes such as ensuring proper execution of a military mission or determining entitlement to benefits. Life MD may also disclose PHI to federal officials for intelligence and national security purposes.
Your Rights Regarding Your PHI
You have the following rights regarding the PHI maintained by Life MD:
- Confidential Communication. You have the right to receive confidential communications of your PHI. You may request that Life MD communicate with you through alternate means or at an alternate location, and Life MD will accommodate your reasonable requests. You must submit your request in writing to Life MD.
- Restrictions. You have the right to request restrictions on certain uses and disclosures of PHI for treatment, payment or health care operations. You also have the right to request that Life MD restrict its disclosures of PHI to only certain individuals involved in your care or the payment of your care. You must submit your request in writing to Life M. Life MD is not required to comply with your request. However, if Life MD agrees to comply with your request, it will be bound by such agreement, except when otherwise required by law or in the event of an emergency.
- Inspection and Copies. You have the right to inspect and copy your PHI. You must submit your request in writing to Life MD. Life MD may impose a fee for the costs of copying, mailing, labor and supplies associated with your request. Life MD may deny your request to inspect and/or copy your PHI in certain limited circumstances. If that occurs, Life MD will inform you of the reason for the denial, and you may request a review of the denial.
- Amendment. You have a right to request that Life MD amend your PHI if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is maintained by Life MD. You must submit your request in your writing to Life MD and provide a reason to support the requested amendment. Life MD may, under certain circumstances, deny your request by sending you a written notice of denial. If Life MD denies your request, you will be permitted to submit a statement of disagreement for inclusion in your records.
- Accounting of Disclosures. You have a right to receive an accounting of all disclosures Life MD has made of your PHI. However, that right does not include disclosures made for treatment, payment or health care operations, disclosures made to you about your treatment, disclosures made pursuant to an authorization, and certain other disclosures. You must submit your request in writing to Life MD and you must specify the time period involved (which must be for a period of time less than six years from the date of the disclosure). Your first accounting will be free of charge. However, Life MD may charge you for the costs involved in fulfilling any additional request made within a period of 12 months. Life MD will inform you of such costs, in advance, so that you may withdraw or modify your request to save costs.
- Breach Notification. You have the right to be notified in the event that Life MD (or a Life MD Business Associate) discovers a breach of unsecured PHI.
Paper Copy. You have the right to obtain a paper copy of this Notice from Life MD at any time upon request. To obtain a paper copy of this notice, please contact Life MD by calling 866-954-8281.
- Complaint. You may complain to Life MD and to the Secretary of the Department of Health and Human Services. If you believe that your privacy rights have been violated. To file a complaint with Life MD, you must submit a statement in writing to Life MD. Attn: Security Officer, 1901 South Congress Avenue, Suite 150, Boynton Beach, FL 33426. Life MD will not retaliate against you for filing a complaint.
- Further Information. If you would like more information about your privacy rights, please contact Life MD by calling 866-54-8281 and ask to speak to the Privacy and Security Officer. To the extent you are required to send a written request to Life MD to exercise any right described in this Notice, you must submit your request to Life MD at Attn: Security Officer, 1901 South Congress Avenue, Suite 150, Boynton Beach, FL 33426.