HIPAA Notice of Privacy Practices
Wellspring Physicians P.A., P.C., and Affiliated Covered Entities
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.
Effective as of December 26, 2024.
Recuro Health’s Commitment to Your Privacy.
This Notice of Privacy Practices (the “Notice”) describes how including, but not limited to, Wellspring Physicians P.C. (NJ), Wellspring Physicians P.A., Wellspring Physicians P.C. (AK), Wellspring Physicians P.C. (CA), Wellspring Physicians P.C. (NY), Wellspring Physicians P.C. (CO), Wellspring Physicians P.C. (MA), Wellspring Physicians P.C. (MI), Wellspring Physicians P.C. (VA), Recuro Health Physicians Association, PA, and other members of its Affiliated Covered Entity (collectively, “Recuro”) may use and disclose your protected health information (“PHI”) to carry out treatment, payment or business operations and for other purposes that are permitted or required by law. An Affiliated Covered Entity is a group of health care providers under common ownership or control that designates itself as a single entity for purposes of compliance with the Health Insurance Portability and Accountability Act (“HIPAA”). The members of the Recuro Affiliated Covered Entity will share PHI with each other for the treatment, payment, and health care operations of the Recuro Affiliated Covered Entity and as permitted by applicable law and this Notice. For a complete list of the members of the Recuro Affiliated Covered Entity, please contact the Recuro Privacy Offer ([email protected]).
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 health or 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, Recuro will receive and create records containing your PHI. Recuro is required by law to maintain the privacy of your PHI and to provide you with notice of its legal duties and privacy practices with respect to your PHI.
Recuro 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 Recuro 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 Recuro changes this Notice, it will post the new Notice on its Web site https://recurohealth.com, and will make the new Notice available upon request.
SECTION 01
Uses And Disclosures Of Your PHI
Recuro may use and disclose your PHI in the following ways:
Your PHI may be used and disclosed by our health care providers, our staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to support our business operations, to obtain payment for your care, and any other use authorized or required by law. Recuro is permitted to use and disclose your PHI for purposes of (a) treatment, (b) payment and (c) health care operations. For example:
Treatment. Recuro may disclose your PHI to another physician or health care provider for purposes of a consult or in connection with the provision of follow-up treatment. For example, a doctor treating you may need to know if you are allergic to a medication because it may affect management of your condition.
Payment. Recuro 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 so that the treatment and services you receive from and through us may be billed to and payment collected from you. For example, we will need to share the credit or debit card details you provide with our bank and payment processer. Or Recuro may share with the primary cardholder that Medic on the bank statements is for a Recuro charge.
Health Care Operations. Recuro may use and disclose your PHI in connection with its health care operations, such as providing customer services and conducting quality review assessments. Recuro may engage third parties to provide various services for Recuro. If any such third party must have access to your PHI in order to perform its services, Recuro will require that third party to enter an agreement that binds the third party to the use and disclosure restrictions outlined in this Notice. For example, we may use PHI to conduct quality assessment reviews to evaluate performance in caring for you. Recuro may also share your PHI with our “business associates” that perform administrative services for us, such as billing services.
SECTION 02
Uses and Disclosures of PHI Based Upon Your Written Authorization
Recuro is permitted to use and disclose your PHI upon your written authorization, to the extent such use or disclosure is consistent with your authorization, unless otherwise permitted or required by law as described below. You may revoke any such authorization at any time, in writing, except to the extent that Recuro has taken an action in reliance on the use or disclosure indicated in the authorization.
SECTION 03
Other Uses and Disclosures that May Be Made and to Which You May Agree or Object
In the circumstances listed below, you may agree or object to the use or disclosure of your PHI in the manner described. In the absence of agreement or objection, Recuro may, using professional judgment, determine whether the disclosure of health information is in your best interest. If such a determination is made, only PHI that is relevant to your health care will be disclosed.
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interests, based on our professional judgment. We may use or disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
Emergencies: In an emergency treatment situation, we may have to use or disclose your protected health information in a context in which consent for the release of information has not already been given. If this happens, Recuro will try to obtain your consent to the release of information as soon as reasonably practicable after the delivery of the treatment. If Recuro is required to treat you and has attempted to obtain your consent but is unable to obtain your consent, it may still use or disclose your PHI to treat you.
SECTION 04
Other Permitted and Required Uses and Disclosures that May Be Made Without Your Consent, Authorization, or Opportunity to Object
There are other circumstances in which we may have to use or disclose your PHI, even without your consent or authorization. These situations include:
As Required by Law. Recuro may use and disclose your PHI to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.
Public Health Activities. Recuro may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. Recuro may also disclose your PHI, if directed by the public health authority, to a government agency that is collaborating with the public health authority.
Communicable Diseases. Recuro may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Abuse or Neglect. Recuro may disclose your PHI to a government authority that is authorized by law to receive reports of child abuse or neglect. In addition, Recuro may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
Food and Drug Administration. Recuro may disclose your PHI to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements; or to conduct post marketing surveillance, as required.
Health Oversight Activities. Recuro 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, government benefit programs, or other government regulatory programs and civil rights laws.
Judicial and Administrative Proceedings. Recuro may disclose your PHI, in certain circumstances, as permitted by applicable law, in response to an order from a court or administrative agency, or in response to a subpoena or discovery request, or other lawful process or request.
Law Enforcement. Recuro may disclose your PHI, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include requests: (1) pursuant to legal processes or as otherwise required by law; (2) for limited information for identification and location purposes; (3) pertaining to potential victims of a crime; (4) relating to suspicion that a death has occurred as a result of criminal conduct; (5) in the event that a crime occurs at Recuro; or (6) relating to a medical emergency (not at Recuro) and it is necessary to alert law enforcement regarding a potential crime.
Coroners, Funeral Directors, and Organ Donation. Recuro may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. Recuro may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out his/her duties. Recuro may disclose such information in reasonable anticipation of death. protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes..
Research. Recuro may, under certain circumstances, use or disclose PHI without your consent or authorization if an Institutional Review Board or Privacy Board approves a waiver of authorization for such disclosure.
Threat to Public Safety. Consistent with applicable federal and state laws, Recuro may disclose your PHI, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.
Information Not Personally Identifiable. Recuro may use or disclose your PHI in ways that do not personally reveal your identity.
Specialized Government Functions. Recuro, 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. Recuro may also disclose PHI to federal officials for intelligence and national security purposes.
SECTION 05
Your Rights Regarding Your PHI
You have the following rights regarding the PHI maintained by Recuro:
Confidential Communication. You have the right to request that Recuro communicate your PHI to you in a certain manner or in a certain location. For example, you may request that Recuro communicate with you through alternate means or at an alternate location, and Recuro will accommodate your reasonable requests. You must submit your request in writing to Recuro. Recuro will not ask the reason for your request.
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 Recuro 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 Recuro. Recuro is not required to comply with your request. However, Recuro is not required to agree to your requested restriction, unless that restriction is regarding disclosure of health information to your health insurance company and: (1) the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and (2) the health information pertains solely to a health care item or service for which you or another person (other than your health insurance company) paid for in full.
Inspection and Copies. You have the right to inspect and copy your PHI. You must submit your request in writing to Recuro. Recuro may impose a fee for the costs of copying, mailing, labor and supplies associated with your request. You may request access to your health information in a certain electronic form and format, if readily producible, or, if not readily producible, in a mutually agreeable electronic form and format. Further, you may request in writing that we transmit such a copy to any person or entity you designate. Your written, signed request must clearly identify such designated person or entity and where you would like us to send the copy. Recuro may deny your request to inspect and/or copy your PHI in certain limited circumstances. If that occurs, Recuro will inform you of the reason for the denial, and you may request a review of the denial. We will comply with the outcome of the review.
Amendment. You have a right to request that Recuro amend or correct your PHI that you believe is incorrect or incomplete. For example, if your date of birth is incorrect, you may request that the information be corrected. To request a correction or amendment to your health information, you must make your request in writing and provide a reason for your request. You have the right to request an amendment for as long as the information is kept by or for us. Under certain circumstances we may deny your request. If your request is denied, we will provide you with information about our denial and how you can file a written statement of disagreement with us that will become part of your medical record.
Accounting of Disclosures. You have a right to receive an accounting of all disclosures Recuro has made of your PHI. Please note that certain disclosures need not be included in the accounting Recuro provides to you, including most disclosures made pursuant to your authorization. Your request must state a time period which may not go back further than six years. You will not be charged for this accounting, unless you request more than one accounting per year, in which case we may charge you a reasonable cost-based fee for providing the additional accounting(s). We will notify you of the costs involved and give you an opportunity to withdraw or modify your request before any costs have been incurred.
SECTION 06
Paper Copy
You have the right to obtain a paper copy of this Notice from Recuro at any time upon request. To obtain a paper copy of this notice, please contact Recuro by calling 1.855.6RECURO.
SECTION 07
Complaint
You may complain to Recuro 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 Recuro, you must submit a statement in writing to Recuro outlining your concerns: Attn: HIPAA Privacy Officer, 309 North Washington Avenue, Suite 13, Bryan TX 77803 or by contacting the HIPAA Officer by telephone at 1.855.6RECURO or by email at [email protected] You have the right to complain to the Secretary of Health and Human Services or the United States Attorney for the judicial district in which the violation occurs if you believe your privacy rights have been violated by Recuro. You will not be penalized or otherwise retaliated against for filing a complaint.
SECTION 08
Further Information
If you would like more information about your privacy rights, please contact Recuro by calling 1.855.6RECURO and ask to speak to the HIPAA Officer. To the extent you are required to send a written request to Recuro to exercise any right described in this Notice, you must submit your request to Recuro at: Attn: HIPAA Officer, 309 North Washington Avenue, Suite 13, Bryan TX 77803.
