NOTICE OF PRIVACY PRACTICES

Last updated March 24, 2022

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.

PURPOSE OF THIS NOTICE

This notice of privacy practices is adopted to ensure that PCP Urgent Care Holdings LLC dba Patient Plus Urgent Care (“Patient Plus”), fully complies with all federal and state privacy protection laws and regulations, in particular, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Patient Plus is required by law to maintain the privacy of Protected Health Information and to provide its patients with a copy of its Notice of Privacy Practices outlining its legal duties and privacy practices with respect to protected health information. This notice of privacy practices shall become effective as of March 24, 2022, and shall remain in effect until it is either amended or canceled. You have a right to receive a paper copy of this notice of privacy practices. If you have any questions or comments concerning this notice, you should contact:

PCP Urgent Care Holdings
5800 One Perkins Place Building 5 Suite A
Baton Rouge, LA 70808

or by telephone at (225) 224-8690.

DEFINITIONS

For the purposes of this notice, the following defined terms shall have the following definitions. “HHS” shall mean the United States Department of Health and Human Services and “Health Information”, “Protected Health Information” or “PHI” shall mean certain Individually Identifiable Health Information, as defined in 45 C.F.R. § 164.501 of the Privacy Standards.

UNDERSTANDING YOUR HEALTH RECORD/INFORMATION

Each time you visit Patient Plus, a record of the care and/or services provided to you by Patient Plus is made. This record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information may be used to plan your care or treatment, communicate with other providers who contribute to your care, serve as a legal document, receive payment from you, your plan, or your health insurer, assess and improve the care we render, and the outcomes we achieve and comply with state and federal laws that require us to disclose your health information.

HOW PATIENT PLUS MAY USE OR DISCLOSE YOUR PHI

Patient Plus collects your PHI and stores it in an electronic medical record (“EMR”). This is your medical record. The medical record is the property of Patient Plus, but the information in the medical record belongs to you. You have a right to access the EMR in a machine-readable electronic format and to direct Patient Plus to send a machine-readable copy directly to a third party. It is the policy of Patient Plus that all PHI may not be used or disclosed unless it meets one of the following conditions:

Treatment. Patient Plus collects information from you regarding your past medical history, present medical problems and/or complaints, as well as any diagnosis and/or past medical treatment at Patient Plus. Information obtained by a nurse, physician, or another member of your healthcare team will be recorded in your medical record and used to determine the treatment that should work best for you. To promote quality care, Patient Plus operates an EMR. This is an electronic system that keeps health information about you. Patient Plus may also provide a subsequent healthcare provider with health information about you (e.g., copies of various reports) that should assist him/her in treating you in the future. Patient Plus may also disclose health information about you to as well as obtain your health information from electronic health information networks in which community health care providers may participate to facilitate the provision of care to patients such as yourself. Patient Plus may use a prescription hub that provides electronic access to your medication history. This will assist Patient Plus healthcare providers in understanding what other medications may have been prescribed for you by other providers.

Payment. Patient Plus will collect billing information from you such as your present address, social security number, date of birth, health insurance carrier, policy number, and any other related billing information. Patient Plus may disclose this information to your health insurance provider, Medicare, Medicaid, or another payor of healthcare claims to process your health insurance claim. We may also send you or a third-party payor a bill.
The information on or accompanying the bill may include information that identifies you, your diagnosis, procedures, and supplies used.

Regular Healthcare Operations. Patient Plus may disclose your healthcare information to physicians, medical assistants, nurses, nurse practitioners, physician assistants, radiology personnel, billing clerks, administrative staff, and other employees involved in your healthcare treatment. We may use the information in your health record to access the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Authorizations. You may sign a written authorization giving Patient Plus authorization to use or disclose your healthcare information to a third party. This authorization may be revoked by providing Patient Plus with a written revocation of said authorization. Without the authorization, Patient Plus may not disclose the patient’s psychotherapy notes.

Notification and Communication with Family. Patient Plus may use and disclose your PHI to notify or assist in notifying your family member, your personal representative, or another person responsible for your care about your location, your general condition, or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.

Open Treatment Areas. Sometimes patient care is provided in an open treatment area. While special care is taken to maintain patient privacy, others may overhear patient information while receiving treatment. Should you be uncomfortable with this, please bring this to the attention of our Chief Medical Officer.

Voicemail Message. Patient Plus may call your home or other designated location and leave a message on your voice mail, in person or by text, in reference to any items that assist Patient Plus in carrying out treatment, payment, and health care operations, such as appointment reminders, insurance items and any call pertaining to your clinical care. We may mail/email your home or other designated location any items that assist Patient Plus in carrying out treatment, payment, and healthcare operations such as appointment reminders, patient satisfaction surveys, and patient statements.

To Avert a Serious Threat to Health or Safety. Patient Plus may use your health information or share it with others when necessary to prevent a serious threat to your health or safety or the health or safety of another person or the public.

Public Health. Patient Plus may disclose your PHI to public health authorities for purposes related to preventing or controlling disease, injury, or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Health Oversight Activities. Patient Plus may release your health information to government agencies authorized to conduct audits, investigations, and inspections of our facility. These government agencies monitor the operation of the healthcare system, government benefit programs, such as Medicare and Medicaid, and compliance with government regulatory programs and civil rights laws.

Marketing. Patient Plus may contact you via mail, email, or text to provide you with a treatment alternative or other health-related benefits or services that may be of interest to you. You have the right to opt-out by notifying us in writing.

Sale of PHI. Patient Plus may not “sell” your PHI (i.e., disclose such PHI in exchange for remuneration) to a third party without your written authorization that acknowledges the remuneration unless such an exchange meets a regulatory exception.

Food and Drug Administration. Patient Plus may disclose to the FDA health information relative to adverse events with respect to food, supplement, product and product defects, or post-marketing surveillance information to enable product recalls repairs or replacement.

Worker’s Compensation. Patient Plus may disclose health information to the extent authorized by and to the extent necessary to comply with laws related to workers' compensation or other similar programs established by law.

Law Enforcement. Patient Plus may disclose a patient’s PHI to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and/or other law enforcement purposes.

Judicial and Administrative Proceedings. Patient Plus may disclose a patient’s PHI in the course of any administrative or judicial proceeding if we have been ordered to do so by a court that is handling a lawsuit or other dispute. Patient Plus may also disclose your PHI in response to a subpoena or discovery request, filed and executed in accordance with the law.

Deceased Individuals. It is the policy of Patient Plus that privacy protections extend to information concerning deceased individuals. Patient Plus may disclose your PHI to coroners, medical examiners, and funeral directors.

Specialized Government Functions. Patient Plus may disclose your PHI for military, national security, and prisoner purposes.

Change of Ownership. In the event that Patient Plus is sold or merges with another organization, your PHI will become the property of the new owner.

Restriction Requests. It is the policy of Patient Plus that serious consideration must be given to all requests for restrictions on uses and disclosures of PHI as published in this privacy policy. You have a right to request restrictions on certain uses and disclosures of their PHI. You may do so by completing Patient Plus’s form entitled “Restrictions”. Patient Plus is not required to agree to the restriction that you request. If a particular restriction is agreed to, Patient Plus is bound by that restriction. If you pay for a specific health product or service out of pocket, you have the right to request that Patient Plus not disclose your information to your insurer. Such a request can also be made in writing by completing Patient Plus’s form entitled “Restriction - Self Pay” and checking the particular box indicating that the service or product was paid for by you. If such a request is made, Patient Plus must agree with your request.

Access to Information. You have the right to inspect and copy your PHI. It is Patient Plus’s policy that access to your PHI must be granted when such access is requested. Such request shall be submitted in writing by completing Patient Plus’s request form entitled “Request for Inspection and/or Copy of Protected Health Information”. Costs associated with the copying of any PHI shall be in accordance with applicable state and federal law.

Designation of Personal Representative. Access to PHI must be granted to your designated personal representative as specified by you when such access is authorized by you. This designation of a personal representative must be made in writing by completing Patient Plus’s form entitled “Designation of Personal Representative”.

Confidential Communications Channels. You have the right to receive your PHI through a reasonable alternative means or at an alternative location. Confidential communication channels can be used within the reasonable capability of Patient Plus, (i.e., do not call me at work, call me at home) as requested by the patient. Such request shall be made in writing by completing Patient Plus’s form entitled “Confidential Channel Communication
Request”.

Amendment of Incomplete or Incorrect Protected Health Information. You have a right to request that Patient Plus amend your PHI that is incorrect or incomplete. Patient Plus is not required to change your PHI and will provide you with information about Patient Plus’s acceptance and/or denial and how you can disagree with the denial. A request to amend a patient’s PHI shall be made in writing by completing Patient Plus’s form entitled “Request for Amendment of Health Information”.

Accounting of Disclosures. You have a right to request an accounting of disclosures. Such written request for an accounting shall be made by completing Patient Plus’s form entitled “Request for Accounting of Disclosures”.

Breach Notification. It is the policy of Patient Plus as required by law to maintain the privacy of a patient’s PHI and to provide the patient with a copy of/access to our legal duties and privacy practices relating to their PHI. If there is a breach (an inappropriate use or disclosure of the patient’s PHI that the law requires to be reported) Patient Plus must notify the patient of said breach.

Preemption of State Law. It is the policy of Patient Plus that the federal privacy regulations are the minimum standard to be used regarding the privacy of a patient’s PHI. If the laws of the State of Louisiana are more stringent in certain areas, the state laws in these areas shall prevail. In all other areas, the federal privacy regulations shall prevail.

Cooperation with Privacy Oversight Authorities. It is the policy of Patient Plus that oversight agencies such as the Office for Civil Rights of the Department of Health and Human Services be given full support and cooperation in their efforts to ensure the protection of PHI within this organization. It is also the policy of Patient Plus that all personnel cooperate fully with all privacy compliance reviews and investigations.

Changes to this Notice of Privacy Practices. Patient Plus reserves the right to amend this Notice of Privacy Practices at any time in the future and will provide a copy of such amendment to the patient upon request or upon the patient’s next visit. Until such an amendment is made, Patient Plus is required by law to comply with this notice.

Complaints. It is the policy of Patient Plus that all complaints by employees, patients, providers, or other entities relating to PHI be investigated and resolved in a timely fashion. Complaints about this Notice of Privacy Practices or how Patient Plus handles a patient’s PHI should be directed to:

Patient Plus Urgent Care
5800 One Perkins Place Building 5 Suite A
Baton Rouge, LA 70808

If you are not satisfied with the manner in which Patient Plus handles a complaint, you may submit a formal complaint to:

Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W. Room 509F HHH Building
Washington, DC 20201