Notice of Privacy Practices
This notice outlines how your medical information may be used and shared and how you can access this information. Please read it carefully.
Summary of Your Privacy Rights
We may use or share your health information for the following purposes:
- Providing Care: To coordinate and manage your healthcare, including consultations and referrals between healthcare providers.
- Processing Payments: To communicate with health plans, insurance providers, or workers’ compensation programs for billing and payment.
- Informing You: To notify you about available health benefits and services or when prescriptions are ready for pickup.
- Legal Requirements: To report abuse, neglect, or domestic violence to appropriate government authorities as required by law.
- Family and Caregiver Communication: Share relevant information with individuals you designate, such as family members, friends, or caregivers.
We may also use your health information for:
- Business Associates: To maintain secure record-keeping through contracted entities.
- Healthcare Operations: To improve quality of care and for public safety purposes.
- Health Oversight Activities: To comply with regulations from federal or state agencies overseeing our operations.
- Legal and Security Reasons: For lawful purposes such as military and national security, legal proceedings, subpoenas, or discovery requests.
- Organ and Tissue Donation Requests: To assist in organ or tissue donation programs.
- Data Breach Notifications: To notify you of any breaches involving your protected health information.
- Law Enforcement Purposes: When required by law or for investigations.
- Coroner, Medical Examiner, or Funeral Director Uses: For death investigations or related duties.
- FDA Reporting: To report adverse events as required.
- Controlled Substance Reporting: To meet legal requirements, including timely reporting to the Department of Justice for controlled substances.
Your Rights
You have the right to:
- Inspect and obtain a copy of this Notice at any time.
- Request restrictions on how your health information is used or disclosed.
- Request confidential communication of your health information.
- Access, amend, and obtain copies of your protected health information.
- Receive a record of disclosures made about your health information.
- Be informed if your protected health information is affected by a data breach.
Suppose you believe your rights have been violated. In that case, you can file a written complaint without fear of retaliation with either DermatologyAlliance’s Compliance Officer or the U.S. Department of Health and Human Services.
Our Responsibilities
DermatologyAlliance is required to:
- Keep your health information private and secure.
- Use or disclose your health information only as permitted by this Notice or as authorized by you.
- Obtain your explicit written authorization for uses not covered by this Notice, including marketing purposes, selling health information, or other unauthorized disclosures.
- Inform you of updates or changes to this Notice as necessary.
Acknowledgment
By receiving this Notice, you acknowledge that you have been informed of your rights. This Notice is available upon request. DermatologyAlliance reserves the right to revise the terms of this Notice at any time, and you will be informed of any significant updates.
Contact Information
For further details or to file a complaint, please contact:
DermatologyAlliance Compliance Officer
12469 Timberland Blvd, Suite 501, Fort Worth, TX 76244
817-431-6555
info@dermatologyalliancetx.com
Effective Date: 01/20/2025
