HIPAA Policies

1. Who This Notice Covers

This Notice of Privacy Practices applies to Advanced Pain Solutions and the healthcare professionals, employees, staff members, contractors, and other individuals who provide services on our behalf and are permitted to access protected health information.

Advanced Pain Solutions provides pain management evaluation, diagnosis, treatment, follow-up care, and related healthcare services.

We are committed to protecting the privacy and security of your medical information in accordance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), applicable federal regulations, and applicable Texas privacy laws.

2. What Protected Health Information Is

Protected health information (“PHI”) is information that identifies you and relates to:

• Your physical or mental health
• Healthcare services you receive
• Treatment provided to you
• Payment for healthcare services

PHI may include information such as:

• Your name and contact information
• Date of birth
• Medical history
• Diagnoses
• Treatment plans
• Medications
• Procedure information
• Imaging and laboratory results
• Insurance information
• Billing and payment information
• Appointment and scheduling information

Information that has been properly de-identified in accordance with applicable law is not considered PHI.

3. How We May Use and Disclose Your Information

We may use and disclose your protected health information without your written authorization for purposes permitted or required by law.

Treatment

We may use or share your health information to provide, coordinate, or manage your healthcare. For example, we may share relevant medical information with physicians, specialists, imaging facilities, laboratories, hospitals, pharmacies, physical therapists, or other healthcare professionals involved in your treatment.

Payment

We may use and disclose your information to obtain payment for healthcare services provided to you. This may include:

• Verifying insurance eligibility
• Obtaining prior authorization
• Submitting claims
• Responding to insurance inquiries
• Processing patient payments
• Coordinating billing matters

Healthcare Operations

We may use your information as necessary to operate and improve our practice. Examples include:

• Quality assessment
• Staff training
• Credentialing
• Compliance activities
• Internal audits
• Patient service improvement
• Business administration
• Healthcare operations

4. Business Associates and Service Providers

Advanced Pain Solutions may use third-party service providers to assist with functions such as:

• Electronic medical records
• Scheduling
• Billing
• Patient communications
• Website forms
• Information technology
• Data storage
• Healthcare administration

When a service provider creates, receives, maintains, or transmits protected health information on our behalf, we require appropriate safeguards and agreements as required by applicable law.

Advanced Pain Solutions does not sell your protected health information.

5. Other Permitted or Required Disclosures

Federal and state laws may permit or require us to disclose your protected health information without your authorization in certain circumstances, including:

• When required by federal, state, or local law
• Public health activities
• Reporting suspected abuse, neglect, or domestic violence
• Health oversight activities
• Judicial or administrative proceedings
• Certain law enforcement purposes
• Coroners, medical examiners, and funeral directors
• Organ and tissue donation where applicable
• Approved research activities
• Preventing or reducing a serious and imminent threat to health or safety
• Certain government functions
• Workers’ compensation matters as permitted by law

6. Uses That Require Your Written Authorization

Uses and disclosures of your protected health information that are not otherwise permitted or required by law generally require your written authorization.

Written authorization may be required for certain uses involving:

• Marketing communications where payment is received from a third party
• Sale of protected health information
• Psychotherapy notes, where applicable
• Other uses not otherwise permitted by law

You may revoke a written authorization at any time by submitting your request in writing.

Your revocation will apply to future uses and disclosures but will not affect information already disclosed in reliance on your previous authorization.

7. Your Rights

You have certain rights regarding the protected health information Advanced Pain Solutions maintains about you.

Get a Copy of Your Health Records

You may request to inspect or receive a copy of certain health and billing records we maintain about you.

Electronic records may be provided electronically when reasonably available and permitted by law.

Applicable federal and Texas timelines will be followed when responding to requests.

A reasonable, cost-based fee may apply where permitted by law.

Ask Us to Correct Your Records

If you believe your medical information is incorrect or incomplete, you may request an amendment.

We may deny a request in certain circumstances permitted by law. If we deny your request, we will provide information regarding the denial and any applicable rights you may have.

Request an Accounting of Disclosures

You may request information regarding certain disclosures of your protected health information made during the period permitted by law.

Certain disclosures, including those related to treatment, payment, healthcare operations, or disclosures you specifically authorized, may not be included.

Request Restrictions

You may ask us to restrict certain uses or disclosures of your health information.

We are not required to agree to every requested restriction unless applicable law requires us to do so.

When You Pay for Care in Full

If you pay for a healthcare service completely out of pocket, you may request that information about that service not be disclosed to your health plan for payment or healthcare operations purposes when applicable law requires us to honor such a request.

Request Confidential Communications

You may ask us to communicate with you in a specific way or at a specific location. For example, you may request that we contact you only through a particular telephone number or email address.

We will accommodate reasonable requests as required by law.

Obtain a Paper Copy

You may request a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.

Breach Notification

If a breach occurs that compromises the privacy or security of your protected health information, Advanced Pain Solutions will provide notification as required by applicable federal and Texas law.

Personal Representatives

If you have legally authorized another individual to act on your behalf, such as through a medical power of attorney or legal guardianship, that individual may exercise applicable privacy rights on your behalf.

We may verify the individual’s legal authority before acting on a request.

8. Additional Rights Under Texas Law

The Texas Medical Records Privacy Act, Texas Health & Safety Code Chapter 181, provides additional protections relating to health information.

Where Texas law provides greater privacy protection than federal law, Advanced Pain Solutions will follow the more protective applicable requirement.

Electronic Health Records

Where applicable, Texas law may provide shorter time periods for responding to requests for electronic health records than federal HIPAA requirements.

Electronic Disclosure

Protected health information may be disclosed electronically for treatment, payment, healthcare operations, and other purposes permitted by applicable law.

Where separate authorization is required by Texas law, we will obtain the appropriate authorization.

Sale of Health Information

Advanced Pain Solutions does not sell protected health information.

Workforce Training

Our workforce receives privacy and security training as required by applicable federal and Texas law.

9. Our Responsibilities

Advanced Pain Solutions is committed to maintaining the privacy and security of protected health information. We will:

• Protect the privacy and security of your protected health information
• Follow the privacy practices described in this notice
• Provide you with a copy of this notice upon request
• Notify affected individuals of breaches when required by law
• Limit uses and disclosures to those permitted or required by law
• Maintain appropriate administrative, physical, and technical safeguards
• Require appropriate protections from service providers that handle PHI on our behalf

We will not use or disclose your protected health information for purposes not described in this notice unless permitted by law or authorized by you in writing.

10. Changes to This Notice

Advanced Pain Solutions may revise this Notice of Privacy Practices from time to time.

Any revised notice may apply to protected health information we already maintain as well as information we receive in the future.

The current version of this notice will be available on the Advanced Pain Solutions website and will display its effective date.

11. Complaints

If you believe your privacy rights have been violated, you may submit a complaint to Advanced Pain Solutions or to the appropriate federal or state authority.

Advanced Pain Solutions will not retaliate against you for filing a privacy complaint.

12. Who to Contact

For questions about this Notice of Privacy Practices, to exercise your privacy rights, or to request a paper copy of this notice, please contact: