Notice of Privacy Practices
Effective Date: [Date — confirm before launch]
Important: This is a placeholder. Before patient care begins, this document must be reviewed and finalized by a qualified healthcare attorney to ensure full HIPAA compliance.
Our Commitment to Your Privacy
Together Pediatrics is committed to protecting the privacy of your child's health information. We are required by law to maintain the privacy of protected health information ("PHI"), to provide you with this Notice of our legal duties and privacy practices with respect to PHI, and to follow the terms of the Notice that is currently in effect.
How We May Use and Disclose Health Information
Treatment: We may use and disclose PHI to provide, coordinate, or manage your child's health care and related services, including sharing information with other healthcare providers involved in your child's care (e.g., specialists, hospitals). Healthcare Operations: We may use and disclose PHI in connection with our healthcare operations, including quality assessment, staff training, and general administrative activities. As Required by Law: We will disclose PHI when required to do so by federal, state, or local law, including public health reporting requirements and mandatory reporting of abuse or neglect. Business Associates: We may share PHI with our business associates (such as billing services, IT vendors, and HIPAA-compliant communication platforms) who assist us in operating our practice. These associates are required by contract to protect the privacy of your information.
Your Rights Regarding Health Information
• Right to Inspect and Copy: You have the right to inspect and obtain a copy of PHI that we maintain about your child. • Right to Amend: You may request that we amend PHI about your child if you believe it is incorrect or incomplete. • Right to an Accounting of Disclosures: You have the right to request a list of disclosures we have made of your child's PHI. • Right to Request Restrictions: You may request restrictions on certain uses and disclosures of PHI about your child. • Right to Confidential Communications: You may request that we communicate with you in a specific way or at a specific location. • Right to a Paper Copy of This Notice: You may obtain a paper copy of this Notice at any time. • Right to Be Notified of a Breach: You have the right to be notified if a breach of your unsecured PHI occurs.
Changes to This Notice
We reserve the right to change this Notice. Any revised Notice will be posted on our website and provided to you upon request. Changes will apply to all PHI we hold at the time of the change.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with Together Pediatrics or with the Secretary of the U.S. Department of Health and Human Services (HHS). We will not retaliate against you for filing a complaint. To file a complaint with Together Pediatrics: hello@togetherpeds.com
Contact
Together Pediatrics — Privacy Officer Indianapolis, Indiana hello@togetherpeds.com