Effective date: October 22, 2026
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.
Our Commitment to Your Privacy
River City Foot & Ankle Clinic is required by law to maintain the privacy of your protected health information (“PHI”), to give you this notice of our legal duties and privacy practices, and to notify you if a breach of your unsecured PHI occurs. We must follow the terms of the notice currently in effect.
PHI is information about you, including demographic information, that can identify you and that relates to your past, present or future physical or mental health, the care you receive, or payment for that care.
How We May Use and Disclose Your Health Information
We may use and disclose your PHI without your written authorization for the following purposes:
- Treatment. To provide, coordinate and manage your care. For example, we may share information with other physicians, specialists, laboratories, imaging centers or pharmacies involved in your care.
- Payment. To bill and receive payment for your care, for example to submit claims to your health insurance plan or confirm your coverage.
- Health care operations. To run our practice, for example for quality reviews, staff training, licensing and accreditation, and business planning.
- Appointment reminders and health-related services. To remind you of appointments and tell you about treatment options or services that may interest you.
- Business associates. To companies that perform services for us, such as billing or IT support, who must sign agreements to protect your information.
- People involved in your care. To a family member, friend or other person you identify who is involved in your care or payment, unless you object.
Other Uses and Disclosures Permitted or Required by Law
- When required by federal, state or local law.
- For public health activities, such as reporting disease, injury or adverse reactions to medications or devices.
- To report suspected abuse, neglect or domestic violence to the proper authorities.
- For health oversight activities, such as audits, inspections and licensure.
- In response to a court or administrative order, subpoena or other lawful process.
- For certain law enforcement purposes.
- To coroners, medical examiners and funeral directors.
- For organ, eye or tissue donation.
- For research, when approved under privacy safeguards required by law.
- To prevent a serious threat to the health or safety of you or others.
- For specialized government functions, such as military and national security activities.
- For workers’ compensation or similar programs, as permitted by law.
Uses That Require Your Written Authorization
We will not use or disclose your PHI for any other purpose without your written authorization. This includes most uses for marketing and any sale of your PHI. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.
Your Rights Regarding Your Health Information
- Right to inspect and copy. You may request to see or get a copy, paper or electronic, of your medical and billing records. We may charge a reasonable, cost-based fee.
- Right to request an amendment. If you believe information in your record is incorrect or incomplete, you may ask us in writing to correct it. We may deny the request in some cases and will tell you why in writing.
- Right to request restrictions. You may ask us to limit how we use or share your PHI for treatment, payment or operations. We are not required to agree, except that we must agree not to share information with your health plan about a service you paid for in full out of pocket, if you ask us.
- Right to request confidential communications. You may ask us to contact you in a specific way, such as at a different phone number or address. We will accommodate reasonable requests.
- Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI in the six years before your request.
- Right to a paper copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Right to be notified of a breach. We will notify you if a breach occurs that may have compromised the privacy or security of your PHI.
- Right to choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights.
To exercise any of these rights, please contact our office using the details below. Some requests must be made in writing.
Changes to This Notice
We reserve the right to change this notice and to make the new notice apply to all PHI we already have about you. The current notice will be posted in our office and on this website, and copies are available on request.
Questions and Complaints
If you have questions about this notice, or believe your privacy rights have been violated, please contact our office:
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-800-368-1019, or online at www.hhs.gov/ocr/complaints.
We will not retaliate against you for filing a complaint.
