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.

Comprehensive Surgical Care (CSC) is required by law to maintain the privacy of your protected health information and to provide you with this notice, which explains our legal duties and privacy practices with respect to your protected health information. We must abide by the terms set forth in this notice. However, we reserve the right to change the terms of this notice and to make the new notice provisions effective for all protected health information we maintain.

Uses and Disclosures of your Protected Health Information:

Treatment: We are permitted to use your medical information as necessary to provide you with medical treatment and services. We may disclose information about you to physicians, nurses, technicians, medical students, or other workforce members who are involved in taking care of you at or through CSC. To assist with your care outside of CSC, we may disclose your information to other health-care providers.

Payment: We are permitted to use and disclose your medical information to get paid for the services you received. For example, we may disclose your information about your exam or procedure to your insurance company so that your insurance company will pay us. We also may tell your insurance company about treatment you are going to receive in order to obtain approval or to determine whether your insurance will cover the treatment. We may disclose your health information to other providers who are involved in your care for their payment purposes. For example, we may release information to emergency responders to allow them to obtain payment or reimbursement for services provided to you.

Health Care Operations: We are permitted to use your medical information for our business operations include training of medical personnel, peer review, and quality improvement. We may disclose your information to another health care provider or health plan if they have a relationship with you and need the information for their own business operations. For example, our quality management department may use your health information to assess the quality of care you received and to ensure that our system continues providing the quality care you and other patients deserve.

Appointment Reminders and Treatment Alternatives, and Health-related Benefits and Services: We may use and disclose your medical information to contact you to remind you that you have an appointment scheduled, to tell you about or recommend possible treatment options or alternatives that may be of interest to you, or to tell you about a product or service that may be of interest to you.

Family Members and Others Involved in Your Care: CSC may disclose your medical information to your family members or friends you are involved in your care, or to someone who helps pay for your care. CSC may also disclose your medical information to disaster relief organizations to help locate individuals during a disaster, or to notify, or assist in the notification, of a family member, a personal representative, or a person responsible for your care of your location, general condition or death. If you do not want CSC to disclose your medical information to family members or other in these circumstances, please notify CSC staff.

Health Oversight Activities: We may disclose your medical information to health oversight agency for activities authorized by law. These oversight activities include government audits, investigations, and inspections. We may also provide your medical information to a government agency that oversees licensing of health care professionals, such as the New Medical Board.

Incidental Disclosures: Incidental disclosures of your health information may occur as a by-product of permitted use and disclosure of your health information. These incidental disclosures are permitted if we have applied reasonable safeguards to protect the confidentiality of your health information.

Inmates: If you are an inmate of a correctional facility or are under the custody of a low enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary to provide you with health care or to protect your health and safety of others, including the correctional institution.

Law Enforcement: We may disclose your health information to law enforcement officials as required by law or as directed by court order, warrant, criminal subpoena, or other lawful process and in other limited circumstances for purposes of identifying or locating suspects, fugitives, material witnesses, missing persons, or crim victims.

Legal Proceedings: We may disclose health information about you in response to a court or administrative order. We also may disclose medical information about you in response to a civil subpoena, discovery request, or other lawful processes by someone involved in legal proceedings. In many cases you will receive advance notice about this disclosure so that you will have a chance to object to sharing your medical information.

Military and Veterans: If you are a member of the armed forces, we may release health information about you as required by military command authorities. We also may release health information about foreign military personnel to the appropriate foreign military authority.

National Security, intelligence, Activities, Protection Services for the President, and Others: We may disclose your medical information to authorized federal officials for lawful intelligence, counterintelligence, or other national security activities authorized by law; for protection of the U.S President, other authorized persons or foreign head of state; or for special authorized investigations.

Public Health Activities: We may disclose your medical information for public health activities as authorized by law. These activities typically include reports to such agencies as the Department of Health and;

Human Services or the Food and Drug Administration: The disclosures are usually made for the purpose of preventing or controlling disease, injury, or disability. Examples include reporting of disease, injury and vital events such as births and deaths, reporting of child and elder abuse, and reporting of reactions to medications and problems with products.

Research: Under certain circumstances, we may use and disclose your medical information for research purposes. All research projects are subject to a special approval process by an Institutional Review Board. This review process governs patient safety and welfare and the privacy of your medical information. Under special circumstances involving research, a Privacy Board has been established to monitor and protect your privacy rights.

Sale of PHI: CSC may not sell your health information without your written authorization.

Required by law: we will disclose your health information about you when required to do so by federal, state, or local law

To Avert a serious threat to Health or Safety: We may use and disclose your medical information, when necessary, to prevent a serious threat to your health and safety or the health and safety of others.

Workers’ Compensation: We may release information about you for workers’ compensation or similar programs as authorized by law. These programs provide benefits for work-related injuries and illnesses.

Coroners, Medical Examiners and Funeral Directors: We may disclose medical information concerning deceased patients to coroners, medical examiners and funeral directors to assist them in carrying out their duties.

Organ and Tissue Donation: We may disclose medical information to organizations that handle organ, eye or tissue donation or transplantation if you have previously agreed to organ donation.

Information with Additional Protection:

Certain types of medical information have additional protection under New Mexico Law. In some circumstances, CSC will require your consent to disclose information about communicable disease and HIV/AIDS, drug and alcohol abuse treatment, genetic testing, and mental health treatment.

Psychotherapy Notes: CSC will not use or disclose your psychotherapy notes without your authorization, unless the use is by the person who wrote the notes for purposes of treatment, for training of medical or counselling professionals, or for CSC to defend itself ain a legal proceeding brought by you. In addition, any disclosure or use must be to the Department of Health and Human Services; required by law for the health oversight of the practitioner that wrote the notes; to the coroner or medical examiner; or to avert a serous threat to health or safety of a person or the public.

Other Uses and Disclosures: Uses and disclosures of your information not described in this notice require your written authorization If you provide CSC with an authorization to use or disclose your medical information, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will not loner use or disclose your medical information for the reasons covered by your written authorization. You understand that we cannot take back any disclosures we have already made with your authorization, and that we are required to retain our records for the care we provided you. To revoke your authorization, please write to the Medical Records Department.

Copy of this Notice: You have the right to receive a paper copy of this notice and any revisions to it upon request. You may obtain a copy by asking our receptionist at your next visit or by calling and asking us to mail you a copy.

Inspect and Copy: You have the right to inspect and copy the medical information we maintain about you in our designated record set as long as we maintain that information. This designated record set includes your medical and billing records, as well as any other records we use for making decisions about you. You may not inspect or copy psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; or medical information that is subject to law that prohibits access to the medical information.

In some circumstances you may have a right to review our denial. If you wish to inspect or copy your medical information, you must submit your request in writing to the attention of our Privacy Officer, Comprehensive Surgical Care (CSC) 4700 Jefferson Street Suite 100 Albuquerque NM 87109. Please identify in your request. We may charge a fee for the cost of copying, mailing, or other supplies used in fulfilling your request. You may mail your request or bring it to our office. We have 30 days to response to your request for information that we maintain at our practice sites, although we may extent the time an additional 30 days, but must inform you of this delay.

Request Amendment:  You have the right to request that we amend your medical information. You must make this request in writing to our Privacy Officer. The request must state the reason for the amendment.

We may deny your request if it is not in writing or does not state the reason for the amendment. We may also deny your request if the information; was not created by us, unless you provide reasonable information that the person who created it no longer available to make the amendment; is not part of the record which you are permitted to inspect and copy; the information is not par to four designated record or is accurate and complete, in our opinion.

Request Restrictions: You may request that CSC request for limit the health information it uses or discloses about you for treatment, payment or health care operations. Additionally, you have the right to request our disclosure of your health information to only certain individuals involved in your care of the payment of your care, such as family members or friends. CSV is not required to agree to your request for a restriction, unless you request that we not hare you medical information with your health insurer about a service for which you (or someone other than your insurer) has paid CSC in full and the disclosure is for the purpose of carrying out payment of health care operations and is not otherwise required by law.

Accounting of Disclosure: You have the right to request a list of certain disclosures of your medical information. Your request must be in writing and must state the time period for the requested information. Your first request for a list of disclosures within a 12-month period will be free. If you request an additional list within 12 months for the first request, we may charge you a fee for the cost of provide the subsequent list. We will notify you of such cost and afford you the opportunity to withdraw your request before any costs are incurred.

Request Confidential Communications: You have the right to request how we communicate with you to preserve your privacy. We may condition the accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. You must submit your request in writing to our Privacy Officer. The request must specify how or where we are to contact you. We will accommodate all reasonable requests.

File a Complaint: You have the right to file a complaint if you believe we have violated your privacy rights. We will not retaliate against you for filling a complaint. Complaints may be submitted:

In writing to our Privacy Officer

Attn: Privacy Officer

Comprehensive Surgical Care

4700 Jefferson Street Suite 100 Albuquerque NM 87109

Compliance Hotline 1-855-662-SAFE Company ID: 7615215386. You have the option of filing a complaint anonymously using the hotline. SAFEHOTLINE.COM.

You can file a complaint with the U.S. Department of Health and Human Services Offices for Civil Rights by sending a letter to 200 Independence Avenue SW Washington D.C. 20201, calling 1-877-696-6775, or by visiting www.hhs.gove.ocr.privacy.hippa/complaints/

Notification if Confidentiality is Breached: We are required to notify affected individuals following a breach of unsecured medical information.

Changes to this Notice: CSC reserves the right to change the terms of this notice and to make the new notice provisions, effective for all medical information we maintain. You may receive a copy of any revised notice at the CSC facility after it becomes effective.