Notice of Privacy Practices

Notice of Privacy Practices

This Notice of Privacy Practices describes the legal obligations of the Premier Health (the Company) and its covered entity affiliates and your legal rights regarding protected health information held by the under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), and the Health Information Technology for Economic and Clinical Health Act (found in Title XIII of the American Recovery and Reinvestment Act of 2009) (collectively referred to as “HIPAA”),.

The Company will only use or disclose your Protected Health Information (PHI) as permitted or required by applicable state and federal law. This Notice applies to your PHI under our control including the medical records generated by us. This Notice also applies to the utilization review and quality assessment activities of the Company.

How We May Use and Disclose Your PHI

In certain circumstances The Company is permitted or required to use and disclose your PHI without obtaining your prior authorization and without offering you the opportunity to object. The following categories describe some of these different circumstances. Note that some information, such as HIV/AIDS information, genetic information, reproductive health information, substance use disorder information, and information of state or federal program recipients may be subject to more stringent confidentiality protections under applicable state or federal laws, and we will abide by these special protections.

Permitted Uses and Disclosures that Do Not Require Your Prior Authorization

The following are the primary circumstances under which the Company may use and disclose your PHI without your prior signed authorization:

Treatment. The company may use or disclose PHI as necessary to treat you or perform services in connection with your treatment or to allow another covered entity or healthcare provider to treat you. For example, we may use or disclose PHI to doctors, nurses, technicians, medical students, pharmacists, lab, x-ray or other health care organizations who are involved in taking care of you. The company may disclose your PHI to third parties to help coordinate your care and make sure that everyone who is involved in your care has the information that they need about you to meet your health care needs.

Payment. The company may use or disclose your PHI as necessary to receive reimbursement or compensation for services provided. We may contact an insurer to get payment authorization for services provided, and we are permitted to use PHI to bill you for the cost of the services provided. For example, we may need to release medical or other information about you to your insurance to process claims for health care services we have rendered. We may also disclose PHI as necessary for another covered entity’s payment activities. or to another person who is responsible for payment.

Healthcare Operations. The Company may use or disclose your PHI for day-to-day healthcare operations and functions for our own internal quality and other business purposes. For example, we may use your PHI to review our services and to evaluate the performance of our staff. We may use your PHI as part of our efforts to continually improve the quality and effectiveness of the health care products and services we provide. We may also use your PHI for strategic planning, training, claims reporting and in developing and testing our information systems and programs. Healthcare operations related to the sale, merger, or consolidation of a covered entity.

Health Information Exchange. The Company may share your information for treatment, payment, and healthcare operations purposes through a Health Information Exchange (HIE) in which we participate in order for participants to efficiently access and use your pertinent medical information necessary for treatment and other lawful purposes. A HIE is a secure electronic system that helps health care providers and entities such as health plans and insurers managed care and treat patients. We will send your health information to the HIEs as we choose to participate in them. Information about your past medical care and current medical conditions and medicines is available not only to us but also to non-affiliate health care providers who participate in the HIE. You have the right to opt out of the HIE. However, even if you do, some of your health information will remain available to certain health care entities as permitted by law.

Incidental disclosures. Your information may be used or disclosed incidentally to a permitted use or disclosure. An example of an incidental disclosure is listing or calling your name in a waiting area for an appointment where others in the waiting area may see or hear your name called. We will make reasonable efforts to limit these incidental uses and disclosures of your protected health information.

Appointment Reminders. The Company may use and disclose your PHI to contact you as a reminder that you have an appointment for treatment or medical care. We may leave message on your answering machine, voice mail, email, or other means.

Treatment Alternatives. We may contact you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Benefits and Services. We may contact you about health-related benefits or services such as disease management programs and community-based activities in which we participate that may be of interest to you.

Third Party Business Associates. The Company may contract with individuals or entities known as Business Associates who we contract with to perform various functions on our behalf or to provide certain types of services. In order to perform these functions or to provide these services, Business Associates will receive, create, maintain, and/or transmit protected health information about you, but only after they agree in writing with us to implement appropriate safeguards regarding your protected health information.

If we disclose your information to these tier parity entities, we will have an agreement with them to safeguard the privacy and security of the information and to not further use or disclose the information. For instance, we may contract with a company that provides billing or health care management services or an auditor.

To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Permitted Use and Disclosures Per Public Policy or Law-That Do Not Require Your Prior Authorization

Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Law Enforcement. We may disclose your PHI if asked to do so by a law enforcement official:
• In response to a court order, subpoena, warrant, summons or similar process.
• To identify or locate a suspect, fugitive, material witness, or missing person.
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement.
• About a death we believe may be the result of criminal conduct.
• About criminal conduct at the facility; and
• In emergency circumstances, not occurring on the premises, to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
• Exceptions may apply to Reproductive Health and Substance Use Disorder records. Reproductive Health Records request may require an Attestation to be completed by the requestor.

As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law. Exceptions may apply to Reproductive Health and Substance Use Disorder records. For example, we may report a gunshot or other violent crime causing bodily harm or reporting a death.

More Stringent State and Federal Laws: Certain State and Federal laws may be more stringent than HIPAA in several areas. The Company will abide by these more stringent state and federal laws.

Public Health and Safety. The Company may use and disclose our PHI for public health activities. We can share information about you for certain situations such as preventing disease, helping with product recalls, reporting adverse reactions to medication, reporting suspected abuse, neglect, or domestic violence, or preventing or reducing a serious threat to anyone’s health or safety.
• to prevent or control disease, injury, or disability.
• to report births and deaths.
• to report reactions to medications or problems with products.
• to notify people of recalls of products they may be using.
• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
• to provide proof of immunization to a school that is required by state or other law to have such proof with agreement to the disclosure by a parent or guardian of, or other person acting in loco parentis for an un-emancipated minor.
• to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence (We will only make this disclosure if you agree or when required or authorized by law).
• Deidentified Substance Use Disorder information.
• Disaster relief
• Public health authorities responsible for maintaining vital statistics or other public health functions
• the Food and Drug Administration in connection with FDA-regulated products

Coroners, Medical Examiners and Funeral Directors. We may disclose your PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release PHI to funeral directors as necessary to carry out their duties.

National Security and Intelligence Activities. Specialized governmental functions. The Secretary, or designee, has the right to see your information in order to make sure we follow the law. We may share your medical information for certain specialized governmental functions, as allowed by law. authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law. Such functions include:

• The Secretary of the United States Department of Health & Human Services
• Military and veteran activities.
• National security and intelligence activities.
• foreign heads of state

Protective Services for the President and Others. The Company may disclose your medical information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or conduct special investigations.

Military and Veterans. If you are a member of the armed forces, the Company may release your PHI as required by military command authorities so that your fitness for duty or for a particular mission may be determined, to comply with military health surveillance requirements, for activities deemed necessary by appropriate military command authorities, or for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Correctional Institutions-Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official, if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

Other Use and Disclosure Situations That Do Not Require Your Prior Authorization

Workers’ Compensation. The Company may release your PHI as authorized by applicable law to the extent necessary to comply with workers’ compensation laws or laws related to similar programs. These programs provide benefits for work-related injuries or illnesses.

Organ and Tissue Donation. If you are an organ donor, the Company may use and disclose your PHI to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Research. Under certain circumstances, we may use and disclose your PHI for research purposes. through an approval process designed to protect patient safety, welfare, and confidentiality. A research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. You will not be the subject of research without your prior written and informed consent. Unless otherwise described in the consent, your identity and your health information will remain private during and after the research. All research projects must comply with state and federal regulations.

To Create De-identified Databases. We may use your health information to create “de-identified” information in accordance with applicable law. After removing information that tells anyone who you are, your de-identified limited medical information may be put into a computer program which may be used for research or public action purposes. If your information is partially de-identified, it is called a “limited data set,” and may be used for similar purposes in accordance with applicable law and regulations.

Permitted Use and Discloser that Do Not Require Your Prior Authorization but Give You the Opportunity to Agree or Object

In certain situations, you have the right to agree or object whether your PHI can be used or released. We may generally make uses and disclosures, if in the exercise of professional judgment, the use or disclosure is determined to be in your best interests. If you agree, do not object, or we reasonably infer that there is no objection, and to the extent permitted by your medical information may be used in the following ways:

Individuals Involved in Your Care or Payment for Your Care. If you are available do not specifically agree or object the Company may release PHI about you to a friend or family member or personal representative who is involved in your medical care and provide any medical information that they need to know if they are involved in caring for you. If you are unavailable or incapacitated, and we determine that a limited disclosure is in your best interest, we may share limited medical information with such individuals. For example, we can tell someone who is assisting with your care that you need to take your medication or get a prescription refilled or give them information on how to care for you. We may give information to someone who helps pay for your care. We may also tell your family or friends your condition and notify them that you are in the facility. We may disclose your PHI to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

If you tell us that you want us to give your medical information to someone specific, we will do so. You will need to fill out an authorization form which gives us permission to release your medical information. You may stop this authorization at any time.

Fundraising Activities. The Company may contact you as part of our effort to raise funds. In making these communications we will only use or disclose limited information about you, including such as demographic information, dates of health care provided to you; department of service; your treating physician; whether you had a positive or negative outcome; and your health insurance status. You have a right to opt out of receiving fundraising communications and all fundraising communications will include information about how you may opt out of future communications.

Facility Directory. Unless you object, the Company may include certain limited information about you in the contact directory. This information may include your name, location in the hospital, your general condition (e.g., fair, stable, etc.) and your religious affiliation. The directory information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they do not ask for you by name.

Media Reports: The Company may release facility directory information to the media (excluding religious affiliation) if the media requests information about you using your name. Note that you may decline to be included in the directory.

Use and Disclosure Situations that Do Require Your Authorization

Except as permitted under HIPAA or as described above, certain disclosures of your protected health information will be made only with your written authorization. Examples: HIV/Aids, Sexually Transmitted Disease, Reproductive Health, Drug and Alcohol information, etc. Other uses and disclosures of your PHI not covered by this Notice or the laws that apply to us will be made only with your written authorization including but not limited to:

As Required By Your Employment: The Company, with your prior consent, may use and disclose your confidential medical information, associated with job duty recommendations or requirements, with your employer HR department or supervisor, or with associated departments. This may include, but is not limited to, assessments, declinations, determinations, drug and alcohol testing results, and results related to fitness for duty requirements, clearances consistent with state or federal requirements.

Drug and Alcohol: The Company in certain circumstances will obtain your written authorization to use and disclose information related to drug and alcohol treatment or rehabilitation.

Marketing: Subject to certain limited exceptions, your written authorization is required in cases where our Ministry receives any direct or indirect financial remuneration in exchange for making the communication to you which encourages you to purchase a product or service or for a disclosure to a third party who wants to market their products or services to you.

Certain Research Requirements: The Company will obtain your written authorization to use or disclose your PHI for certain research purposes when required by HIPAA or clinical research laws and regulations.

Psychotherapy Notes: Uses and disclosures of psychotherapy notes require your written authorization.

Substance Use Disorder Counseling. Uses and disclosures of SUD counseling notes maintained separately from SUD treatment records require your written authorization.

Sale of PHI: Subject to certain limited exceptions, disclosures that constitute a sale of PHI require your written authorization.

Other Uses and Disclosures: Any other uses or disclosures of PHI that are not described in this Notice of Privacy Practices may require your written authorization (if not permitted by HIPAA). Written authorizations will let you know why we are using your PHI. You have the right to revoke an authorization at any time.

You may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose your PHI for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you or when we have acted in reliance upon your prior authorization, or if you signed the authorization as a condition of obtaining insurance coverage.

Other Situations

In some circumstances, your medical information may be restricted in a way that limits some of the uses and disclosures described in this Notice. For example, there are special restrictions on the use or disclosure of certain categories of information such as treatment related Reproductive Health Care, or certain Alcohol or Drug related treatment information.

Reproductive Health Care Privacy. The Company is prohibited from the use or disclosure of reproductive protected health information.

• to conduct a criminal, civil, or administrative investigation into or impose criminal, civil, or administrative liability on any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care, where such health care is lawful under the circumstances in which it is provided.
• the identification of any person for the purpose of conducting such investigation or imposing such liability.
The prohibition applies where it has reasonably determined that one or more of the following conditions exist:
• Reproductive health care is lawful under the law of the state in which such health care is provided under the circumstances in which it is provided,
• the reproductive health care is protected, required, or authorized by Federal law, including the U.S. Constitution, regardless of the state in which such health care is provided.
• The reproductive health care was provided by a person other than the covered health care provider, health plan, or health care clearinghouse (or business associates) that receives the request for PHI and the presumption described below applies.

We may disclose your PHI for purposes permitted under the Privacy Rule where the request for the use or disclosure of PHI is not made to investigate or impose liability on any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care; and the reproductive healthcare is presumed to be lawful under the circumstances in which it was provided unless otherwise knowledgeable that the care was not lawful.

We will require an attestation from the requestor that the use or disclosure is not for a prohibited purpose.

Substance Use Disorder (SUD) The Company is prohibited from disclosing your information for civil, criminal administrative or legislative proceeding without your authorization or a court order. We may disclose your PHI with your single authorization for treatment payment and health care operations:

• to use and disclose and disclose your drug and alcohol treatment information for all future uses and disclosure.
• to redisclose your information to covered entities and business associates according to the scope of your consent.
• We will apply extra protections and require a separate authorization for the use and disclosure of counseling notes.

Your Health Information Rights

The HIPAA Privacy Rule provides individuals with rights in regard to their protected health information. If you wish to make a patient rights request, you must submit your specific request in writing to the Privacy Officer or designer. All requests will be reviewed and considered. Under certain circumstances, we may deny your request. If this occurs, you have the right to have the denial reviewed.

Right to Inspect and Obtain Electronic or Paper Copies of Your Medical Record. You have the right to inspect and request copies of PHI that we maintain about you. This includes medical and billing records, but does not include psychotherapy notes, information compiled in anticipation of or for use in civil, criminal, or administrative proceedings, or certain information that is governed by the Clinical Laboratory Improvement Act. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. Additionally, you have the right to ask us to send a copy of your PHI to other individuals or entities that you designate. You may also access information via patient portal if made available by our affiliate.

Right to Request an Amendment. If you feel that PHI maintained about you is incorrect or incomplete, you may submit a written request that we amend. We are obliged to review any such request but are not obliged to agree to it. Specifically, we may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
• was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
• is not part of the medical information kept by or for the facility.
• is not part of the information which you would be permitted to inspect and copy; or
• is accurate and complete.
To request must be made in writing and submitted to the Medical Records Department of your facility as designated below. In addition, you must provide a reason that supports your request. If we deny your request, you have the right to file a statement of disagreement with us and any future disclosures of the disputed information will include your statement. but we will tell you why in writing within 60 days.

Right to Accounting of Disclosures. You have the right to request an accounting of disclosures for six years prior including substance use disorder information for up to three years prior. This is a list of when, what, to whom, and why we disclosed medical information about you. To request this list or accounting of disclosures, you must submit your request in writing on the form described above. Your request must state a time period, within the six (6) years immediately preceding the request. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free of charge. For additional requests in the same 12-month period, we may charge you a reasonable cost-based fee for providing you with the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment, or health care operations. You also have the right to request a limitation on the PHI we disclose about you to someone who is involved in your care or the payment for your care. The request must be made in writing. If we agree, we will comply with your request unless the information is needed to provide emergency treatment. We are not required to agree to the requested restrictions, unless your request is that we not disclose information to a health plan for payment.

If you pay for a service or healthcare item out-of-pocket in full, you can ask us not to share information for purpose of payment or our operations with your health insurer. We will say “yes” to such a request unless a law requires us to share that information.

Right to Request Confidential Communications. You have the right to request that we communicate with you about your health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. You must make your request in writing. Please note that if you choose to receive communications from us via email or other electronic means, those may not be a secure means of communication and your PHI that may be contained in our emails to you will not be encrypted.

Communications. Please note that email and text messaging and communications over the internet have certain risks, such as interception by others, misaddressed/misdirected messages, shared accounts, messages forwarded to others, or messages stored on unsecured, portable electronic devices, and may not be a secure method of transmitting information. By providing us with your email address or mobile phone number, you understand these risks and consent to us by communicating with you via e-mail or text message about your treatment or payment for your care. If you choose to communicate with us or any of via unsecure electronic communication, we may respond to you in the same manner in which the communication was received and to the same e-mail address or account from which you sent your original communication.

Privacy After Death. The federal Health Insurance Portability and Accountability Act (HIPAA) grants privacy protections to a person’s medical information even after death. However, HIPAA also establishes that a patient’s designated personal representative has a legal right to access the patient’s records. The Company will provide the records to his or her designated personal representative if one exists.

Notification of a Breach. Under certain circumstances you have the right to be notified following a breach of your unsecured PHI, and we will notify you in accordance with applicable law.

Right to receive a paper copy of this Notice. You have the right to copy a paper of this Notice. You may obtain a copy of this Notice by printing directly from websites or requesting verbally or via email.

Special Circumstances for Minors. In most cases, parents are the personal representatives for their minor children and can exercise individual rights, such as access to the medical record, on behalf of their minor children. The Company has discretion to provide or deny a parent access to the minor’s health information, provided the decision is made by a licensed health care professional in the exercise of professional judgment.

In certain circumstances the parent is not considered the personal representative, (Example: when the minor can legally consent to their own care for certain treatments), and the minor must give written authorization to use and disclose the PHI to the parent .The Company defers to State and other law to determine the rights of parents to access and control the protected health information of their minor children.

OUR OBLIGATIONS

Our Legal Duties. We are required by law to:

• Make sure that medical information that identifies you is kept private.
• Give you this notice of our legal duties and privacy practices with respect to your medical information.
• Notify you following a breach affecting your unsecured protected health information; and
• Follow the terms of the notice that is currently in effect.
• Obtain your acknowledgment that you have access to this Notice
• The Company complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Language assistance services, free of charge, are available to you.

Who Must Follow This Notice.
This Notice describes the Company practices and that of:
• All team members, students, contractors, and other personnel.
• All departments and units of the Company
• Any member of a volunteer group allows us to help you while you are in our care.
• Any physician or allied health professional who is a member of the Company and involved in your care and entering PHI into your record.
• All entities, sites and locations will follow the terms of this Notice. When this Notice refers to “the Company,” “we” or “us,” it is referring to the following entities, sites, and locations. In addition, these entities may share medical information with each other for treatment, payment or health care operations purposes described in this Notice.

This Notice of Privacy Practices covers an Affiliated Covered Entity (“ACE”). When this Notice refers to the Premier Health ACE, it is referring to the Company and all of its subsidiaries and affiliates as a covered entity under HIPAA it is referring to [Convenient Care, Freedom Urgent Care, Hendrick Urgent Care, Holy Cross Urgent Care, Lake After Hours, Lake Urgent Care, LCMC Health Urgent Care, Lourdes Urgent Care, MercyOne Urgent Care, Mount Carmel Urgent Care, Premier Health Consultants, Rapides Urgent Care, St. Francis Urgent Care, St. Joseph’s/Candler Urgent Care, Total Occupational Medicine, Total Urgent Care, Trinity Health Of New England Urgent Care]. Pursuant to 45 C.F.R. § 164.105(b), Each of the Premier Health subsidiaries or affiliates hereby designates itself as a single covered entity for purposes of compliance with HIPAA. This designation may be amended from time to add new covered entities that are under the common control and/or ownership of Premier Health. To obtain a list of the most current listing of these entities, please access the Company website or contact the Privacy Officer. “ACE” amended 2/2025.

Acknowledgement of Receipt of this Notice. You will be asked to provide a signed acknowledgement of access to and/or receipt of this Notice. Our intent is to make you aware of the possible uses and disclosures of your protected health information and your privacy rights. The delivery of health care services will in no way be conditioned upon your signed acknowledgement.

Changes to This Notice. The Company reserves the right to change our practices and the terms of this Notice at any time and to make the new Notice provisions effective for all PHI that we maintain. The new Notice will be available upon request in our Facilities and on our website.
Effective: April 14, 2010, Revision Date: September 1, 2013, April 5 2019, February 10, 2025

Questions or Complaints

If you have any questions about the Notice, or believe that the Company has violated your privacy rights, you may file a complaint with the Privacy Officer listed below. We will promptly investigate any complaints in an effort to resolve the matter. We may not penalize or retaliate against you for filing such a complaint.

Privacy Officer; 10319 Jefferson Hwy Baton Rouge, LA 70809 (225) 214-9352 Compliance@phcurgentcare.com

You may also file a written complaint with the U.S. Department of Health and Human Services Office of Civil Rights, 200 Independence Avenue, S. W., Washington, DC 20201 or by calling (877) 696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/