3. WHEN AND WITH WHOM DO WE SHARE YOUR PERSONAL INFORMATION?
4. HOW LONG DO WE KEEP YOUR INFORMATION?
5. HOW DO WE KEEP YOUR INFORMATION SAFE?
6. DO WE COLLECT INFORMATION FROM MINORS?
7. WHAT ARE YOUR PRIVACY RIGHTS?
8. CONTROLS FOR DO-NOT-TRACK FEATURES
9. DO WE MAKE UPDATES TO THIS NOTICE?
10. HOW CAN YOU CONTACT US ABOUT THIS NOTICE?
11. HOW CAN YOU REVIEW, UPDATE, OR DELETE THE DATA WE COLLECT FROM YOU?
We collect personal information that you voluntarily provide to us when you express an interest in obtaining information about us or our products and Services, when you participate in activities on the Services, or otherwise when you contact us.
We process your personal information for a variety of reasons, depending on how you interact with our Services, including:
We do not knowingly solicit data from or market to children under 18 years of age. By using the Services, you represent that you are at least 18 or that you are the parent or guardian of such a minor and consent to such minor dependent’s use of the Services. If we learn that personal information from users less than 18 years of age has been collected, we will deactivate the account and take reasonable measures to promptly delete such data from our records. If you become aware of any data we may have collected from children under age 18, please contact us at admin@mensclinictx.com.
However, please note that this will not affect the lawfulness of the processing before its withdrawal nor, when applicable law allows, will it affect the processing of your personal information conducted in reliance on lawful processing grounds other than consent.
Most web browsers and some mobile operating systems and mobile applications include a Do-Not-Track ("DNT") feature or setting you can activate to signal your privacy preference not to have data about your online browsing activities monitored and collected. At this stage no uniform technology standard for recognizing and implementing DNT signals has been finalized. As such, we do not currently respond to DNT browser signals or any other mechanism that automatically communicates your choice not to be tracked online. If a standard for online tracking is adopted that we must follow in the future, we will inform you about that practice in a revised version of this privacy notice.
United States
Based on the applicable laws of your country, you may have the right to request access to the personal information we collect from you, change that information, or delete it. To request to review, update, or delete your personal information, please fill out and submit a data subject access request.
NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
Effective Date: 10/01/2023
Practice Name: Hollytree Health / The Men’s Clinic by Hollytree Health
Contact: Blake Williams, MSN, APRN, FNP-C, ENP-C
Phone: (903) 352-3250
Email: Admin@mensclinictx.com
Address: 7262 Crosswater Ave. Tyler, TX 75703
This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
Our Legal Duties
We are required by applicable federal and state law to maintain the privacy and security of your Protected Health Information, also called PHI. PHI includes information that identifies you and relates to your past, present, or future health, healthcare treatment, or payment for healthcare services.
We are required to:
How We May Use and Disclose Your PHI
We may use and disclose your PHI for the following purposes:
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare. This may include sharing information with providers, pharmacies, laboratories, imaging centers, specialists, or other healthcare professionals involved in your care.
Examples include using your medical history, lab results, medication list, allergies, diagnoses, treatment plans, and visit notes to provide care or coordinate referrals.
Payment
We may use and disclose your PHI to obtain payment for healthcare services. This may include billing, payment processing, claims-related activities when applicable, membership administration, or communication with entities involved in payment for your care.
Because our clinic operates as a direct primary care practice, we generally do not bill insurance for in-office membership services. However, PHI may still be used or disclosed when needed for payment-related purposes, outside lab services, imaging, prescriptions, or other services connected to your care.
Healthcare Operations
We may use and disclose your PHI for healthcare operations, including quality improvement, staff training, credentialing, licensing, compliance, auditing, business planning, customer service, and other administrative activities necessary to operate our practice.
Appointment Reminders and Health-Related Communications
We may use or disclose your PHI to contact you about appointments, follow-up care, lab results, treatment options, prescription refills, care coordination, membership updates, or other health-related services that may be of interest to you.
Individuals Involved in Your Care
We may disclose PHI to a family member, caregiver, personal representative, or other person involved in your care or payment for your care when you give us permission, when we reasonably infer that you do not object, or when otherwise permitted by law.
Business Associates
We may disclose PHI to third-party vendors or service providers who perform services for us, such as electronic medical record systems, billing platforms, secure communication tools, laboratories, payment processors, or other operational vendors. These business associates are required to protect PHI according to applicable law.
As Required or Permitted by Law
We may use or disclose PHI when required or permitted by law, including for:
Uses and Disclosures Requiring Written Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice when authorization is required by law. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
Your Rights Regarding Your Health Information
You have the following rights regarding your PHI:
Right to Inspect and Copy
You have the right to inspect or request a copy of your medical records and other health information we maintain about you, subject to certain legal exceptions.
To request access or copies, please submit a written request to our office using the contact information listed above. We may charge a reasonable, cost-based fee for copies as permitted by law.
Right to Request an Amendment
If you believe information in your medical record is incorrect or incomplete, you may request that we amend the record. Your request must be submitted in writing and should explain why the amendment is needed.
We may deny the request in certain circumstances, such as if we did not create the information, if the information is not part of the records we maintain, or if we believe the record is accurate and complete. If denied, you may submit a written statement of disagreement.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your PHI. This list will not include all disclosures, such as disclosures made for treatment, payment, healthcare operations, or those you authorized.
To request an accounting of disclosures, submit a written request to our office.
Right to Request Restrictions
You have the right to request that we limit how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to all requested restrictions, except in certain situations required by law.
If we agree to a restriction, we will follow it unless the information is needed to provide emergency treatment or otherwise permitted by law.
Right to Request Confidential Communications
You have the right to request that we communicate with you in a certain way or at a certain location. For example, you may ask that we contact you by a specific phone number, mailing address, or communication method.
We will accommodate reasonable requests when possible.
Right to Receive a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Right to Be Notified of a Breach
You have the right to be notified if we discover a breach of unsecured PHI that may have compromised the privacy or security of your information.
Right to File a Complaint
You have the right to file a complaint if you believe your privacy rights have been violated. You may file a complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a complaint.
How to Exercise Your Rights
To exercise any of your rights described in this Notice, please contact:
Practice Name: Hollytree Health / The Men’s Clinic by Hollytree Health
Contact: Blake Williams, MSN, APRN, FNP-C, ENP-C
Phone: (903) 352-3250
Email: Admin@mensclinictx.com
Address: 7262 Crosswater Ave. Tyler, TX 75703
Requests may need to be submitted in writing so we can properly process and document them.
How to File a Complaint With Our Practice
If you believe your privacy rights have been violated, you may submit a complaint to us using the contact information above. Please include your name, contact information, a description of the concern, and any relevant details so we can review and respond appropriately.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not deny care, penalize you, or retaliate against you for filing a privacy complaint.
Changes to This Notice
We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have about you as well as any information we receive in the future. The current Notice will be available upon request and posted on our website.
Questions
If you have questions about this Notice or how your health information is used or disclosed, please contact us using the information listed above.
