• NOTICE OF PRIVACY PRACTICES

  • 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.

    We understand that medical information about you and your health is personal, and we are committed to protecting this information. When you receive care at The Vine Pediatrics and Lactation PLLC, a record of the care and services you receive is made. Typically, this record contains your history and physical, your test results, your diagnosis, your treatment plan and your billing record. This information is recorded electronically in an electronic health record. Our practice utilizes an electronic medical record. This is a secure, HIPPA-compliant, cloud-based electronic health record system. 

    Your record serves as a: 

    • Basis for planning your treatment and services;
    • Means of communication among the physicians and other health care providers involved in your care;
    • Means by which you or a third-party payor can verify that services billed were actually provided;
    • Source of information for public health officials;
    • and Tool for assessing and continually working to improve care rendered.

    Telemedicine services utilizing audio-visual communications for our patients are provided through doxy.me. Through this platform, all data is encrypted, your sessions are anonymous, and none of your information is stored. They adhere to all HIPAA, PIPEDA, and GDPR data privacy requirements. More information about their security can be found at https://doxy.me/patients

    This Notice of Privacy Practices (the "Notice") tells you about the ways we may use and disclose your protected health information ("medical information") and your rights and our obligations regarding the use and disclosure of your medical information. This Notice applies to The Vine Pediatrics and Lactation PLLC, including its providers and employees (the "Practice").

    I. OUR OBLIGATIONS.
    We are required by law to:

    • Maintain the privacy of your medical information, to the extent required by state and federal law;
    • Give you this Notice explaining our legal duties and privacy practices with respect to medical information we collect and maintain about you;
    • Notify affected individuals and the Department of Health & Human Services following a breach of unsecured medical information that presents a significant risk of financial, reputational or other harm to you, to the extent required by law;
    • Follow the terms of the version of this Notice that is currently in effect.
  • II. HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.

    The following categories describe the different reasons that we typically use and disclose medical information. These categories are intended to be general descriptions only, and not a list of every instance in which we may use or disclose your medical information. Please understand that for these categories, the law generally does not require us to get your authorization in order for us to use or disclose your medical information.

    A. For Treatment. We may use and disclose medical information about you to provide you with health care treatment and related services, including coordinating and managing your health care. We may disclose medical information about you to physicians, nurses, other health care providers and personnel who are providing or involved in providing health care to you (both within and outside of the Practice). For example, should your care require referral to or treatment by another physician of a specialty outside of the Practice, we may provide that physician with your medical information in order to aid the physician in his or her treatment of you.

    B. For Payment. We may use and disclose medical information about you so that we or may bill and collect from you, an insurance company, or a third party for the health care services we provide. This may also include the disclosure of medical information to obtain prior authorization for treatment and procedures from your insurance plan. For example, we may send a claim for payment to your insurance company, and that claim may have a code on it that describes the services that have been rendered to you. If, however, you pay for an item or service in full, out of pocket and request that we not disclose to your health plan the medical information solely relating to that item or service, as described more fully in Section IV of this Notice, we will follow that restriction on disclosure unless otherwise required by law.

    C. For Health Care Operations. We may use and disclose medical information about you for our health care operations. These uses and disclosures are necessary to operate and manage our practice and to promote quality care. For example, we may need to use or disclose your medical information in order to assess the quality of care you receive or to conduct certain cost management, business management, administrative, or quality improvement activities or to provide information to our insurance carriers.

    D. Quality Assurance. We may need to use or disclose your medical information for our internal processes to assess and facilitate the provision of quality care to our patients.

    E. Utilization Review. We may need to use or disclose your medical information to perform a review of the services we provide in order to evaluate whether that the appropriate level of services is received, depending on condition and diagnosis.

    F. Credentialing and Peer Review. We may need to use or disclose your medical information in order for us to review the credentials, qualifications and actions of our health care providers.

    G. Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that we believe may be of interest to you.

    H. Appointment Reminders and Health Related Benefits and Services. We may use and disclose medical information, in order to contact you (including, for example, contacting you by phone and leaving a voicemail or message on an answering machine) to provide appointment reminders and other information. We may use and disclose medical information to tell you about health-related benefits or services that we believe may be of interest to you. This may be done by email or text message.

    I. Business Associates. There are some services (such as billing or legal services) that may be provided to or on behalf of our Practice through contracts with business associates. When these services are contracted, we may disclose your medical information to our business associate so that they can perform the job we have asked them to do. To protect your medical information, however, we require the business associate to appropriately safeguard your information.

    J. Individuals Involved in Your Care or Payment for Your Care. We may disclose medical information about you to a friend or family member who is involved in your health care, as well as to someone who helps pay for your care, but we will do so only as allowed by state or federal law (with an opportunity for you to agree or object when required under the law), or in accordance with your prior authorization.

    K. As Required by Law. We will disclose medical information about you when required to do so by federal, state, or local law or regulations.

    L. To Avert an Imminent Threat of Injury to Health or Safety. We may use and disclose medical information about you when necessary to prevent or decrease a serious and imminent threat of injury to your physical, mental or emotional health or safety or the physical safety of another person. Such disclosure would only be to medical or law enforcement personnel.

    M. Organ and Tissue Donation. If you are an organ donor, we may use and disclose medical information 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.

    N. Limited Data Set. System may use or disclose your medical information for purposes of health care operations, research, or public health activities if the information is stripped of direct identifiers and the recipient agrees to keep the information confidential.

    O. Military and Veterans. If you are a member of the armed forces, we may use and disclose medical information about you as required by the appropriate military authorities.

    P. Workers' Compensation. We may disclose medical information about you for your workers' compensation or similar program. These programs provide benefits for work-related injuries. For example, if you have injuries that resulted from your employment, workers' compensation insurance or a state workers' compensation program may be responsible for payment for your care, in which case we might be required to provide information to the insurer or program.

    Q. Public Health Risks. We may disclose medical information about you to public health authorities for public health activities. As a general rule, we are required by law to disclose certain types of information to public health authorities, such as the Texas Department of State Health Services. The types of information generally include information

    • To prevent or control disease, injury, or disability (including the reporting of a particular disease or injury.
    • To report births and deaths.
    • To report suspected child abuse or neglect.
    • To report reactions to medications or problems with medical devices and supplies.
    • 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 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.
    • To provide information about certain medical devices.
    • To assist in public health investigations, surveillance, or interventions.

    R. Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include audits, civil, administrative, or criminal investigations and proceedings, inspections, licensure and disciplinary actions, and other activities necessary for the government to monitor the health care system, certain governmenta benefit programs, certain entities subject to government regulations which relate to health information, and compliance with civil rights laws.

    S. Legal Matters. If you are involved in a lawsuit or a legal dispute, we may disclose medical information about you in response to a court or administrative order, subpoena, discovery request, or other lawful process. In addition to lawsuits, there may be other legal proceedings for which we may be required or authorized to use or disclose your medical information, such as investigations of health care providers, competency hearings on individuals, or claims over the payment of fees for medical services.

    T. Law Enforcement, National Security and Intelligence Activities. In certain circumstances, we may disclose your medical information if we are asked to do so by law enforcement officials, or if we are required by law to do so. We may disclose your medical information to law enforcement personnel, if necessary to prevent or decrease a serious and imminent threat of injury to your physical, mental or emotional health or safety or the physical safety of another person. We may disclose medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

    U. Coroners, Medical Examiners and Funeral Home Directors. We may disclose your medical information 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 medical information about our patients to funeral home directors as necessary to carry out their duties.

    V. Inmates. If you are an inmate of a correctional institution or under custody of a law enforcement official, we may disclose medical information about you to the health care personnel of a correctional institution as necessary for the institution to provide you with health care treatment.

    W. Incidental Uses and Disclosures. Uses and disclosures that occur incidentally with a use or disclosure described in this Section II are acceptable if they occur notwithstanding the Practice’s reasonable safeguards to limit such incidental uses
    and disclosures.

    X. Electronic Disclosures of Medical Information. Under Texas law, we are required to provide notice to you if your medical information is subject to electronic disclosure. This Notice serves as general notice that we may disclose your medical information electronically for treatment, payment, or health care operations or as otherwise authorized or required by state or federal law.

    Y. Information Regarding Minors. Parents are the personal representatives for their minor children and can exercise individual rights, such as access to medical records, on behalf of their minor children. Exceptions to this include the minor's right to seek independent treatment. Any minor who is either in the military or 16 years old and living apart from one's parents (and thus eligible for emancipation) may consent to medical treatment. However, all minors in Texas may consent to treatment pertaining to pregnancy, drug or alcohol abuse, or infectious diseases.

    Z. Written Authorization. The Practice may use or disclose your medical information under circumstances that are not described above only if you provide permission by “written authorization.” After you provide written authorization, you may revoke that authorization, in writing, at any time by sending notice of the revocation to the Practice. If you revoke an authorization, the Practice will no longer use or disclose your medical information under the circumstances permitted by that authorization. However, the Practice cannot take back any disclosures already made under that authorization.

  •  III. OTHER USES OF MEDICAL INFORMATION

    A. Other Permitted and Required Uses and Disclosures Will Be Made Only With Your Consent, Authorization or Opportunity to Object unless required by law.

    B. Right to Revoke Authorization. If you provide us with written authorization to use or disclose your medical information for such other purposes, you may revoke that authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your medical information for the reasons covered by your written authorization. You understand that we are unable to take back any uses or disclosures we have already made in reliance upon your authorization, and that we are required to retain our records of the care that we provided to you.

     

    IV. YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.

    Federal and state laws provide you with certain rights regarding the medical information we have about you. The following is a summary of those rights.

    A. Right to Inspect and Copy. You have the right to inspect and copy your protected health information. You must submit your request to do so in writing to the  Practice’s HIPAA Officer at the address listed in Section V below. In certain circumstances allowed by law, we may deny your request to review or copy your medical information. We will give you any such denial in writing. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the Practice will review your request and the denial. The person conducting the review will not be the person who denied your request. We will abide by the outcome of the review. You may request copies of such information but the Practice may charge you a reasonable fee. 

    Right to Amend. If you feel that medical information the Practice has about you is incorrect or incomplete, you may ask the Practice to amend the information. You have the right to request an amendment for as long as the information is kept by or for
    the Practice. You must make your request in writing to the Privacy Officer, and you must give a reason that supports your request. If the Practice denies your request for an amendment, the Practice will explain to you its reasons for denial and your appeal rights following denial.

    Right to an Accounting of Disclosures. You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This is a list of the disclosures we have made for up to six years prior to the date of your request of your medical information. The Practice
    does not have to list the following disclosures:
    • Disclosures for treatment;
    • Disclosures for payment;
    • Disclosures for health care operations;
    • Disclosures of a limited data set for health care operations, research, or public health activities;
    • Disclosures to you;
    • Disclosures to individuals involved with your health care;
    • Disclosures to authorized federal officials for national security activities;
    • Disclosures that occur incidentally with other permissible uses and disclosures;
    • Disclosures made under your written authorization; and
    • In certain circumstances, disclosures to law enforcement officials or health oversight agencies.

    You must make your request in writing to the Privacy Officer. Your request must
    state the time period during which the disclosures were made, which may not include dates more than six years prior to the request. The Practice may charge you a fee for the list of disclosures if you request more than one list within 12 months. You must submit your request in writing to the Practice's HIPAA Officer at the address set forth in Section V below.

    Right to Request Restrictions. You have the right to request a restriction of your health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to individuals involved with your care or for notification purposes described in this Notice of Privacy Practices. Your request must state the specific restriction and to whom you want the restriction to apply. The Practice is not required to agree to a restriction you may request. If the Practice believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another Healthcare Professional.  To request restrictions, you must make your request in writing to the Practice's HIPAA Officer at the address listed in Section V of this Notice below.

    Right to Request Confidential Communications. You have the right to request to receive confidential communications from us by alternative means or at an alternative location. To request such confidential communications, you must make your request in writing to the Practice's HIPAA Officer at the address listed in Section V below. We will use our best efforts to accommodate all reasonable requests.

    Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice at any time. To obtain a copy of this Notice, you must make your request in writing to the Practice's HIPAA Officer at the address set forth in Section V below.

    Right to Breach Notification. The Practice makes every effort to secure your health information, including the use of encryption whenever possible. In the event that any
    of your medical information that has not been encrypted is the subject of a breach, the Practice will provide you with a written or electronic notification about the breach as required by federal law.

    Right to Make a Complaint. If you believe your privacy rights have been violated, you may file a written complaint with the Practice’s Privacy Officer or with the federal government’s Department of Health and Human Services. The Practice will not penalize you or retaliate against you in any way if you file a complaint.

     

    V. COMPLAINTS

    If you believe your privacy rights have been violated, you may file a written complaint with the Practice’s Privacy Officer or with the federal government’s Department of Health and Human Services.

    To file a complaint with the Practice, you may call us at 832-802-4920 or send a written letter as below:

    The Vine Pediatrics and Lactation
    8990 Kirby Drive
    Suite 220
    Houston, Texas 77054

    You may also file a complaint in writing with the Secretary of the Department of Health & Human Services at:

    Secretary of Health & Human Services
    Region VI, Office for Civil Rights
    U.S. Department of Health & Human Services
    1301 Young Street
    Suite 1169
    Dallas, TX 75202

  • VI. THE PRACTICE'S RIGHT TO REVISE THIS NOTICE

    We reserve the right to change this Notice at any time, along with our privacy policies and practices. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well, as well as any information the Practice receives while such notice is in effect. Within 60 days of a material revision to this Notice, the Practice will provide the revised notice to all patients. When changes have been made to the Notice, you may obtain a revised copy by sending a letter to the Practice's HIPAA Officer at the address listed in Section V.

     

    This Notice was published and becomes effective on 1/12/2022.

  • The Vine Pediatrics and Lactation PLLC
    8990 Kirby Drive
    Suite 220
    Houston, Texas 77054
    832-802-4920 (phone)
    832-336-3947 (fax)
    www.vinepediatrics.com

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