HIPPA NOTICE OF PRIVACY PRACTICES
HIPAA Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
For any questions regarding this notice, contact Apex Med Family Healthcare’s Customer Relations Department at (909) 581-8509.
Hearing Impaired Services: TTY 711
Language or LEP (Limited English Proficiency) Services: Call the number on your insurance ID card for no-cost assistance.
Who Will Follow This Notice
This notice applies to the practices of:
Healthcare Professionals: Any authorized personnel entering information into your clinic chart.
Apex Med Locations: All Apex Med Family Healthcare locations and departments.
Contracted Providers: Physicians, specialists, and allied health professionals affiliated with Apex Med.
Employees and Staff: All Apex Med Family Healthcare employees, contractors, and personnel.
Partner Organizations: Contracted health plans and healthcare delivery entities for treatment, payment, or operations purposes.
Our Pledge Regarding Medical Information
We are committed to protecting your medical information.
We create records of the care and services you receive to provide quality care and comply with legal requirements.
We are required by law to:
Keep your identifiable medical information private.
Provide you with this notice of legal duties and privacy practices.
Follow the terms of this notice currently in effect.
How We May Use and Disclose Medical Information
Below are examples of permissible uses and disclosures:
1. For Treatment
We may share medical information with healthcare providers for your care (e.g., doctors, nurses, or specialists).
Example: A doctor may share your diabetes condition with a dietitian for counseling.
2. For Payment
To bill and collect payment from you, insurance companies, or third parties.
Example: Informing your health plan to confirm coverage for a treatment.
3. For Healthcare Operations
To improve clinic operations and ensure quality care.
Example: Evaluating staff performance or reviewing treatment outcomes.
Participation in the Inland Empire Health Information Exchange (IEHIE) allows providers to share complete records for improved care.
4. Appointment Reminders
Contacting you about upcoming appointments.
5. Treatment Alternatives and Health-Related Benefits
Informing you about treatment options or services that may interest you.
6. Fundraising Activities
Using basic demographic details (e.g., dates of care) for fundraising purposes.
Opt-Out Option: Notify us if you prefer not to receive fundraising communications.
7. Individuals Involved in Your Care
Sharing information with family or friends involved in your care or payment, unless you request otherwise.
8. Research
Participation in approved research projects under strict privacy safeguards.
9. As Required by Law
Disclosures mandated by federal, state, or local laws.
10. Averting Serious Threats
To prevent serious harm to you or others.
Special Situations
We may use or disclose medical information for the following purposes:
Organ and Tissue Donation
Facilitating organ or tissue donation if you are a donor.
Military and Veterans
Compliance with military command authority for service members.
Workers’ Compensation
Reporting work-related injuries or illnesses.
Public Health Risks
Reporting disease control, medication reactions, recalls, abuse, or neglect.
Oversight Activities
Audits, inspections, and investigations by health oversight agencies.
Legal Proceedings
Compliance with court orders, subpoenas, or other lawful processes.
Law Enforcement
Assisting with crime investigations or reports.
Reporting criminal conduct in the clinic.
Coroners, Medical Examiners, and Funeral Directors
Facilitating death investigations and funeral arrangements.
National Security
Authorized disclosures for national security purposes.
Inmates
Sharing necessary medical information with correctional institutions for care and safety.
Your Rights Regarding Medical Information
You have specific rights regarding your medical information:
1. Right to Inspect and Copy
You may request access to your records.
Submit written requests to:
Apex Med Family Healthcare Medical Records Department
99 North San Antonio Ave., Suite 210, Upland, CA 91786.
2. Right to Amend
Request corrections to inaccurate or incomplete records.
Submit written requests with supporting reasons to the Medical Records Department.
3. Right to an Accounting of Disclosures
Request a list of non-treatment-related disclosures for the last six years.
First request is free; subsequent requests may incur fees.
4. Right to Request Restrictions
Limit how your information is used or shared.
We are not obligated to comply but will attempt reasonable accommodations.
5. Right to Request Confidential Communications
Specify preferred methods or locations for communication.
6. Right to a Paper Copy
Request a physical copy of this notice, even if you agreed to receive it electronically.
Changes to This Notice
We reserve the right to update this notice.
Current notices will be posted in the clinic and provided during visits.
Complaints
If you believe your privacy rights have been violated:
Contact the Vice President of Quality/Risk Management at:
Apex Med Family Healthcare Quality/Risk Management Department
99 North San Antonio Ave., Suite 210, Upland, CA 91786.File a complaint with the Department of Health and Human Services.
No retaliation for complaints will occur.
Other Uses of Medical Information
Uses not covered by this notice will require your written permission. You may revoke consent at any time, but disclosures made prior to revocation cannot be undone.