NOTICE OF PRIVACY PRACTICES

Effective Date: 6/1/2026

This Notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully.

Our Commitment to Your Privacy

We understand that your urology care involves sensitive personal information. We are committed to protecting your health information and complying with the Health Insurance Portability and Accountability Act (IBPAA).

How We Use and Share Your Health Information

Treatment

We may use and share your information with physicians, nurses, medical assistants, labs, imaging centers, pharmacies, or other healthcare providers involved in your care.

Payment

We may use and disclose your information to bill and receive payment from insurance companies or other responsible parties.

Healthcare Operations

We may use your information for practice operations such as quality improvement, staff training, accreditation, and compliance activities.

Other Uses and Disclosures Allowed by Law

We may disclose your information without your written authorization for:

•       Public health reporting

•       Abuse, neglect, or domestic violence reporting

•       Health oversight activities

•       Legal proceedings or court orders

•       Law enforcement purposes

•       Organ donation

•        Workers' compensation

•       Preventing a serious threat to health or safety

•       Specialized government functions (military, national security)

Uses Requiring Your Written Authorization

We will obtain your written permission before:

•       Using your information for marketing

•       Selling your health inf01mation

•       Sharing psychotherapy notes

•       Any use not described in this Notice

You may revoke your authorization at any time in writing.

Your Rights Regarding Your Health Information

Right to Access

You may request to view or obtain a copy of your medical record. We will provide access within 30 days as required by HIPAA.

Right to Request Amendments

If you believe your record is incorrect or incomplete, you may request an amendment.

Right to Request Restrictions

You may ask us to limit how we use or disclose your information. We are not required to agree, except for self-pay services where you request that information not be sent to insurance.

Right to Confidential Communications

You may request that we contact you at a specific phone number, address, or email.

Right to an Accounting of Disclosures

You may request a list of certain disclosures we have made of your information.

Our Responsibilities

We are required to:

•       Maintain the privacy of your health information

•       Provide you with this Notice

•       Notify you if a breach occurs involving your unsecured health information

•       Follow the terms of this Notice

We may update this Notice at any time. Updated versions will be available on our website.

Questions or Complaints

If you have questions or believe your privacy rights have been violated, you may contact:

Greenville Urology, PA Phone: (864) 607-4126

You may also file a complaint with the U.S. Department of Health & Human Services. We will not retaliate against you for filing a complaint.