Notice of Privacy Practices

Our commitment

We are required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of protected health information (PHI), provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.

How we may use and disclose PHI

We may use and disclose PHI for:

• Treatment — to provide, coordinate, or manage your child’s care, including with other providers involved in care when appropriate.
• Payment — to bill for services when applicable (for example, certain specialty or non-membership fees) and related activities.
• Health care operations — quality improvement, training, business planning, customer service, and practice administration.
• As required or permitted by law — including public health, abuse/neglect reporting, health oversight, judicial proceedings, law enforcement, and serious threats to health or safety, when legally allowed or required.
• With your written authorization — for uses and disclosures not otherwise permitted by law; you may revoke authorization in writing except to the extent we have already acted on it.

Your rights

You have the right to:

• Request restrictions on certain uses and disclosures of PHI (we are not always required to agree).
• Request confidential communications by alternative means or locations.
• Inspect and obtain a copy of PHI in your designated record set, with limited exceptions.
• Request an amendment to PHI you believe is incorrect or incomplete.
• Receive an accounting of certain disclosures of PHI.
• Obtain a paper copy of this notice upon request, even if you agreed to receive it electronically.
• File a complaint if you believe your privacy rights have been violated.

Our duties

We will notify you as required by law following a breach of unsecured PHI. We may change this notice and make the revised notice effective for PHI we already have as well as information we receive in the future. The current notice will be posted on our website and available upon request.

Complaints

If you believe your privacy rights have been violated, you may contact Sparkle Pediatrics at info@sparklepediatrics.com or 904.333.2896, or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be retaliated against for filing a complaint.

Contact for privacy questions

Privacy contact: Sparkle Pediatrics PLLC, 88 Roberts Village Court, Suite 702, Saint Johns, Florida 32259. Email: info@sparklepediatrics.com. Phone: 904.333.2896.