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.
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 Premier Endocrinology 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 about you;
· Notify affected individuals following a breach of unsecured medical information under federal law; and
· 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.
Protected Health Information (PHI) means any information that identifies you—or could reasonably be used to identify you—and that relates to your past, present, or future physical or mental health or condition, the health care services you receive, or payment for those services. PHI may be in any form (electronic, paper, or oral) and includes demographic details and common identifiers (for example, your name, address, date of birth, phone number, email address, medical record or account numbers, and Social Security number).
A. For Treatment. We may use and disclose your PHI to provide you with health care treatment and related services, including coordinating and managing your health care. We may disclose your PHI to physicians, nurses, DME vendors, 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. Moreover, we may share your PHI with individuals who are actively engaged in your care, including family members, friends, and other healthcare providers.
B. For Payment. We may use and disclose your PHI so that we 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 your PHI 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. We may share your PHI with a collection agency for the purpose of collecting outstanding payments or with a regulatory body or insurance provider to assess the medical necessity of the services rendered or the accuracy of billing statements.
C. For Health Care Operations. We may use and disclose your PHI 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. We may use documentation support tools—such as human scribes, virtual scribe services, or HIPAA-compliant AI technologies like AI medical scribes—to help create and maintain your medical record. When needed for this purpose, we may capture audio or video of your visit or transmit limited protected health information (PHI) to these services.
In addition, we may use artificial intelligence and augmented intelligence technologies ("AI") to assist with aspects of your medical care and administrative operations. AI tools may analyze health data, create clinical notes, summarize conversations during your visit, and streamline administrative tasks. All AI-generated recommendations and records are reviewed by your healthcare provider. The use of AI is intended to assist our healthcare professionals and enhance your care, but it does not replace their expertise, judgment, or decision-making. If you prefer not to have AI tools involved in your care, please notify us, and we will discuss alternative options.
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 PHI to perform a review of the services we provide in order to evaluate whether the appropriate level of services was provided, depending on the condition and diagnosis.
F. Credentialing and Peer Review. We may need to use or disclose your PHI in order for us to review the credentials, qualifications and actions of our health care providers.
G. Treatment Alternatives. We may use and disclose your PHI 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 your PHI to contact you—such as by phone and, when needed, by leaving a voicemail—to provide appointment reminders and other information, and to tell you about health-related benefits or services that may be of interest to you. We may also send other reminders (e.g., pre-visit instructions, online check-in links, refill notices, screening or vaccination prompts, and notifications about test results or follow-up care), and we may use a reception check-in list and announce your name in the waiting area when it is your turn to be seen. We may reach you by phone/voicemail, text/SMS, email reminders, secure portal or app notifications, or mail, and we will include only the necessary information in any message.
I. Business Associates. There are some services (such as billing vendors, IT providers, legal counsel, durable medical equipment (DME) suppliers, and medical interpretation/translation 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 PHI to our business associate so that they can perform the job we have asked them to do. To protect your PHI, 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 your PHI to a friend or family member who is involved in your health care, as well as to someone who helps pay for your care. If you are unable to make decisions, we may share your protected health information with your designated health care agent under a Durable Power of Attorney for Health Care or with your legally authorized personal representative. In a disaster or emergency, we may disclose your PHI to disaster relief organizations to help coordinate your care and to inform family or friends of your location and general condition, as permitted by law.
K. As Required by Law. We will disclose your PHI 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 your PHI 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 your PHI 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. Research. We may use or disclose your PHI for research purposes in certain situations. Texas law permits us to disclose your medical information without your written authorization to qualified personnel for research, but the personnel may not directly or indirectly identify a patient in any report of the research or otherwise disclose identity in any manner. Additionally, a special approval process will be used for research purposes, when required by state or federal law. For example, we may use or disclose your information to an Institutional Review Board or other authorized privacy board to obtain a waiver of authorization under HIPAA. Additionally, we may use or disclose your medical information for research purposes if your authorization has been obtained when required by law, or if the information we provide to researchers is “de-identified.” We collaborate with research partners under HIPAA‑compliant Business Associate Agreements (BAAs), data use agreements, and/or research agreements when we disclose PHI without your written authorization.
O. Military and Veterans. If you are a member of the armed forces, we may use and disclose your PHI as required by the appropriate military authorities.
P. Workers’ Compensation. We may disclose your PHI 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 your PHI 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 used:
· 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 your PHI 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 governmental 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 your PHI 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 PHI 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 PHI 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 your PHI 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 PHI 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 our patient’s PHI 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 your PHI to the health care personnel of a correctional institution as necessary for the institution to provide you with health care treatment.
W. 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 a 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.
III. 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. Under most circumstances, you have the right to inspect and/or copy your PHI that we have in our possession, which generally includes your medical and billing records. To inspect or copy your medical information, you must submit your request to do so in writing to Premier Endocrinology PLLC.
If you request a copy of your information, we may charge a fee for the costs of copying, mailing, or certain supplies associated with your request.
If your requested medical information is maintained in an electronic format (e.g., as part of an electronic medical record, electronic billing record, or other group of records maintained by the Practice that is used to make decisions about you) and you request an electronic copy of this information, then we will provide you with the requested medical information in the electronic form, if it is readily producible in that form.
In certain very limited circumstances allowed by law, we may deny your request to review or copy your medical information.
B. Right to Amend. If you feel the PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by the Practice. To request an amendment, your request must be in writing and submitted to Premier Endocrinology PLLC. In your request, you must provide a reason as to why you want this amendment.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that (i) was not created by us (ii) is not part of the information kept by the Practice, (iii) is not part of the information which you would be permitted to inspect and copy, or (iv) is accurate and complete.
C. Right to an Accounting of Disclosures. You may request a list of certain disclosures of your PHI we made in the six years before your request. The list will not include disclosures for treatment, payment, or health care operations; disclosures you authorized (including research you agreed to participate in); disclosures of a limited data set; disclosures to you; incidental disclosures; or other disclosures excluded by law. To request an accounting, write to Premier Endocrinology PLLC office and specify the time period (up to six years) and the format (paper or electronic). The first accounting you request in a 12‑month period is free; we may charge a reasonable, cost‑based fee for additional requests and will notify you of the cost in advance.
D. Right to Request Restrictions. You may ask us not to use or share your PHI for treatment, payment, or health care operations, or not to share it with people involved in your care or payment. We are not required to agree and may say no if we believe it could affect your care. If you pay in full out of pocket for a specific item or service, you can ask us not to share information about that item or service with your health plan for payment or health care operations; we will agree unless a law requires us to share it. To request a restriction, write to Premier Endocrinology PLLC office.
E. Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time.
F. Right to Breach Notification. In certain instances, we may be obligated to notify you (and potentially other parties) if we become aware that your medical information has been improperly disclosed or otherwise subject to a “breach” as defined in and/or required by HIPAA and applicable state law.
G. Right to Request Confidential Communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will accommodate reasonable requests.
IV. Uses and Disclosures Requiring Your Authorization.
Uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. In particular, most uses of psychotherapy notes, most marketing communications, and any sale of PHI require your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already relied on it.
V. CHANGES TO 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 any information we receive in the future.
VI. COMPLAINTS.
If you believe that your privacy rights as described in this Notice have been violated, you may file a complaint with the Practice at the following address or phone number:
HIPAA Privacy Officer (Practice Owner)
Premier Endocrinology PLLC
7103 S Peek Rd. Suite 220
Richmond, Texas 77407
Phone number: 346.999.2130
To file a complaint, you may either call or send a written letter. The Practice will not retaliate against any individual who files a complaint.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) at 800-368-1019 or online at https://www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate.
OTHER IMPORTANT PRIVACY INFORMATION:
Patient portal and electronic communications. We offer a secure patient portal where you can view, download, and transmit certain medical and billing information and message our team. Portal use is optional.
How we contact you. We may use the mailing addresses, phone numbers, and email addresses you provide to communicate with you about treatment, payment, and health care operations (for example, appointment reminders or billing). Please tell us promptly if your contact information changes.
Email and downloads. Our default is to deliver information through secure methods (such as our patient portal). Unencrypted email or use of an unencrypted medium is not our preferred method. If, after we explain the risks, you direct us to send your information that way, we will honor your request if it is readily producible and not prohibited by law. We may ask you to confirm your direction (for example, in writing, via a secure message, or through a verbal request that we document), and we will verify the destination you specify. If the files cannot be sent by standard email (for example, due to size or format), we will offer alternatives. We are not responsible for protecting the information during transmission by unencrypted email that you requested or after it reaches you or another recipient you designate.
Sensitive information. Certain information (for example, psychotherapy notes; substance use disorder treatment records; HIV/sexually transmitted infection information; and some mental health or genetic information) may have additional protections under federal or Texas law. We will follow the stricter law.
Incidental disclosures. Despite reasonable safeguards, limited incidental disclosures may occur (for example, someone may overhear your name). Such incidental disclosures are permitted by law.
Business associates. We may share your information with service providers (for example, billing, IT, and cloud services). We require them to protect your information under written agreements and applicable law.
Health Information Exchange (HIE). We may electronically share your health information with other healthcare providers, hospitals, pharmacies, laboratories, and health plans involved in your care or in payment/operations through secure exchange networks (for example, through our electronic health record vendor’s exchange services and regional or national HIEs). This helps your care team access important information when needed, including in emergencies, and may reduce duplicate testing. Access is limited to authorized users for permitted purposes and is subject to auditing and other safeguards. If you do not want your information to be available for query through certain HIEs, you may opt out where permitted by law and by the HIE; opting out will not affect disclosures required by law or some direct exchanges for treatment.
VII. Acknowledgment of Receipt of Notice of Privacy Practices.
By signing below, you acknowledge receipt of this Notice of Privacy Practices. Your treatment is not conditioned on signing this acknowledgment.
Patient Name: _____________________________________
(Please Print Name)
Patient Date of Birth: _______________________________
SIGNATURES:
Patient/Legal Representative: _______________________________________ Date:________________
If Legal Representative, relationship to Patient: ______________________________________________
Witness (optional) : Date:_______________
Premier Endocrinology PLLC Notice of Privacy Practices Effective Jan 2026