Notice of Privacy Practices

This notice applies to Summit Spine Associates and to Dr. Miguel Jimenez, MD, along with the staff, contractors and business associates who help the practice care for you. It covers the health information the practice creates or receives about you — your medical record, imaging, surgical and treatment records, and the billing records connected to your care.

HIPAA calls this protected health information. This notice uses "your health information" to mean the same thing.

The practice may use and share your health information without asking your permission first for the following purposes.

• Treatment. To provide and coordinate your care. For example, sharing your MRI and operative notes with an anesthesiologist, a physical therapist, or the referring physician managing the rest of your care.
• Payment. To bill and be paid for your care. For example, sending your diagnosis and the procedure performed to your health plan so a claim can be processed, or confirming coverage before surgery is scheduled.
• Health care operations. To run the practice and keep the quality of care high. For example, reviewing surgical outcomes internally, training staff, or working with an auditor or attorney advising the practice.

Other situations permitted or required by law

The practice may also use or share your health information, without your authorization, where the law permits or requires it:

• Appointment reminders and treatment options. To contact you about a scheduled appointment, or to tell you about treatment alternatives and health-related services that may interest you. You may ask the practice to stop.
• People involved in your care. To share relevant information with a family member, friend, or anyone else you identify as involved in your care or in paying for it. If you are present and able to decide, the practice will give you the chance to object first.
• As required by law. Where a federal, state or local law requires the disclosure.
• Public health and safety. To report disease, injury, births and deaths; to report suspected abuse, neglect or domestic violence; to report problems with medications or medical devices to the FDA; and to prevent a serious and imminent threat to someone's health or safety.
• Health oversight. To agencies conducting audits, investigations, inspections and licensure reviews.
• Lawsuits and legal proceedings. In response to a court or administrative order, and in some cases a subpoena, discovery request or other lawful process.
• Law enforcement. In the limited circumstances HIPAA allows — for example, to respond to a court order or to identify a suspect, fugitive, witness or missing person.
• Workers' compensation. As authorized by workers' compensation laws for work-related injuries.
• Research, organ donation, medical examiners, and the military. In the specific circumstances HIPAA permits, including research approved by a review board that has evaluated the privacy safeguards.

Uses that always require your written permission

Some uses are never permitted without your signed authorization:

• Marketing. Most uses of your health information to market a product or service to you.
• Sale of your information. Any disclosure that amounts to a sale of your health information.
• Psychotherapy notes. Most uses and disclosures of psychotherapy notes, where the practice maintains any.
• Patient stories and testimonials. Using your name, image, or details of your treatment in the practice's advertising — including on this website, in printed material, or on social media. A review you post publicly elsewhere does not on its own give the practice permission to republish it.

Any other use or disclosure not described in this notice will be made only with your written authorization. You may revoke that authorization in writing at any time, which stops any further use or sharing for the purpose you had approved. Revoking it cannot undo something already done in reliance on it.

Where Florida and federal law are stricter

Some categories of information carry protections stronger than HIPAA's, and where that is so, the stricter rule governs. These include HIV and AIDS test results under Florida law, mental health records, substance use disorder treatment records under 42 CFR Part 2, and genetic information. Information in these categories generally cannot be shared without your specific written permission, even in situations where this notice otherwise allows sharing.

These rights are yours. To use any of them, contact the practice using the details at the end of this notice — most requests need to be in writing.

• Get a copy of your records. You may inspect and get a copy of your medical and billing records, usually within 30 days of asking. If you want an electronic copy of a record kept electronically, the practice will provide it in the form you ask for where it can readily do so. A reasonable, cost-based fee may apply to copies.
• Ask for a correction. If you believe something in your record is wrong or incomplete, you may ask the practice to amend it. The practice may decline, but must tell you why in writing, and you may file a statement of disagreement that will be kept with the record.
• Get a list of disclosures. You may request an accounting of certain disclosures the practice made in the six years before your request. Disclosures for treatment, payment and health care operations, and those you authorized, are not included. One list in any twelve-month period is free.
• Ask for limits on what is shared. You may ask the practice to restrict how it uses or shares your information. The practice is not usually required to agree — but it must agree to one request: if you pay for a service in full and out of pocket, you may direct that the practice not share information about that service with your health plan.
• Ask to be contacted differently. You may ask the practice to reach you at a particular phone number or address — for example, only at your mobile, or by mail to a different address. Reasonable requests will be accommodated, and you do not have to say why.
• Get a paper copy of this notice. You may ask for a paper copy at any time, even if you agreed to receive it electronically.
• Be told if your information is breached. The practice will notify you if a breach compromises the privacy or security of your health information.
• Choose someone to act for you. A person with legal authority to make health care decisions for you — a guardian, or someone holding a medical power of attorney — may exercise these rights on your behalf.

Summit Spine Associates is required by law to protect the privacy and security of your health information, to give you this notice describing its legal duties and privacy practices, and to follow the terms of the notice currently in effect.

The practice will not use or share your information other than as described here unless you tell it in writing that it may. If you give permission and later change your mind, you may revoke it in writing at any time.

The practice may change this notice, and any change applies to information it already holds as well as information it receives afterwards. A revised notice will be posted on this page and made available at the office, and it takes effect on the date it is published.

You may complain to the practice, to the federal government, or both. Complaining costs you nothing, and the practice will not retaliate against you for it — your care will not be affected in any way.

To complain to the practice, contact the Privacy Officer using the details below. To complain to the federal government, contact the Office for Civil Rights at the U.S. Department of Health and Human Services:

The practice's Privacy Officer is responsible for this notice and can help with any request described in it.

This notice covers health information held by the practice. Information collected through this website — which is very little, and does not include anything you would type into a form — is covered separately by the website privacy policy.