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.
Who this notice covers
Your medical care is provided by an independent, licensed medical group and its clinicians (the “Covered Entity”), who maintain your medical record. PeptoRx (Alveon LLC) supports your non-clinical membership experience and acts as a Business Associate of the Covered Entity under HIPAA. This notice summarizes how your protected health information (“PHI”) may be used and disclosed.
How your PHI may be used and disclosed
Treatment
To provide, coordinate, and manage your care — for example, sharing information among your clinician, pharmacy, and laboratory.
Payment
To process payment for the services and medications you receive.
Healthcare operations
For quality assurance, support, and administrative activities needed to run the service.
As required or permitted by law
For example, to public-health authorities, or where otherwise required by applicable law.
Your rights regarding your PHI
- To request access to and a copy of your records;
- To request corrections or amendments;
- To request an accounting of certain disclosures;
- To request restrictions on certain uses and disclosures;
- To request confidential communications;
- To receive a paper copy of this notice;
- To be notified in the event of a breach of unsecured PHI.
Our duties
We and the Covered Entity are required to maintain the privacy of PHI, to provide this notice of our legal duties and privacy practices, and to notify affected individuals following a breach of unsecured PHI as required by law.
Complaints
You may file a complaint with the Covered Entity using the contact below, or 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
Privacy contact: [privacy@peptorx.org — to confirm]
Covered Entity / medical group: [name & contact — confirm with OpenLoop]
Effective date: [to confirm]