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HIPAA Privacy

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.

Our Commitment to Your Privacy

Sustain MD is required by law to maintain the privacy of your protected health information (PHI) and to provide you with this notice of our legal duties and privacy practices. We are required to abide by the terms of this notice currently in effect.

What is Protected Health Information (PHI)?

Protected Health Information includes any information about you that:

  • Relates to your past, present, or future physical or mental health or condition

  • Relates to the provision of healthcare to you

  • Relates to payment for your healthcare

  • Identifies you or could reasonably be used to identify you

Examples of PHI Include:

  • Your medical records and health history

  • Conversations with doctors and nurses

  • Information in our computer system about you

  • Your billing information

  • Test results and imaging

How We May Use and Disclose Your PHI

1. Treatment

We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes consultation with other healthcare providers.

Example:

If you have a fractured bone, we may send your X-rays to an orthopedic specialist for follow-up care. We may also share your medical information with your primary care physician to ensure continuity of care.

2. Payment

We may use and disclose your PHI to obtain payment for services we provide, including billing and collection activities.

Example:

We may send your insurance company information about the treatment you received so they can process your claim. We may also disclose information to your health plan to determine if they will cover a particular treatment.

3. Healthcare Operations

We may use and disclose your PHI for healthcare operations, which include quality assessment, training, and business management activities.

Example:

We may use your medical records to review the quality of care you received or to train our staff. We may combine health information about many patients to decide what additional services we should offer.

4. Other Uses Permitted Without Your Authorization

  • As Required by Law: When federal, state, or local law requires disclosure

  • Public Health Activities: To prevent or control disease, injury, or disability

  • Health Oversight Activities: To authorized health oversight agencies for audits, investigations, and inspections

  • Legal Proceedings: In response to a court order, subpoena, or other lawful process

  • Law Enforcement: For law enforcement purposes as required by law

  • To Avert Serious Threat: To prevent a serious threat to health or safety

  • Military and Veterans: If you are a member of the armed forces

  • Workers’ Compensation: For workers’ compensation programs

  • Coroners and Funeral Directors: To identify a deceased person or determine cause of death

Your Rights Regarding Your PHI

1. Right to Inspect and Copy

You have the right to inspect and obtain a copy of your medical and billing records. We may charge a reasonable fee for copying and mailing costs. In certain circumstances, we may deny your request, but you may request a review of that denial.

2. Right to Amend

If you believe information in your medical record is incorrect or incomplete, you may request that we amend it. We may deny your request if we did not create the information, if it is not part of our records, if it is not permitted to be inspected, or if it is accurate and complete.

3. Right to an Accounting of Disclosures

You have the right to request an accounting of certain disclosures of your PHI made by us during the six years prior to your request. This does not include disclosures for treatment, payment, or healthcare operations.

4. Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request unless it involves disclosure to a health plan for payment purposes and you have paid out-of-pocket in full.

5. Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may request that we only contact you at work or by mail.

6. Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this notice at any time, even if you have agreed to receive it electronically.

7. Right to Be Notified of a Breach

We will notify you if there is a breach of your unsecured PHI.

When We Need Your Written Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes other than treatment, payment, or healthcare operations. Examples include:

  • Most uses and disclosures of psychotherapy notes

  • Marketing communications

  • Sale of your PHI

  • Other uses not described in this notice

You may revoke your authorization in writing at any time, except to the extent we have already taken action based on your authorization.

Our Responsibilities

We are required to:

  • Maintain the privacy of your PHI

  • Provide you with this notice of our legal duties and privacy practices

  • Follow the terms of the notice currently in effect

  • Notify you if we are unable to agree to a requested restriction

  • Accommodate reasonable requests for confidential communications

  • Notify you of any breach of your unsecured PHI

Changes to This Notice

We reserve the right to change this notice and make the new notice apply to PHI we already have as well as any information we receive in the future. We will post a copy of the current notice in our facility and on our website. The notice will contain the effective date on the first page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint.

To File a Complaint or Exercise Your Rights

Contact Our Privacy Officer:

Sustain MD

851 Bradley St NE, Concord, NC 28025

Phone: 704-561-1566

Email: info@sustainmd.net

Or Contact:

U.S. Department of Health and Human Services

Office for Civil Rights

200 Independence Avenue, S.W.

Washington, D.C. 20201

Phone: 1-877-696-6775

Website: www.hhs.gov/ocr/privacy/hipaa/complaints/

Questions

If you have questions about this notice or would like additional information, please contact our Privacy Officer using the contact information provided above.

Important

This notice is effective as of January 2026 and applies to all protected health information created or received by Sustain MD.