Notice of Privacy Practices

Effective Date: [INSERT DATE]

1. Our Commitment to Your Privacy

Hayek Medical ("we," "us," "our") is committed to protecting the privacy and security of your protected health information ("PHI"). PHI is information that may identify you and that relates to your past, present, or future physical or mental health, the healthcare you have received, or payment for that care.

We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices with respect to PHI, and follow the terms of the Notice currently in effect.

2. How We May Use and Disclose Your PHI

For Treatment

We may use and disclose your PHI to coordinate your care, including communicating with your prescribing physician(s), pharmacy, laboratory, or other healthcare providers involved in your treatment.

For Payment

We may use and disclose your PHI to bill and obtain payment for the services we provide. This may include sharing information with your health insurance company to verify benefits, obtain prior authorizations, or process claims.

For Healthcare Operations

We may use and disclose your PHI to operate our business — for example, for quality improvement, training, accreditation, audits, legal services, and customer service.

To Business Associates

We contract with third parties ("business associates") to perform services on our behalf, such as shipping, billing, IT hosting, and clinical coordination. We require these business associates to protect your PHI under written agreements.

As Required by Law

We will use and disclose your PHI when required to do so by federal, state, or local law, including for public health activities, health oversight, judicial and administrative proceedings, law enforcement, and to avert serious threat to health or safety.

With Your Authorization

For uses and disclosures not described above, we will obtain your written authorization before using or disclosing your PHI. You may revoke a written authorization at any time, except to the extent we have already acted in reliance on it.

3. Uses and Disclosures That Require Your Specific Authorization

The following uses and disclosures will be made only with your written authorization:

• Marketing communications (with limited exceptions);
• Sale of PHI;
• Most uses and disclosures of psychotherapy notes;
• Other uses and disclosures not described in this Notice.

4. Your Rights Regarding Your PHI

Right to Access and Copy

You have the right to inspect and obtain a copy of your PHI in our designated record set. We may charge a reasonable, cost-based fee for copies. To request access, contact our Privacy Officer (below).

Right to Amend

If you believe your PHI is incorrect or incomplete, you have the right to request that we amend it. We may deny your request under certain circumstances, in which case we will explain why in writing.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your PHI in the six (6) years prior to your request, with limited exceptions.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, except in the case of disclosures to a health plan for services you have paid for in full out of pocket.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your PHI in a particular way or at a particular location.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice, even if you have agreed to receive it electronically.

Right to Be Notified of a Breach

You have the right to be notified following a breach of unsecured PHI affecting you, in accordance with applicable law.

5. Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have about you, as well as PHI we receive in the future. We will post the current Notice on our website and at any service location, and provide a copy upon request.

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Our Privacy Officer
[Privacy Officer Name]
Hayek Medical
[Street Address, City, State, ZIP]
Phone: (855) 243-8228 · Email: [privacy@yourcompany.example]

Or with the U.S. Department of Health and Human Services, Office for Civil Rights:

200 Independence Avenue, SW
Washington, D.C. 20201
1-877-696-6775 · www.hhs.gov/ocr

We will not retaliate against you for filing a complaint.

7. Contact Us

For questions about this Notice or our privacy practices, please contact our Privacy Officer at the address above.