Privacy Policy in Hudson at AFC Urgent Care
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 REVEIW IT CAREFULLY.
Neprus Hudson, Inc and NepHealth PC d/b/a AFC Urgent Care Hudson is
required by law to maintain the privacy of your Protected Health Information (PHI). This Notice describes how we
will treat your PHI and how we may use and disclose your PHI to carry out treatment, payment or health care
operations and for other purposes that are permitted or required by law. We may share your health information
for treatment, payment and health operations as described in this Notice. This Notice also describes your rights
to access and control your PHI. PHI is information about you, including demographic information, that may
identify you and that relates to your past, present or future physical or mental health or condition and related
health care services.
Uses and Disclosures of Protected Health Information: Your PHI may be used and disclosed by the Nurse Practitioner/Physician Assistant,
our office staff and others outside of our offices that are involved in your care and treatment for the purpose
of providing health care services to you, to pay your health care bills, to support the operation of the
business, and any other use required by law. We may disclose PHI to family members, close friends or others
concerned with your care and treatment.
Treatment: We will use and disclose your PHI to provide, coordinate, or manage your health care and any
related services. This includes the coordination or management of your health care with a third party. For
example, your PHI may be provided to a Nurse Practitioner/Physician Assistant to whom you have been referred or are receiving treatment from
to ensure that the Nurse Practitioner/Physician Assistant has the necessary information to diagnose or treat you.
Payment: Your PHI will be used to obtain payment for your health care services. For example, we may
provide PHI to your insurance company to obtain authorization and payment for services rendered. We may contact
the Guarantor for your visit in order to obtain payment.
Healthcare Operations: We may use or disclose your PHI in order to support our business activities. These
activities include, but are not limited to business associates, quality assessment activities, internal
investigations, performance reviews, and training employees. In addition, we will use a sign-in sheet at the
registration desk where you will be asked to provide your name and insurance company. We may also call you by
name in the waiting room when the Nurse Practitioner/Physician Assistant is ready to see you. We may use or disclose your PHI to contact you
to remind you of an appointment, to notify you of test results, to inform you of health-related services that
may be of interest to you, and to check on your treatment, progress, and satisfaction with our services.
We may use or disclose your PHI in the following situations without your authorization: As required by Law, for
Public Health issues, Communicable Diseases, Health Oversight, Abuse Administration or Neglect, Food and Drug
requirements, Legal proceedings, Law Enforcement, Coroners, Funeral Directors, Organ Donation, Preliminary
Research Identification, Research with an IRB waiver, Criminal Activity, Military Activity, to avert a serious
and imminent threat to a person or the public, National Security, to comply with Worker’s Compensation laws,
Inmates, Disaster Relief and other Required Uses and Disclosures. Under the law, we must make disclosures to you
and when required by the Secretary of the Department of Health and Human Services.
Other permitted and required uses and disclosures, such as for marketing or sale of your PHI to third parties,
will be made only with your authorization. Once given, you may withdraw authorization at any time in writing
delivered to the address given below.
You have the right to inspect and copy your protected health information. Under federal law, you may not inspect
or copy psychotherapy notes, information compiled in anticipation of, or use in, a legal proceeding, and PHI
that is otherwise prohibited.
You have the right to request a restriction of your protected health information. This means you may ask us not
to use or disclose any part of your PHI for the purposes of treatment, payment or health care operations. Your
request must be in writing, delivered to the address given below, and state the specific restriction requested
and to whom you want the restriction to apply. If you have paid for your services in full and ask us not to
disclose your visit to your insurance company, we will honor that request. We are not required to agree to any
other restriction that you may request and if we believe it is in your best interest to permit use and
disclosure of your PHI, it will not be restricted. You then have the right to use another health care
professional.
You have the right to receive confidential communications from us by alternative means or at an alternative
location by notifying us in writing, delivered to the address given below.
You have the right to obtain a paper copy of this notice from us, upon request to (603) 802-4050.
You may have the right to ask us to amend your protected health information. If we deny your written request for
amendment, you have the right to deliver a statement of disagreement with us at the address given below and we
may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health
information. Your request must be in writing, delivered to the address given below. We are required to notify
you if your unsecured PHI is involved in a reportable breach.
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have
been violated. Or, you may file a complaint with us by mail or by contacting Susheel Paudel, i.e. our Privacy Officer at the following
address or phone number: 3 Flagstone Dr. Unit A, Hudson, NH
03051 We will not retaliate against you for filing a complaint.
We reserve the right to change the terms of this notice. Any change will apply to all PHI that we maintain. We
post our current policy at each location and on our website. All written requests must be delivered to the
Clinic Manager or mailed to HIPAA Privacy Officer.