1. Our Commitment to Your Privacy

Hugo Lopez and Associates (“we,” “us,” or “our”) is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) and your rights regarding that information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable state laws.

We are required by law to:

• Maintain the privacy of your PHI

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

• Notify you if a breach of unsecured PHI occurs

• Follow the terms of the notice currently in effect

2. How We May Use and Disclose Your Protected Health Information

We may use and disclose your PHI for the following purposes without your written authorization:

Treatment
We may share your information with physicians, nurses, specialists, laboratories, pharmacies, and other healthcare providers involved in your care to coordinate and provide treatment.

Payment
We may use and disclose PHI to bill and collect payment from you, your insurance company, or other third-party payers. This includes determining eligibility, coverage, and medical necessity.

Healthcare Operations
We may use PHI for our internal operations, such as quality assessment, staff training, licensing, auditing, business planning, and improving the services we provide.

Other Permitted Uses and Disclosures (without authorization, as allowed by law):

• Public health activities (e.g., reporting certain diseases or adverse events)

• Health oversight activities (e.g., audits, investigations by government agencies)

• Judicial and administrative proceedings (e.g., in response to a court order or subpoena)

• Law enforcement purposes (as required by law)

• To avert a serious threat to health or safety

• Workers’ compensation claims

• Coroners, medical examiners, and funeral directors

• Organ and tissue donation organizations

• Research (under specific conditions and institutional review board approval)

• Military and veterans’ activities, national security, and protective services (as required by law)

Uses and Disclosures Requiring Your Written Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes not covered above, including:

• Most uses and disclosures of psychotherapy notes

• Marketing purposes

• Sale of your PHI

• Any other use or disclosure not described in this notice

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

3. Your Rights Regarding Your Health Information

You have the following rights:

• Right to Inspect and Copy — You may request to review or obtain a copy of your medical and billing records. We may charge a reasonable fee for copies.

• Right to Request Amendment — You may request that we amend your records if you believe information is incorrect or incomplete. We may deny the request in certain circumstances and will provide a written explanation.

• Right to an Accounting of Disclosures — You may request a list of certain disclosures of your PHI made by us (excluding those for treatment, payment, and healthcare operations).

• Right to Request Restrictions — You may ask us to restrict how we use or disclose your PHI. We are not required to agree to every request, except in limited situations involving disclosures to a health plan when you have paid out-of-pocket in full.

• Right to Request Confidential Communications — You may request that we communicate with you by alternative means or at alternative locations (e.g., only by mail or at a different address).

• Right to a Paper Copy of This Notice — You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically.

• Right to Be Notified of a Breach — You have the right to be notified if a breach of your unsecured PHI occurs.

To exercise any of these rights, please submit a written request to our Privacy Officer at the contact information below.

4. Our Responsibilities

We are required to:

• Protect the privacy of your PHI

• Provide you with this notice

• Abide by the terms of the notice currently in effect

• Notify you of any material changes to this notice

• Obtain your authorization when required

We reserve the right to change our privacy practices and this notice. Any revised notice will be posted in our office and will be available upon request. Changes will apply to PHI we already have as well as information we receive in the future.

5. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights.

To file a complaint with us:
Contact our Privacy Officer using the information below. We will not retaliate against you for filing a complaint.

To file a complaint with the federal government:
U.S. Department of Health and Human Services
Office for Civil Rights
https://www.hhs.gov/hipaa/filing-a-complaint

6. Contact Information

Privacy Officer
Hugo Lopez and Associates
1101 Santa Fe
Corpus Christi, Texas 78404
Phone: 361-257-1427
Fax: 361-567-0074
Email: info@hlopezandassociates.com

7. Acknowledgment

By receiving care at Hugo Lopez and Associates, you acknowledge that you have been offered a copy of this Notice of Privacy Practices.