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 REVIEW IT CAREFULLY.

Introduction

Precision Wound Management, LLC is committed to protecting your health information. We are required by law to:

• Maintain the privacy of your protected health information (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 to communicate health information by alternative means or locations

How We May Use and Disclose Your Health Information

For Treatment

We may use and disclose your health information to provide, coordinate, or manage your healthcare and related services. This includes coordination of care with other healthcare providers.

Example: We may share your wound care information with your primary care physician or referring specialist to coordinate your treatment plan.

For Payment

We may use and disclose your health information to obtain payment for services we provide, including billing and collections activities.

Example: We may submit claims to your insurance company that include information about your diagnosis and treatments to obtain payment for our services.

For Healthcare Operations

We may use and disclose your health information for our healthcare operations, including quality assessment, staff training, business planning, and administrative purposes.

Example: We may use your health information to evaluate the performance of our staff in caring for you or to review treatment outcomes.

Business Associates

We may disclose your health information to our business associates who perform services on our behalf. These business associates are required by contract to safeguard your information.

Other Uses and Disclosures Without Your Authorization

We may use or disclose your health information without your written authorization in the following situations:

• As Required by Law: When required by federal, state, or local law
• Public Health Activities: For disease prevention, reporting communicable diseases, or reporting adverse events from medical devices
• Health Oversight Activities: To authorized health oversight agencies for audits, investigations, or inspections
• Judicial and Administrative Proceedings: In response to a court order, subpoena, or discovery request
• Law Enforcement: For law enforcement purposes as required by law or in response to legal process
• Coroners, Medical Examiners, and Funeral Directors: To identify a deceased person or determine cause of death
• Organ and Tissue Donation: For organ procurement or transplantation purposes
• Research: For research purposes when approved by an institutional review board or privacy board
• Serious Threat to Health or Safety: To prevent or lessen a serious threat to health or safety
• Military and Veterans: For armed forces personnel as required by military authorities
• Workers' Compensation: For workers' compensation or similar programs
• Abuse, Neglect, or Domestic Violence: When required by law to report suspected abuse, neglect, or domestic violence

Uses and Disclosures That Require Your Authorization

Other uses and disclosures of your health information not covered by this Notice will be made only with your written authorization. You may revoke your authorization in writing at any time, except to the extent that we have already acted in reliance on your authorization.

We will obtain your written authorization before using or disclosing your health information for:

• Marketing purposes
• Sale of your health information
• Most uses and disclosures of psychotherapy notes (if applicable)

Your Individual Rights

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or healthcare operations. We are not required to agree to your request but will consider it carefully. If we agree, we will comply with your request unless the information is needed for emergency treatment.

Right to Receive 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 ask that we contact you only at work or by mail. We will accommodate all reasonable requests.

Right to Inspect and Copy

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

Right to Amend

If you believe that 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 the information is accurate and complete, or if you would not be permitted to inspect and copy the record. If we deny your request, you may submit a written statement of disagreement.

Right to an Accounting of Disclosures

You have the right to receive a list of certain disclosures we have made of your health information. This list will not include disclosures for treatment, payment, healthcare operations, or disclosures made with your authorization. The first list you request within a 12-month period will be free. For additional lists, we may charge a reasonable fee.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this Notice at any time, even if you have agreed to receive it electronically. You may request a copy at our office or by contacting our Privacy Officer.

Right to Notification of a Breach

You have the right to be notified in the event of a breach of your unsecured health information.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information
• Provide you with this Notice of our legal duties and privacy practices
• Notify you following a breach of your unsecured health information
• Follow the terms of the Notice currently in effect

Changes to This Notice

We reserve the right to change this Notice at any time. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in our office 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 U.S. Department of Health and Human Services. You will not be penalized or retaliated against for filing a complaint.

To File a Complaint with Us:

Contact our Privacy Officer:

Privacy Officer
Precision Wound Management, LLC
2921 Hwy 77, Suite 12-13
Marion, AR 72364
Phone: (870) 559-4252
Fax: (870) 559-4253
Email: info@pwmcare.com

To File a Complaint with the Federal Government:

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/

Contact Information

For more information about this Notice or to exercise any of your rights, please contact:

Privacy Officer
Precision Wound Management, LLC
2921 Hwy 77, Suite 12-13
Marion, AR 72364
Phone: (870) 559-4252
Fax: (870) 559-4253
Email: info@pwmcare.com
Hours: Monday - Friday, 10:00 AM - 5:00 PM

Effective Date: January 1, 2025

This Notice of Privacy Practices applies to Precision Wound Management, LLC and all employees, staff, and other personnel.