This Notice of Privacy Practices (“Notice”) explains how your medical information may be used and disclosed, and how you can access this information. Please review it carefully.
If you have questions about this Notice, please contact our Privacy Officer at 804-673-0134.
We are dedicated to protecting the privacy of your Protected Health Information (PHI). This Notice outlines how your PHI may be used within our practice or network, and how it may be disclosed (shared outside our practice or network) for treatment, payment, or healthcare operations. We may also share your information for other purposes permitted or required by law. Additionally, this Notice describes your rights to access and manage your PHI.
We are legally required to maintain the confidentiality of your PHI and will comply with the terms described in this Notice.
We reserve the right to update this Notice at any time. Any changes will apply to all PHI we maintain. Upon request, we will provide you with the revised Notice by posting it in our office, making copies available upon request or by mail, and posting the updated version on our website (https://www.vacancer.com/).
Uses and Disclosures of Protected Health Information (PHI)
We may use or disclose your PHI for your health care treatment. Your PHI may be used and disclosed by your physician, our office staff, and others outside of our office involved in your care to provide health care services.
Example: If you are referred to another physician for evaluation, your PHI may be provided to ensure the physician has necessary information for diagnosis or treatment. Similarly, we may share your PHI with specialists or laboratories involved in your care.
Your PHI may be used or disclosed for payment purposes, including billing or collecting payments. PHI may be shared with billing companies, insurance companies, health plans, government agencies, and collection agencies.
Example: If you undergo a procedure at our facility, we must share service details (such as x-rays) with your insurance provider for billing. Occasionally, prior authorization is needed before performing certain procedures, requiring us to share your PHI.
We may use or disclose your PHI as needed to support the business activities of our practice, known as healthcare operations.
Examples:
- Training healthcare personnel, students, or ancillary staff such as billing personnel.
- Performing quality improvement initiatives.
- Resolving internal issues or complaints.
We may use or disclose your PHI in connection with contracted services provided by entities known as “business associates.” Only the minimum necessary PHI will be shared, and these associates are required to safeguard your information.
Uses and Disclosures Without Your Authorization
We may use or disclose your PHI without your permission in the following situations:
- Required by Law: Adhering to requirements to report gunshot wounds, suspected abuse, or neglect.
- Public Health Activities: Controlling disease, injury, or disability, as required by public health authorities.
- Health Oversight Activities: Compliance audits, investigations, and inspections by authorized agencies.
- Legal Proceedings: Assisting in legal matters as required by judicial order or lawful process.
- Law Enforcement: As authorized by law.
- Coroners, Medical Examiners, and Funeral Directors: For identification or determination of cause of death.
- Research: With appropriate Institutional Review Board approval.
- Government Functions: For national security, military, or correctional institution requirements.
- Workers’ Compensation: In accordance with applicable laws.
Uses and Disclosures That May Involve Your Input
Unless you object, we may share your PHI with family members, friends, or persons identified by you, to the extent they are involved in your care or payment. When you are unable to agree or object, the healthcare provider will use professional judgment to determine whether sharing the information is in your best interest. For example, we may discuss post procedure instructions with the person who drove you to the facility unless you tell us specifically not to share the information.
We may use or disclose your PHI to notify or assist in notifying a family member or other responsible person, about your location, condition, or death. Further we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts.
Uses and Disclosures Requiring Written Authorization
The following uses and disclosures require your explicit written consent:
- Marketing communications
- Sale of your information
- Release of psychotherapy notes
Written authorization specifies how you wish your information to be used or disclosed. You may revoke your authorization at any time in writing, except where information has already been acted upon based on prior authorization.
Your Privacy Rights
You have specific rights concerning your PHI. All requests to exercise these rights must be made in writing.
Right to Access: You may inspect and obtain copies of your PHI maintained in our records. Electronic copies are available upon request. Certain exceptions may apply, and reasonable fees may be charged. There are some exceptions to records which may be copied, and the request may be denied. You may have a right to have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical record.
Right to Request Restrictions: You may ask us not to use or disclose any part of your PHI for treatment, payment, or healthcare operations. While we are not obligated to agree, we will honor agreed-upon restrictions unless the information is needed for emergency treatment. We must accept restriction requests limiting disclosure to a health plan when you pay out of pocket in full.
Right to Confidential Communications: You may request communication through alternative means or locations. We will accommodate reasonable requests and will not require explanations.
Right to Amend: If you believe your PHI is incorrect or incomplete, you may request an amendment, providing a reason. If denied, you will be given the opportunity to submit a disagreement.
Right to an Accounting of Disclosures: You may obtain a list of disclosures of your PHI for purposes other than treatment, billing and payment, or healthcare operations made after April 14, 2003, up to six years back. Additional requests within a 12-month period may incur fees.
Breach Notification: In the event of a breach of privacy or security of your health information, we will provide you with written notification of the incident and provide you with applicable steps to reduce the impact of the breach.
Copy of Notice: You have the right to obtain a paper copy of this Notice. If you would like a paper copy of this Notice, please request one from our Privacy Officer or request one when you are in our offices.
Complaints: If you believe your rights have been violated or have concerns about our privacy practices, contact our Privacy Officer at 804-673-0134. You may also file a complaint with the United States Secretary of Health and Human Services. We will not retaliate against anyone filing a complaint.
Additional Notices
Substance Use Disorder (SUD) Treatment Privacy: If we receive or maintain treatment records about you from a SUD program, subject to 42 CFR part 2, or testimony about records, we will not use or disclose it in any civil, criminal, administrative, or legislative proceedings against you unless you provide written consent, or we receive a court order, after notice and an opportunity to be heard is provided to you or the record holder. Additionally, any court order for use or disclosure must come with a subpoena or identify applicable legal authority.
Redisclosure: PHI disclosed for any reason may be redisclosed by the recipient and is no longer protected by HIPAA or state law.
This Notice was published and is effective as of March 1, 2026.