Who follows this notice. Andrew Charles Storer, Nurse Practitioner in Acute Care, PLLC, doing business as Flintlock Health ("Flintlock," "we," "us"), and all of its clinicians and staff. Flintlock Health LLC provides non-clinical administrative services to the practice as our business associate and must protect your information under a written agreement.
Questions? Contact our Privacy Officer at [email protected] or (917) 565-8504.
1. Your rights
When it comes to your health information, you have the following rights. To use any of them, contact us at [email protected], through your patient portal, by phone at (917) 565-8504, or by fax at (917) 580-6335.
Get a copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
- We will provide a copy or a summary, usually within 30 days of your request and sooner when New York law requires it. We may charge a reasonable, cost-based fee as allowed by federal and New York law. You won't be denied a copy because you can't afford it.
- You can also ask us to send a copy directly to another person you name.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete.
- We may say no, but we'll tell you why in writing within 60 days, and you can submit a statement of disagreement.
Request confidential communications
- You can ask us to contact you in a specific way (for example, only through the patient portal, or only at a certain phone number or email) or to send mail to a different address.
- We will say yes to all reasonable requests. We will not ask why.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree if it would affect your care.
- If you pay for a service or item out of pocket in full, you can ask us not to share information about it with your health insurer for payment or operations. We will say yes unless a law requires us to share it.
Get a list of those we've shared information with
- You can ask for a list (an accounting) of the times we've shared your health information in the six years before your request, who we shared it with, and why.
- The list will include all disclosures except those for treatment, payment, and health care operations, and certain others (such as any you asked us to make). We'll provide one list a year free and may charge a reasonable, cost-based fee for additional lists within 12 months.
Get a copy of this notice
You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically. We'll send one promptly.
Choose someone to act for you
If you have given someone medical power of attorney, or if someone is your legal guardian or health care proxy, that person can exercise your rights and make choices about your health information. We will confirm that the person has this authority before we act.
2. Your choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference, tell us and we'll follow your instructions.
You have both the right and the choice to tell us whether to:
- Share information with family, close friends, or others involved in your care or in paying for it.
- Share information in a disaster relief situation.
If you can't tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share it when needed to lessen a serious and imminent threat to health or safety.
We never share your information in these cases unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
Fundraising. Flintlock does not conduct fundraising. If that ever changes, you will be able to opt out of any fundraising communications, and we will tell you how.
3. How we use and share your information
We typically use or share your health information in the following ways without your written permission.
To treat you
We use your health information and share it with other professionals who are treating you. Examples: your clinician reviews your history and lab results during a telehealth visit; we send a prescription to the pharmacy that fills it; we order labs from a laboratory; we retrieve your medication history through the electronic prescribing network to check for interactions; we share information with a specialist you are referred to.
To run our practice
We use and share your health information to run the practice, improve your care, and contact you when needed. Examples: reviewing the quality of care, training, sending appointment and refill reminders, managing the patient portal, and working with the companies that support our operations, such as our electronic health record, secure messaging, e-fax, and payment vendors.
To bill and get payment for your services
Flintlock memberships are self-pay. We use your information to process membership and other payments. When a laboratory, pharmacy, or other provider bills your health insurance directly, we may share information they need for that purpose. Example: we give a lab your diagnosis code so it can bill your insurer for a test.
Business associates
Some services are provided by companies we contract with, such as our EHR platform, management company, pharmacies acting on our behalf, and technology vendors. They may need your information to do their work. Each must sign an agreement promising to protect it as required by HIPAA.
4. Other uses and disclosures
We are allowed or required to share your information in other ways, usually ones that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
- As required by law. We will share information when federal, state, or local law requires it, including with the U.S. Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
- Public health and safety. We may share information to report certain diseases to public health authorities (including reportable sexually transmitted infections and HIV as required by New York law), report adverse reactions to medications, help with product recalls, prevent or reduce a serious threat to anyone's health or safety, and report suspected abuse, neglect, or domestic violence as required or allowed by law.
- Prescription monitoring. Before prescribing certain controlled substances (such as testosterone or modafinil), New York law requires us to check, and in some cases report to, the state's Prescription Monitoring Program.
- Health oversight. We may share information with agencies for activities authorized by law, such as audits, investigations, inspections, and licensure.
- Lawsuits and legal actions. We may share information in response to a court or administrative order, or in response to a subpoena when the law allows.
- Law enforcement. We may share information with law enforcement officials for purposes permitted by law, such as complying with a court order or warrant.
- Research. We may use or share information for health research only as allowed by law, generally with your authorization or with approval from a review board that has protected your privacy.
- Coroners, medical examiners, funeral directors, and organ donation. We may share information as allowed by law.
- Workers' compensation. We may share information for workers' compensation claims as allowed by law.
- Special government functions. We may share information for military, national security, and presidential protective services as allowed by law.
- Incidental disclosures. Some limited disclosures may happen as a by-product of an otherwise permitted use, despite reasonable safeguards.
5. Extra protections under New York law
Where New York law gives you more privacy protection than federal law, we follow New York law.
- HIV-related information. Under New York Public Health Law Article 27-F, we will not share confidential HIV-related information (including HIV test results, PrEP care, and related diagnoses) without your specific written authorization, except in the limited situations the law allows, such as with your other treating providers, for required public health reporting, and under a special court order. Anyone who receives this information from us is prohibited from sharing it further unless the law allows it.
- Genetic test results. Under New York Civil Rights Law Section 79-l, we will not share the results of genetic tests without your specific written consent, except as the law allows.
- Mental health information. Mental health information receives extra protection under New York law, and we will share it only as those laws allow.
- Access to your records. New York Public Health Law Section 18 gives you the right to inspect and get copies of your records, and limits what we may charge for paper copies.
6. Substance use disorder treatment records
Flintlock is not a substance use disorder treatment program. If we receive records from a program protected by federal law (42 CFR Part 2), we will protect them as that law requires. Those records, or testimony about their content, will not be used or shared in any civil, criminal, administrative, or legislative investigation or proceeding against you unless you give specific written consent or a court issues an order that meets the requirements of Part 2, along with a subpoena or similar legal requirement.
7. Uses that need your written permission
We will not use or share your information for any purpose not described in this notice unless you give us written permission (an authorization). This includes marketing, sale of your information, and most uses of psychotherapy notes. You can revoke an authorization at any time by telling us in writing. Revoking it will not undo anything we already did in reliance on it.
8. Our responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing.
For more information, see the U.S. Department of Health and Human Services page Your Rights Under HIPAA.
9. Complaints
If you believe your privacy rights have been violated, you can file a complaint with us by contacting our Privacy Officer at [email protected] or (917) 565-8504.
You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mail at 200 Independence Avenue, S.W., Washington, D.C. 20201, by phone at 1-877-696-6775, or online at www.hhs.gov/ocr/complaints.
We will not retaliate against you for filing a complaint.
10. Changes to this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The current notice will always be available on this page, in your patient portal, and on request.
Contact
Privacy Officer: Andrew Storer
Flintlock Health · Serving New York State
Email: [email protected]
Phone: (917) 565-8504 · Fax: (917) 580-6335