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. This page is a plain-language summary. The complete Notice of Privacy Practices is provided to every patient at intake through our secure patient portal, and a paper copy is available on request.

Our commitment

R3 Women's Wellness, PLLC is required by law to keep your protected health information private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. Mental health information receives additional protection under North Carolina law, and we honor those protections.

How we may use and disclose your information

• Treatment. To provide and coordinate your care, including with other providers involved in your treatment such as your OB, midwife, therapist or pharmacy, with your permission where required.
• Payment. To bill and collect payment from you or your health plan, including verifying benefits and submitting claims.
• Health care operations. To run the practice, such as quality review, training and administration.
• As required or permitted by law. For example, to report suspected abuse, to prevent a serious and imminent threat to health or safety, in response to a valid court order, or to public health authorities as the law requires.

Other uses and disclosures, including psychotherapy notes, most marketing, and any sale of your information, require your written authorization, which you may revoke at any time in writing.

Your rights

• Access. To see and get a copy of your health record, with limited exceptions.
• Amendment. To ask us to correct information you believe is incorrect or incomplete.
• Accounting of disclosures. To receive a list of certain disclosures we have made.
• Restrictions. To ask us to limit how we use or share your information. We must agree if you paid in full out of pocket and ask us not to share that information with your health plan.
• Confidential communications. To ask us to contact you in a specific way or at a specific location.
• A paper copy of this notice at any time.
• To be notified if a breach of your unsecured health information occurs.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Changes to this notice

We may change this notice and make the new notice apply to all information we maintain. The current notice is always available in the patient portal and on this page.

Contact

Privacy Officer, R3 Women's Wellness, PLLC
10027 Clayton Blvd, Suite C, Clayton, NC 27520
(919) 473-6909 · tiirini@r3womenswellness.com