PRIVATE POLICY

                                        Privacy Policy for Revive Spine and Pain Care

Effective Date: October 22, 2022 and revised October 21, 2024

This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.

Introduction

At Revive Spine and Pain Care ("we," "us," or "our"), we are committed to protecting your privacy and ensuring the confidentiality of your health information. This Privacy Policy outlines how we collect, use, and protect your personal and protected health information (PHI) as required by the Health Insurance Portability and Accountability Act (HIPAA).

We are required by law to maintain the privacy of your PHI and provide you with this notice of our privacy practices. This notice also describes your rights regarding your health information and how you can access it. By using our services or visiting our website www.revivepaincare.com, you agree to the practices described in this policy.

We collect various types of information, including:

• Personal Information: Identifiable data such as your name, address, phone number, and email.
• Protected Health Information (PHI): Information related to your medical history, treatment, and health care services provided by us.
• Non-Personal Information: Data automatically collected from your use of the website, such as IP addresses and browsing activity.

We may use your information for the following purposes:

• Treatment: To provide and coordinate your healthcare services. This includes consultations with specialists or referrals to other healthcare providers. For example, your doctor may need to access your medical history to determine the best course of treatment.
• Payment: To bill and receive payment from insurance companies or third-party payers for the healthcare services provided to you.
• Healthcare Operations: For administrative tasks, such as evaluating the performance of our staff, quality assurance activities, and business management.

We may use or disclose your PHI without your authorization in the following circumstances:

• For Treatment: Sharing your health information with other healthcare professionals directly involved in your care.
• For Payment: Using your health information to bill for services and obtain reimbursement from insurers or other payers.
• For Healthcare Operations: Administrative activities such as quality assessments, business planning, and internal audits.

We are committed to complying with all SMS TCR (The Campaign Registry) guidelines when using text messaging to communicate with our patients. SMS opt-in or phone numbers for the purpose of SMS are not being shared with any third party or affiliate. By providing your phone number, you consent to receiving text messages from us for appointment reminders, treatment updates, and other healthcare-related communications. These communications are directly related to your care and the services you receive from Revive Spine and Pain Care.

SMS Communication Includes:

• Appointment reminders and scheduling confirmations.
• Updates about your treatment plan, medication, or upcoming procedures.
• Notifications of follow-up care or other healthcare-related matters.

User Consent & Opt-In
We will only send text messages after obtaining your express consent (opt-in) through written or electronic means. You will be required to confirm your consent to receive messages by checking a box during registration or verbally agreeing in person. We will also provide clear details of what type of messages you will receive and the frequency of communication.

Opt-Out
You have the right to opt out of receiving text messages from us at any time. To opt out, reply "STOP" to any message you receive from us. Once you opt out, you will no longer receive SMS communications from us, though you will still receive necessary communication by other means (email, phone calls, etc.). Message and data rates may apply to text messaging.

Frequency
The frequency of SMS communications will vary based on the nature of your relationship with our clinic. Typically, we will send text messages for the purposes listed above. However, no marketing or promotional SMS messages will be sent without your explicit consent.

Third-Party Providers
We use third-party services, such as RingCentral, to manage our text messaging services. Your phone number and any messages sent or received via SMS are protected under the terms of this policy and applicable law. We take all necessary steps to ensure that third-party providers comply with privacy and data protection regulations.

Message and Data Rates
Standard message and data rates from your mobile carrier may apply. Patients are responsible for any such charges related to text message communications.

We will not disclose your PHI to family members, friends, or any other individual involved in your care or payment without your explicit authorization. You must provide written approval before we share your information with anyone, including your family or friends. If you wish for us to share information with specific individuals, you must complete and sign a HIPAA authorization form.

We can use or disclose your protected health information for purposes of treatment, payment and health care operations.

• Treatment means the provision, coordination or management of your health care, including consultations between health care providers regarding your care and referrals for health care from one health care provider to another. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Therefore, the doctor may review your medical records to assess whether you have potentially complicating conditions like diabetes.
• Payment means activities we undertake to obtain reimbursement for the health care provided to you, including determinations of eligibility and coverage and other utilization review activities. For example, prior to providing health care services, we may need to provide information about your medical condition to your insurance carrier (or other third party payor)  to determine whether the proposed course of treatment will be covered. When we subsequently bill the carrier or other third party payor for the services rendered to you, we can provide the carrier or other third party payor with information regarding your care if necessary to obtain payment.
• Health Care Operations refer to the support functions of our practice related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient complaints, physician reviews, compliance programs, audits, business planning, development, management and administrative activities. For example, we may use your medical information to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what services are not needed, and whether certain new treatments are effective.

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you or relate specifically to your medical care through our office. For example, we may leave appointment reminders on your answering machine or with a another person who may answer the telephone at the number that you have given us in order to contact you.

We may disclose your protected health information to your family or friends or any other individual identified by you when they are involved in your care or the payment for your care. We will only disclose the protected health information directly relevant to their involvement in your care or payment. We may also use or disclose your protected health information to notify, or assist in the notification of, a family member, a personal representative, or another person responsible for your care of your location, general condition or death. If you are available, we will give you an opportunity to object to these disclosures, and we will not make these disclosures if you object. If you are not available, we will determine whether a disclosure to your family or friends is in your best interest, and we will disclose only the protected health information that is directly relevant to their involvement in your care.

We will allow your family and friends to act on your behalf to pick up prescriptions, medical supplies, X-rays, and similar forms of protected health information, when we determine, in our professional judgment, that it is in your best interest to make such disclosures.

We may also disclose your PHI in the following situations without your prior consent or authorization:

• Public Health Activities: Reporting information for the purpose of controlling disease, injury, or disability.
• Health Oversight Activities: To comply with government health oversight agencies' requests.
• Legal Requirements: In response to a court order, subpoena, or other lawful process.
• Law Enforcement: For law enforcement purposes as required by law, such as reporting crimes on our premises.
• Serious Threats: If we believe, in good faith, that disclosure is necessary to prevent a serious and imminent threat to public health or safety.

Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement, or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Military and Veterans. If you are a member of the Armed Forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:

• To prevent or control disease, injury or disability
• To report births and deaths
• To report victim of abuse, neglect, or domestic violence
• To report reactions to medications
• To notify people of product, recalls, repairs or replacements
• To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

Health Oversight Activities. We may disclose medical information to federal or state agencies that oversee our activities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. We may disclose protected health information to persons under the Food and Drug Administration’s jurisdiction to track products or to conduct post-marketing surveillance.

Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in a response to a subpoena, discovery request or other lawful process by someone else involved in the dispute.

Law Enforcement. We may release medical information if asked to do so by a law enforcement official:

• In response to a court order, subpoena, warrant, summons or similar process
• To identify or locate a suspect, fugitive, material witness, or missing person
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement
• About a death we believe may be the result of a criminal conduct
• About criminal conduct on our premises
• In emergency circumstances to report a crime; the location of the crime or victims or the identity, description or location of the person who committed the crime

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary for the institution to provide you with health care, to protect your health and safety or the health and safety of others, or for the safety and security of the correctional institution.

Serious Threats. As permitted by applicable law and standards of ethical conduct, we may use and disclose protected health information if we, in good faith, believe that the use of disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Disaster Relief. When permitted by law, we may coordinate our uses and disclosures of protected health information with public or private entities authorized by law or by charter to assist in disaster relief efforts.

Under HIPAA, you have the following rights regarding your PHI:

• Right to Access: You have the right to inspect or obtain copies of your medical and billing records.
• Right to Request Restrictions: You may request restrictions on the use and disclosure of your PHI, though we are not required to agree to your request.
• Right to Request Confidential Communications: You can request that we communicate with you via alternative methods or at alternative locations.
• Right to Amend: You may request corrections to your PHI if you believe it is inaccurate or incomplete.
• Right to an Accounting of Disclosures: You have the right to receive a list of certain disclosures of your PHI made by us.
• Right to a Paper Copy of This Notice: You may request a paper copy of this privacy notice at any time.

1. You have the right to request restrictions on our uses and disclosures of protected health information for treatment, payment and health care operations. However, we are not required to agree to your request.
2. You have the right to reasonably request to receive communications of protected health information by alternative means or at alternative locations.
3. Subject to payment of a reasonable copying charge as provided by state law, you have the right to inspect or obtain a copy of the protected health information contained in your medical and billing records and in any other practice records used by us to make decisions about you, except for:
   
   • Psychotherapy notes, which are notes recorded by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint or family counseling session and that have been separated from the rest of your medical record
   • Information compiled in a reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.
   • Protected health information involving laboratory tests when your access is required by law
   • If you are a prison inmate and obtaining such information would jeopardize your health, safety, security, custody, or rehabilitation or that of other inmates, or the safety of any officer, employee, or other person at the correctional institution or person responsible for transporting you
   • If we obtained or created protected health information as part of a research study for as long as the research is in progress, provided that you agreed to the temporary denial of access when consenting to participate in the research
   • Your protected health information is contained in records kept by a federal agency or contractor when your access is required by law
   • If the protected health information was obtained from someone other than us under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information
   • We may also deny a request for access to protected health information if:
     
   • A licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger your life or physical safety or that of another person
   • The protected health information makes reference to another person (unless such other person is a health care provider) and a licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to cause substantial harm to such other person
   • The request for access is made by the individual’s personal representative and a licensed health care professional has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to you or another person
   • If we deny a request for access for any of the three reasons described above, then you have the right to have our denial reviewed in accordance with the requirements of applicable law.

           4.  You have the right to request a correction to your protected health information,

                we may deny your request for correction, if we determine that the protected 

                health information or record that is the subject of the request:

• Was not created by us, unless you provide a reasonable basis to believe that the originator of protected health information is no longer available to act on the requested amendment
• Is not part of your medical or billing records
• Is not available for inspection as set forth above
• Is not accurate and complete
• In any event, any agreed upon correction will be included as an addition to, and not a replacement of, already existing records.

If have the right to receive an accounting of disclosures of protected health information made by us to individuals or entities other than to you for the period provided by law, except for disclosures:

• To carry out treatment, payment and health care operations as provided above
• To persons involved in your care or for other notification purposes as provided by law
• For national security or intelligence purposes as provided by law
• To correctional institutions or law enforcement officials as provided by law
• That occurred prior to April 14, 2003
• That are otherwise not required by law to be included in the accounting

1. You have the right to request and receive a paper copy of this notice from us.
2. The above rights may be exercised only by written communication to us. Any revocation or other modification of consent must be in writing delivered to us.

We implement reasonable and appropriate administrative, physical, and technical safeguards to protect your PHI. However, no system is entirely secure, and we cannot guarantee absolute security, particularly for communications through text messages or emails.

We reserve the right to modify or update this Privacy Policy at any time, in accordance with applicable laws. Any changes will be effective upon posting to our website. You may request the most current version of this notice from our office.

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

If you have any questions about this Privacy Policy or wish to exercise your privacy rights, please contact us at:

Revive Spine and Pain Care
Phone: 404-596-1695
Email: info@revivespineandpain.com
Address: 10160 Medlock Bridge Rd Suite 100, Duluth, Georgia 30097