Notice of Privacy Practices (HIPAA)

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.

1. Our Commitment to Your Health Privacy

At Atlantic Nephrology and Hypertension, we understand that medical information about you and your health is confidential and personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at our Hazlet office to provide you with quality medical care and to comply with certain legal requirements.

2. How We May Use and Disclose Medical Information About You

• For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to primary care doctors, cardiologists, endocrinologists, nurses, technicians, or medical students who are involved in taking care of you. For example, our physicians fax consultation notes to your referring primary care physician so they can coordinate your complete treatment plan.
• For Payment: We may use and disclose medical information about you so that the treatment and services you receive at our office may be billed to and payment may be collected from you, an insurance company (such as Medicare or Horizon BCBS), or a third party.
• For Health Care Operations: We may use and disclose medical information about you for practice operations. These uses and disclosures are necessary to run the practice and make sure that all of our patients receive quality care.
• Appointment Reminders: We may use and disclose medical information to contact you as a reminder that you have an appointment for medical care at Atlantic Nephrology.

3. Your Rights Regarding Medical Information About You

You have the right to inspect and copy medical information that may be used to make decisions about your care. You have the right to request an electronic copy of your records, to request an amendment if you feel that medical information we have about you is incorrect or incomplete, to request an accounting of disclosures, and to request confidential communications.

4. Good Faith Estimate Notice (Federal No Surprises Act)

Under Section 2799B-6 of the Public Health Service Act, health care providers are required to provide patients who are not enrolled in an insurance plan or coverage, or a Federal health care program, or not seeking to file a claim with their plan or coverage, with a written "Good Faith Estimate" of expected charges.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare service.
• You can ask our Hazlet front desk for a Good Faith Estimate before you schedule your consultation.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill under federal law.

5. Nondiscrimination & Language Assistance (Section 1557)

Atlantic Nephrology and Hypertension complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We provide free language assistance services to individuals whose primary language is not English, including Spanish language assistance directly in our clinic.

6. Questions & Privacy Officer Contact

If you have any questions about this notice or wish to exercise any of your privacy rights, please contact our Practice Manager & Privacy Officer: