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.

Pulse Surgery Center (Pulse Physician Organization) is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and share your health information without your authorization

For treatment

We use your health information to provide your care and to coordinate it with others. For example, your surgeon, your anesthesia provider, and your recovery nurse share your history, allergies, and medications so your procedure is safe.

For payment

We use and share your information to bill and be paid. For example, we send information about your procedure to your health plan to obtain authorization and payment.

For health care operations

We use your information to run and improve the center. For example, reviewing outcomes and case files as part of our quality improvement and accreditation programs.

Others involved in your care

With your agreement, or where you have had the chance to object, we may share relevant information with a family member, friend, or caregiver involved in your care or payment. This includes the person who drives you home and receives your discharge instructions.

Appointment reminders, follow-up, and health information

We may contact you about your appointment, your recovery, or treatment alternatives.

As required or permitted by law

We may use or share your information for the following purposes.

• Public health activities.
• Reporting suspected abuse, neglect, or domestic violence.
• Health oversight.
• Judicial and administrative proceedings.
• Law enforcement purposes.
• Coroners, medical examiners, and funeral directors.
• Organ and tissue donation.
• Approved research.
• To prevent a serious and imminent threat to health or safety.
• Specialized government functions.
• Workers' compensation.
• To correctional institutions.

Uses and disclosures that require your written permission

We will not use or share your information for any purpose other than those described above without your written authorization. In particular, your written authorization is required for the following.

• Most uses and disclosures of psychotherapy notes, if we maintain any.
• Marketing communications, where we receive payment from a third party.
• Any sale of your health information.
• [[Fundraising: if the center conducts fundraising, add a statement that you may be contacted and how to opt out of future fundraising communications. If it does not, delete this line.]]

You may revoke an authorization at any time, in writing, except to the extent we have already acted on it.

Your rights

• Inspect and copy your record, including an electronic copy if we keep it electronically. Under Texas law, if we maintain your record in an electronic health record, we will provide it to you in electronic form, in the format you request if we can readily produce it, within 15 business days of your written request.
• Request an amendment if you believe information is incorrect or incomplete. We may deny the request and will explain why in writing.
• Receive an accounting of certain disclosures we have made.
• Request restrictions on how we use or share your information. We are not required to agree, except that we must agree to your request not to disclose information to your health plan about a service you paid for in full, out of pocket.
• Request confidential communications. For example, that we call you only at a particular number or write to you at a particular address.
• Receive a paper copy of this notice, even if you agreed to receive it electronically.
• Be notified if a breach occurs that compromises the privacy or security of your information.
• File a complaint. See below.

To exercise any of these rights, contact our Privacy Officer in writing at the address below.

Our duties

We are required by law to maintain the privacy of your protected health information, to provide you with this notice, and to abide by its terms. We reserve the right to change this notice and to make the revised notice effective for information we already hold as well as information we receive in the future. If we make a material change, we will post the revised notice on this website and at the center, and will provide a copy on request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against, and your care will not be affected, for filing a complaint.

Privacy Officer

Caitlyn Sims
Pulse Surgery Center, 25450 Kuykendahl Rd., Ste 110, Tomball, TX 77375
Phone 713.804.1959 Email csims@pulsephysicians.com.