1. Treatment. We will use and disclose your PHI to provide, coordinate, and manage your healthcare and any related services. For example, we may record your sleep habits via videotape during your overnight sleep study, and we may use the results to help us reach a diagnosis. Many of the people who work for our practice, including but not limited to, our sleep technicians and/or medical office staff, may use or disclose your PHI in order to treat you or to assist others in your treatment. Since you were referred to our facility from your primary care or specialist’s office, we may request that your doctor share your medical information with us. Also, we may provide your doctor with information about your particular condition so that he or she can appropriately treat you for other medical conditions. Additionally, we may disclose your PHI to others who assist in your care, such as your spouse, children, or parents.
2. Payment. Our practice may use and disclose your PHI in order to bill and collect payment for the services and products you may receive from us. This can include activities that your health insurance plan may undertake before it approves or pays for the health care services, determining eligibility or coverage for insurance benefits, reviewing services provided for medical necessity, and/or undertaking utilization review activities. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover your treatment. We also may use and disclose your PHI to obtain payment from other third parties and to bill you directly for services and supplies.
3. Health Care Operations. Our practice may use and disclose your PHI to operate our business. These activities include, but are not limited to, quality assessment activities, employee review activities, licensing, marketing, and for other business activities.
   
   For example, we may use a sign-in sheet at the registration desk where you will be asked to sign your name. Your name may be called in the waiting room when it is time for your provider to see you. We may use or disclose your PHI to contact you to remind you of your appointment.
   
   "Business associates" perform various activities (e.g. billing, transcription services) for us. We will share your PHI with business associates whenever appropriate. A written contract with the business associate will outline the terms that will protect the privacy of your PHI.
   
   We might use or disclose you PHI to discuss with you information about treatment alternative or other health-related services. We may also use and disclose your PHI for other marketing activities. For example, your name and address may be used to send you a newsletter about services our practice offers. You may contact our Privacy Office to request that these materials not be sent to you.
4. Disclosures Required By Law. Our practice will use and disclose your PHI when we are required to do so by federal, state, or local law.
5. Release of Information to Family/Friends. Our practice may release your PHI to a friend of family member that is involved in your care or who assists in taking care of you. For example, a parent or guardian may ask that a family member go to our facility to pick up paperwork containing medical information for them. In this example, the family member may have access to another family member’s medical information.

1. Others Involved in Your Healthcare: Unless your object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to object to such a disclosure, we may disclose such information if we determine that is in your best interest. We may use or disclose PHI to notify or assist in notifying a family member, personal representative, or any other person that is responsible for your care. Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosure to family or other individuals involved in your health care.
2. Emergencies: We may use or disclose your PHI in an emergency treatment situation. If this happens, your provider will try to obtain your consent as soon as reasonably practicable after the delivery of treatment. If your provider or another provider in the practice is required by law to treat you and the provider has attempted to obtain your consent but is unable, he or she may still use your PHI to treat you.
3. Communication Barriers: We may use and disclose your PHI if your provider or another provider in the practice attempts to obtain your consent but is unable to do so due to substantial communication barriers and the provider determines, using professional judgment, that you intend to under the circumstances.

1. Public Health. Our practice may disclose your PHI to public health authorities that are authorized by law to collect information for the purpose of:
   • Maintaining vital records, such as births and deaths
   • Preventing or controlling disease, injury, or disability
   • Notifying a person regarding potential exposure to a communicable disease
   • Notifying a person regarding a potential risk for spreading, contracting a disease or condition
   • Reporting reactions to drugs or problems with products or devices
   • Notifying individuals if a product or device they may be using has been recalled
   • Notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
   • Because Texas law requires physicians to report child abuse or neglect, we may disclose medical information to a public agency authorized to receive reports of child abuse or neglect. Texas law also requires a person having cause to believe that an elderly or disabled person is in a state of abuse, neglect, or exploitation to report the information to the state, and HIPAA privacy regulations permit the disclosure of information to report abuse or neglect of elders or the disabled.
2. Health Oversight: We may disclose PHI to a health oversight agency for activities authorized by law. Oversight activities can include investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.
3. Required by Law: We may use or disclose your PHI to the extent that the use or the disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.
4. Legal Proceedings: We may disclose PHI in the course of any judicial or administrative proceeding, in response to a court or administrative tribunal order (to the extent such disclosure is expressly authorized). We also may disclose your PHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
5. Law Enforcement: We may also disclose PHI, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include
   • Legal process and otherwise required by law
   • Limited information requests for identification and location purposes
   • Pertaining to victims of a crime
   • Suspicion that death has occurred as a result of criminal conduct
   • In the event that a crime occurs on the premises of the practice, and
   • Medical emergency (not on the Practice’s premises) and it is likely that a crime has occurred.
6. Abuse or Neglect: We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that your have been a victim of abuse, neglect or domestic violence to the government entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
7. Coroners, Funeral Directors, and Organ Donation: We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. PHI may be sued and disclosed for cadaveric organ, eye or tissue donation purposes.
8. Research: Our practice may use and disclose your PHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your PHI for research purposes except when: (a) our use or disclosure was approved by an Institutional Review Board or a Privacy Board: (b) we obtain the oral or written agreement of a researcher that (i) the information being sought is necessary for the research study; (ii) the use or disclosure of your PHI is being used only for the research and (iii) the researcher will not remove any of your PHI from our practice; or (c) the PHI sought by the researcher only relates to decedents and the researcher agrees either orally or in writing that the use or disclosure is necessary for the research and, if we request it, to provide us with proof of death prior to access to the PHI of the decedents.
9. Food and Drug Administration: We may disclose your PHI to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.
10. Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
11. Inmates: We may use or disclose your PHI if you are an inmate of a correctional facility and your provider created or received your PHI in the course of providing care to you.
12. Workers’ Compensation: Our practice may release your PHI for worker’s compensation and similar programs.
13. Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et.seg.

1. Confidential Communications. Your have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, but not leave a message on the answering machine. We will accommodate reasonable request. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Officer.
2. You have the right to request a restriction of your PHI. This means you may ask us not to use or disclose any part of your PHI for the purposes off treatment, payment, or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may or may not be involved in your care or for notification purposes as described in the Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
   
   Your provider is not required to agree to a restriction. If the provider believes it is in your best interest to permit use and disclosure of your PHI, your PHI will not be restricted. If your provider does agree to the requested restriction, we may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with your provider. In order to request a restriction in our use or disclosure of your PHI, you must make your request in writing to Privacy Officer, 713-827-8896. Your request must describe in a clear and concise fashion:
   1. the information you wish restricted;
   2. whether you are requesting to limit our practice’s use, disclosure or both; and
   3. to whom you want the limits to apply
3. You have the right to inspect and copy your PHI. You may inspect and/or copy health information that is within the designated record set, which is information that is used to make decisions about your care. Texas law requires that requests for copies be made in writing, and we ask that requests for inspection of your health information also be made in writing. Please send your request to the Privacy Officer,
4. 7500 San Felipe, Suite 550, Houston, TX 77063.
5. We may ask that a narrative of that information be provided rather than copies. However, if you do not agree to our request, we will provide copies.
   
   Texas law requires us to be ready to provide copies or a narrative within 15 days of your request. We will inform you when the records are ready or if we believe access should be limited. If we deny access, we will inform you in writing. Our practice may charge a fee for the costs of copying, mailing, labor and supplies associated with your request.
   
   Under federal law, however, you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and PHI that is subject to law that prohibits access to PHI. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical record.
   
   You must submit your request in writing to Privacy Officer
6. 7500 San Felipe, Suite 550, Houston, TX 77063.
7. In order to inspect and/or obtain a copy of your medical record. Our practice may charge a fee for the costs of copying, mailing, labor and supplies associated with your request.
8. You may have the right to have your provider amend your PHI. This means you may request an amendment of PHI about you in your medical record for as long as we maintain it. To request an amendment, your request must be made in writing and submitted to Privacy Officer, 713-827-8896. You must provide us with a reason that supports your request for amendment. We will respond within 60 days of your request.
   
   In certain cases, we may deny your request for an amendment. We may deny your request if you ask us to amend information that is in our opinion:
   • accurate and complete
   • not part of the PHI kept by or for the practice:
   • not part of the PHI which you would be permitted to inspect and copy; or
   • not created by our practice, unless the individual or entity that created the information is not available to amend the information.
   If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact our Privacy Officer to determine if you have questions about amending your medical record.
9. You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in the Notice of Privacy Practices. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. An "accounting of disclosure" is a list of certain non-routine disclosure our practice has made of your PHI for non-treatment or operations. Purposes. Use of your PHI as part of the routine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse; or the billing department using your information to file your insurance claim. In order to obtain an accounting of disclosures, you must submit your request in writing to Privacy Officer, 713-827-8896. All requests for an accounting of disclosures must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before April 14, 2003.
   
   The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists with the same 12-month period. Our practice will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.
10. Complaints. You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy office of your complaint. We will not retaliate against you for filing a complaint.
    
    You may contact our Privacy Officer at 713-827-8896 or in writing to 7500 San Felipe Suite 550, Houston, TX 77063 for further information about the complaint process.
11. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
12. Our Promise to You: We are required by law and regulation to protect the privacy of your medical information, to provide you with this notice of our privacy practices with respect to protected health information, and to abide by the terms of the notice of privacy practices in effect.

Again, if you have any questions regarding this notice or our health information privacy policies, please contact our Privacy Officer at 713-827-8896. Thank you.