Notice of Privacy Practices

About This Notice

Thrive Medical Weight Loss ("we," "us," or "our") is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to maintain the privacy of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health condition, the provision of healthcare to you, or payment for healthcare services.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of your health records

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or summary of your health information, usually within thirty (30) days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your health records

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say "no" to your request, but we will tell you why in writing within sixty (60) days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will consider all reasonable requests and will say "yes" if the request is reasonable.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care. If you pay for a service or healthcare item out of pocket in full, you can ask us not to share that information with your health insurer for the purpose of payment or our operations, and we will say "yes" unless a law requires us to share that information.

Get a list of those with whom we have shared information

You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all disclosures except for those about treatment, payment, healthcare operations, and certain other disclosures. We will provide one accounting per year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this Notice

You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can file a complaint if you feel we have violated your rights by contacting us using the information at the end of this Notice. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/ or by calling 1-877-696-6775. We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, tell us and we will follow your instructions.

Sharing with family, friends, or others involved in your care

We may share health information with a family member, friend, or other person you identify as being involved in your healthcare or payment for your care, or in the event of a disaster relief situation. If you are not able to tell us your preference (for example, if you are unconscious), we may share your information if we believe it is in your best interest.

Marketing purposes

We will not use or share your health information for marketing purposes without your written authorization. You have the right to revoke any such authorization at any time by submitting a written request to us.

Sale of your information

We will never sell your health information. Any disclosure of your PHI that constitutes a sale requires your written authorization.

Psychotherapy notes

If applicable, we will not disclose psychotherapy notes without your written authorization except in limited circumstances permitted by law, such as for certain law enforcement purposes or to prevent a serious threat to health or safety.

How We Use or Disclose Your Health Information

We are allowed or required to share your health information in the following ways:

Treatment

We can use your health information and share it with other professionals who are treating you. For example, a provider treating you for a condition may need to know your current medications to recommend appropriate weight loss treatment.

Payment

We can use and share your health information to bill and get payment from health plans or other entities. For example, we may share information about you with your health insurance company to obtain payment for services we provide to you.

Healthcare operations

We can use and share your health information to run our practice, improve your care, and contact you when necessary. For example, we may use your information to evaluate the quality and competence of our healthcare providers.

Public health and safety

We can share health information about you for certain situations such as:

• Preventing disease and reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone's health or safety

Research

We can use or share your information for health research, subject to certain protections. All research projects are subject to a special approval process and your information will be de-identified whenever possible.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena with appropriate protections.

Law enforcement

We can share health information with law enforcement officials for law enforcement purposes, to identify or locate a suspect, fugitive, material witness, or missing person, or to report certain types of wounds or injuries.

Workers' compensation

We can use or share health information about you for workers' compensation claims as authorized by and to the extent necessary to comply with laws relating to workers' compensation and similar programs.

Organ and tissue donation

If you are an organ donor, we can share health information with organ procurement organizations as necessary to facilitate organ, eye, or tissue donation and transplantation.

Coroners, medical examiners, and funeral directors

We can share health information with a coroner, medical examiner, or funeral director as necessary for them to carry out their duties.

Reproductive health information

We will not use or disclose your reproductive health information for purposes of investigating or imposing liability on any person for the mere act of seeking, obtaining, providing, or facilitating lawful reproductive healthcare, as protected under applicable federal and state law.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information
• We must follow the duties and privacy practices described in this Notice and give you a copy of it
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by letting us know in writing

Changes to This Notice

We can change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request and on our website. The effective date will be updated to reflect any changes.

Contact Us

If you have questions about this Notice, wish to exercise any of your rights, or want to file a complaint about our privacy practices, please contact us:

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at www.hhs.gov/ocr/privacy/hipaa/complaints/ or by calling 1-877-696-6775. You will not be penalized or retaliated against for filing a complaint.