At Green Country Ultrasound LLC, your health information privacy is important. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose your protected health information (PHI), your rights regarding that information, and our legal obligations under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).​

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A.  OUR COMMITMENT TO YOUR PRIVACY:

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Green Country Ultrasound LLC is dedicated to maintaining the privacy of your individually identifiable, protected health information (PHI). In conducting our business, we will create records regarding you and the services we provide to you. This includes information we collect from you via our online contact/scheduling form and patient referral forms. We strive to maintain the confidentiality of health information that identifies you. This notice explains the privacy practices that we maintain concerning your PHI.  

The terms of this notice apply to all records containing your PHI that are created or retained by Green Country Ultrasound LLC. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all of your records that Green Country Ultrasound LLC has created or maintained in the past, and for any of your records that we may create or maintain in the future. You may request a copy of our most current notice at any time.

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B.  IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:

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Green Country Ultrasound LLC

Attn: Privacy Officer

5323 S 65th West Ave

Tulsa, OK 74107

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C.  WE MAY USE AND DISCLOSE YOUR PHI IN THE FOLLOWING WAYS:

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The following categories describe the different ways in which we may use and disclose your PHI, unless you object:

1. Services:  Green Country Ultrasound LLC may use your PHI to provide you with imaging services. 

2. Payment:  Green Country Ultrasound LLC may use and disclose your PHI in order to bill and collect payment for the services and items you may receive from us. We do not accept or bill insurance, so we do not disclose your information for the purpose of being reimbursed by insurance. However, we may use and disclose your PHI to obtain payment from those that may be responsible for such costs, such as family members.  

3. Appointment Reminders: Green Country Ultrasound LLC may use and disclose your PHI to contact you and remind you of an appointment.

4. Disclosures Required by Law: Green Country Ultrasound LLC will use and disclose your PHI when we are required to do so by federal, state, or local law or regulation.

5. Third Parties: Green Country Ultrasound LLC will never sell, share, rent, or disclose your personal information such as your phone number, address, or SMS content for marketing purposes.

D.  MANDATORY DISCLOSURES:

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The following categories describe unique scenarios in which we may be required by law to use or disclose your PHI:

1. Health Oversight Activities: Green Country Ultrasound LLC may disclose your PHI to a health oversight agency for activities required by law.  Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor compliance with civil rights laws and the health care system in general.

2. Lawsuits and Similar Proceedings: Green Country Ultrasound LLC may use and disclose your PHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. 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.

3. Law Enforcement: Green Country Ultrasound LLC may release PHI if required to do so by a law enforcement official: regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement, concerning a death we believe has resulted from criminal conduct, regarding criminal conduct at our offices in response to a warrant, summons, court order, subpoena or similar legal process, to identify/locate a suspect, material witness, fugitive or missing person, or in an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator).

4. Organ and Tissue Donation: Green Country Ultrasound LLC may release your PHI to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.

5. Serious Threats to Health or Safety: Green Country Ultrasound may use and disclose your PHI when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.

6. Military: Green Country Ultrasound LLC may disclose your PHI if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.

7. Workers’ Compensation: Green Country Ultrasound LLC may release your PHI if required for workers’ compensation and similar programs.

8. Minors: Green Country Ultrasound LLC may disclose the PHI of minor children to their parents or guardians unless such disclosure is otherwise prohibited by law.

9. Business Associates: Green Country Ultrasound LLC may disclose PHI to our Business Associates who perform functions on our behalf or provide us with services if the use of your PHI is necessary for those functions or services. For example, we may use another company to do our electronic medical and billing records storage and data transmission, or to provide transcription or consulting services for us. All of our Business Associates are obligated, under contract with us, to protect the privacy and ensure the security of your PHI. They are also required to obtain identical assurances from any subcontractors they may use to help them provide their services to us.

 

E.  YOUR RIGHTS REGARDING YOUR PHI:

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The health and billing records we maintain are the physical property of Green Country Ultrasound LLC. The information in it, however, belongs to you.  You have a right to:

1. Confidential Communications: You have the right to request that Green Country Ultrasound LLC 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, rather than work. In order to request a type of confidential communication, you must make a written request to the Privacy Officer, specifying the requested method of contact, or the location where you wish to be contacted. Green Country Ultrasound LLC will accommodate reasonable requests. You do not need to give a reason for your request.

2. Requesting Restrictions: You have the right to request a restriction in our use or disclosure of your PHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your PHI, you must make your request in writing to the Privacy Officer. Your request must describe in a clear and concise fashion: (a) the information you wish restricted, (b) whether you are requesting to limit our Practice’s use, disclosure or both; and (c) to whom you want the limits to apply.

3. Inspection and Copies: You have the right to inspect and obtain a copy of the PHI that may be used to make decisions about you, including patient medical records and billing records. You must submit your request in writing to the Privacy Officer in order to inspect and/or obtain a copy of your PHI.  Green Country Ultrasound LLC may charge a fee for the costs of copying, mailing, and supplies associated with your request. Our Practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. 

4. Paper Copy of this Notice: You may receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact the Privacy Officer.

5. Filing a Complaint: If you believe your privacy rights have been violated, you may file a complaint with our Practice. To file a complaint with our Practice, contact our privacy officer at the address provided above. All complaints must be submitted in writing, and you will not be penalized for filing a complaint.

6. Right to Provide an Authorization for Other Uses and Disclosures: Green Country Ultrasound LLC will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. You have the right, at any time, to revoke your authorization to disclose your PHI. Simply send a written notice of revocation to the Privacy Officer at the address provided above. After you revoke your authorization, we will no longer use or disclose your PHI for the reasons described in the authorization. Please note- we are required to retain records of your care.

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F. SMS MESSAGING TERMS AND CONDITIONS:

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When communicating with our office via SMS messaging, the following terms and conditions may apply:

1. SMS Consent Communication: We are committed to your privacy and will never sell, share, rent, or disclose your personal information such as your phone number or SMS content for marketing purposes.

2. Types of SMS Communications: You may receive SMS test messages from Green Country Ultrasound LLC; we may use SMS messaging to contact you for appointment scheduling or appointment reminders.

   Message Frequency: Messaging frequency may vary.

3. Potential Fees for SMS Messaging: Message and data rates may apply.

4. Opt-Out Method. To opt out at any time, text STOP or contact us by calling (918) 238-7329.

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If you have questions regarding this notice or our health information privacy policies, please contact the Privacy Officer listed above.