NOTICE OF PRIVACY PRACTICES

Renaissance Medical Center
3832 W Humphrey St, Tampa, FL 33614
Phone: (813) 440-4420
Email: admin@renaissancemedicalcenter.org

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

1. Our Commitment to Your Privacy

Renaissance Medical Center is committed to maintaining the privacy and security of your Protected Health Information (PHI). PHI includes information about your health, medical conditions, treatment, and payment for healthcare services that can identify you.

We are required by law, including the Health Insurance Portability and Accountability Act (HIPAA), to:

• Maintain the privacy of your PHI
• Provide you with this Notice of our legal duties and privacy practices
• Follow the terms of this Notice currently in effect

2. How We May Use and Disclose Your PHI

We may use and disclose your PHI for the following purposes without your written authorization:

A. Treatment

We may use and share your PHI to provide, coordinate, or manage your healthcare.
Example: Sharing information with specialists, labs, or pharmacies involved in your care.

B. Payment

We may use and disclose your PHI to bill and collect payment.
Example: Submitting claims to your insurance provider or verifying coverage.

C. Healthcare Operations

We may use PHI for operational purposes such as:

• Quality assessment and improvement
• Staff training and credentialing
• Licensing and accreditation activities
• Business management and administrative services

3. Other Permitted and Required Uses and Disclosures

We may also use or disclose your PHI without your authorization in the following situations:

Public Health Activities

• Reporting diseases, injuries, or vital events
• Preventing or controlling disease spread

Health Oversight Activities

• Audits, inspections, and investigations by government agencies

Legal Proceedings

• In response to court orders, subpoenas, or legal processes

Law Enforcement

• To comply with law enforcement requests under applicable law

Serious Threats to Health or Safety

• To prevent or lessen a serious and imminent threat

Workers’ Compensation

• As required by workers’ compensation laws

Coroners, Medical Examiners, and Funeral Directors

• For identification and official duties

4. Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization before using or disclosing your PHI for:

• Marketing purposes (where required by HIPAA)
• Sale of your PHI
• Psychotherapy notes (if applicable)
• Any use not described in this Notice

You may revoke your authorization at any time in writing.

5. Your Rights Regarding Your PHI

You have the following rights under HIPAA:

A. Right to Access

You may inspect and obtain a copy of your medical records in paper or electronic format.

B. Right to Amend

You may request corrections to your PHI if you believe it is inaccurate or incomplete.

C. Right to an Accounting of Disclosures

You may request a list of certain disclosures we have made of your PHI.

D. Right to Request Restrictions

You may request limits on how we use or disclose your PHI.
We are not required to agree, except in limited circumstances (e.g., self-pay restrictions).

E. Right to Confidential Communications

You may request that we contact you in a specific way (e.g., only by phone or at a different address).

F. Right to a Paper Copy

You may request a paper copy of this Notice at any time.

6. Our Responsibilities

We are required to:

• Maintain the privacy and security of your PHI
• Notify you promptly if a breach occurs that may compromise your information
• Follow the terms of this Notice
• Not use or disclose your PHI other than as described unless you authorize it

7. Business Associates

We may share your PHI with third-party vendors (known as Business Associates) who perform services on our behalf, such as billing, IT support, or data storage.

All Business Associates are required to:

• Sign Business Associate Agreements (BAAs)
• Safeguard your PHI in compliance with HIPAA

8. Electronic Communications & Patient Portal

If you use our website or patient portal:

• We implement safeguards to protect your information
• Communications via email or SMS may not always be secure
• You should avoid sharing highly sensitive medical information through unsecured channels unless necessary

9. Special Situations

Minors

We comply with applicable laws regarding the privacy of minors’ health information.

Family and Friends

We may share relevant PHI with individuals involved in your care unless you object.

Disaster Relief

We may disclose PHI to assist in disaster relief efforts.

10. Changes to This Notice

We reserve the right to change this Notice at any time.
Any revised Notice will apply to all PHI we maintain and will be made available:

• On our website
• At our facility upon request

11. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services.

We will not retaliate against you for filing a complaint.

Contact Us:
Renaissance Medical Center
3832 W Humphrey St, Tampa, FL 33614
Phone: (813) 440-4420
Email: admin@renaissancemedicalcenter.org

File with HHS:
You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services at:
https://www.hhs.gov/hipaa/filing-a-complaint

12. Acknowledgment of Receipt

You may be asked to sign an acknowledgment that you have received this Notice of Privacy Practices.