HIPAA Notice of Privacy Practices
Effective Date: March 1, 2021 · Last Updated: March 2025
Your Rights Are Protected by Federal Law
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. You have the right to receive a copy of this notice.
1. Who We Are
West Atlanta Primary Care, LLC is a covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations. This Notice applies to all protected health information (PHI) we create or receive in connection with providing you care.
We are required by law to: (1) maintain the privacy of your PHI; (2) provide you with this notice of our legal duties and privacy practices; and (3) notify you following a breach of unsecured PHI.
2. How We May Use & Disclose Your Health Information
The following categories describe the ways we may use and disclose your health information without your authorization. For each category we explain what we mean and give examples.
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. For example, we may share information with a specialist, hospital, laboratory, or other healthcare provider involved in your care.
Payment
We may use and disclose your PHI to obtain payment for services rendered. This includes billing your insurance carrier, verifying coverage, and processing claims. For example, we may send your diagnosis and treatment information to your insurer so they can pay for your visit.
Healthcare Operations
We may use and disclose your PHI for our internal operations, including quality assessment and improvement, staff training, accreditation, licensing, and business planning. For example, we may review patient records to evaluate the performance of our clinical team.
Appointment Reminders
We may contact you to remind you of upcoming appointments or follow-up care using phone, voicemail, text, or email, unless you instruct us otherwise.
Treatment Alternatives
We may use or disclose your PHI to tell you about possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits & Services
We may use or disclose your PHI to inform you about health-related benefits, services, or programs that may be relevant to your care.
Required by Law
We will disclose your PHI when required to do so by federal, state, or local law, including court orders, subpoenas, or law enforcement requests as permitted under HIPAA.
Public Health Activities
We may disclose your PHI for public health activities such as reporting communicable diseases to public health authorities, reporting adverse events related to medications, or notifying persons who may have been exposed to a disease.
Serious Threats to Health or Safety
We may disclose your PHI to prevent or lessen a serious and imminent threat to the health or safety of you, another person, or the public, consistent with applicable law and ethical standards.
Workers’ Compensation
We may disclose your PHI as authorized by and to the extent necessary to comply with workers’ compensation laws and other similar programs.
3. Uses & Disclosures Requiring Your Authorization
Other uses and disclosures of your PHI not covered by this Notice or by applicable law will be made only with your written authorization. You may revoke an authorization at any time in writing. Revocation will not apply to disclosures already made in reliance on your authorization.
We will obtain your written authorization before using or disclosing your PHI for marketing purposes, selling your PHI, or using psychotherapy notes beyond what is permitted by law.
4. Your Rights Regarding Your Health Information
You have the following rights with respect to your protected health information. To exercise any of these rights, please submit a written request to our Privacy Contact listed at the end of this Notice.
Right to Inspect & Copy
You have the right to inspect and obtain a copy of your medical records and other PHI used to make decisions about your care. We may charge a reasonable fee for copies. In certain limited circumstances, we may deny your request.
Right to Amend
If you believe your PHI is incorrect or incomplete, you may request an amendment. We may deny the request if the information was not created by us, is not part of records we maintain, or is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or healthcare operations, or for certain other activities.
Right to Request Restrictions
You may request that we restrict certain uses or disclosures of your PHI. We are not required to agree to a restriction except in limited circumstances. If you paid for a service in full out of pocket, you may request we not disclose that information to your health plan.
Right to Confidential Communications
You may request that we communicate with you at a specific address or by a specific method (e.g., only by mail, or only to a certain phone number). We will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically. Contact our office to request a printed copy.
Right to Receive Breach Notifications
You have the right to be notified in the event of a breach of your unsecured protected health information, as required by law.
5. Our Duties
- 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 authorize it in writing.
- We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all PHI we maintain. Revised notices will be available at our office and on our website.
6. How to File a Complaint
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, Office for Civil Rights (OCR). We will not retaliate against you for filing a complaint.
File a complaint with HHS Office for Civil Rights:
200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
Website: hhs.gov/ocr/privacy
7. Privacy Contact
For questions about this Notice or to exercise any of your rights described above, please contact us:
West Atlanta Primary Care, LLC
Privacy Officer
4904 Timber Ridge Drive, Suite 102
Douglasville, GA 30135
Fax: 1-888-498-4621
Office Hours: Monday – Friday, 8:00 AM – 5:00 PM