The Village Family Medicine, PLLC.
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR COMMITMENT TO YOUR PRIVACY
The Village Family Medicine (“TVFM”) is committed to protecting your personal health information (“PHI”). We create and maintain medical records of the care you receive and are required by federal law (HIPAA) to keep this information private, secure, and accessible to you upon request.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
1. Treatment
We may use and disclose your PHI to provide, coordinate, or manage your medical care. This includes sharing information with:
For example, we may send clinical information required for a referral to a specialist, transmit a lab order, provide imaging centers with relevant details needed for your test, or share medication information with a pharmacy to ensure safe treatment.
2. Health Care Operations
We may use your PHI for internal operations necessary to run our practice and maintain quality care. This may include:
3. Payment
Although The Village Family Medicine does not bill insurance companies, we may use or disclose PHI for limited payment-related purposes, including:
4. Public Health & Legal Requirements
We may disclose PHI when required by federal, state, or local law, including:
5. To Prevent a Serious Threat
We may disclose PHI if necessary to prevent or lessen a serious and imminent threat to your health or the health and safety of others, consistent with applicable law.
6. Disclosures to Family, Caregivers, or Emergency Contacts
With your permission, we may share PHI with:
In emergencies, we may share relevant PHI if it is in your best interest and permitted by law.
7. Electronic Communications
We may use email, text messaging, and the patient portal to communicate with you regarding scheduling, medical updates, or administrative matters.
While reasonable safeguards are used, these methods may not be fully secure.
You may opt out of these communication methods at any time.
8. Other Uses Require Written Authorization
Any use or disclosure of your PHI not described in this Notice requires your explicit written authorization.
You may revoke an authorization at any time in writing, except to the extent that PHI has already been used or disclosed.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights under HIPAA:
1. Right to Request Restrictions
You may request limitations on how we use or disclose your PHI for treatment, operations, or to individuals involved in your care.
We are not required to agree, but if we do, we will honor the restriction unless prohibited by law or necessary for emergency care.
2. Right to Request Confidential Communications
You may request to be contacted at a specific phone number, email, or mailing address.
3. Right to Access Your Medical Record
You may inspect or request an electronic or paper copy of your PHI.
Requests will be completed within 30 days unless an extension is permitted by law.
A reasonable cost-based fee may apply.
4. Right to Request an Amendment
If you believe your PHI is incorrect or incomplete, you may request an amendment.
Requests must be made in writing and include a reason for the amendment.
We may deny certain requests but will provide a written explanation if we do so.
5. Right to an Accounting of Disclosures
You may request a list of certain disclosures we have made of your PHI in the past six years, excluding those made for treatment, operations, or any disclosures you authorized.
6. Right to a Copy of This Notice
You may request a paper or electronic copy of this Notice at any time, even if you have agreed to electronic delivery.
OUR RESPONSIBILITIES
The Village Family Medicine is legally required to:
We reserve the right to revise this Notice at any time in compliance with applicable law.
Any updated Notice will be available on request and posted in our office and/or website.
QUESTIONS OR COMPLAINTS
If you have questions, concerns, or believe your privacy rights have been violated, you may contact:
The Village Family Medicine, PLLC
Attn: Privacy Officer
120 Storage Solutions Ln, Suite 123
White Post, VA 22663
You may also file a complaint with the U.S. Department of Health and Human Services (HHS). You will not be penalized for filing a complaint.
OUR COMMITMENT TO YOUR PRIVACY
The Village Family Medicine (“TVFM”) is committed to protecting your personal health information (“PHI”). We create and maintain medical records of the care you receive and are required by federal law (HIPAA) to keep this information private, secure, and accessible to you upon request.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
1. Treatment
We may use and disclose your PHI to provide, coordinate, or manage your medical care. This includes sharing information with:
- Laboratories for bloodwork or diagnostic testing
- Imaging centers such as X-ray, MRI, ultrasound, CT, and mammography facilities
- Pharmacies for prescribing or clarifying medications
- Specialists, consultants, or other clinicians involved in your care
- Hospitals, urgent care centers, or emergency departments
- Other healthcare providers assisting in your treatment
For example, we may send clinical information required for a referral to a specialist, transmit a lab order, provide imaging centers with relevant details needed for your test, or share medication information with a pharmacy to ensure safe treatment.
2. Health Care Operations
We may use your PHI for internal operations necessary to run our practice and maintain quality care. This may include:
- Quality improvement activities
- Appointment scheduling and reminders
- Internal charting, documentation, and training
- Audits, licensing, and legal compliance
- Maintaining secure medical records
3. Payment
Although The Village Family Medicine does not bill insurance companies, we may use or disclose PHI for limited payment-related purposes, including:
- Processing membership fees or service payments
- Providing documentation you request for FSA/HSA reimbursement
- Communicating with you regarding billing, receipts, or account issues
- We do not submit insurance claims or communicate with insurers on your behalf.
4. Public Health & Legal Requirements
We may disclose PHI when required by federal, state, or local law, including:
- Reporting certain communicable diseases
- Reporting suspected abuse, neglect, or domestic violence
- Responding to court orders, subpoenas, or legal investigations
- Supporting health oversight activities, including audits or compliance reviews
5. To Prevent a Serious Threat
We may disclose PHI if necessary to prevent or lessen a serious and imminent threat to your health or the health and safety of others, consistent with applicable law.
6. Disclosures to Family, Caregivers, or Emergency Contacts
With your permission, we may share PHI with:
- Family members
- Caregivers
- Individuals involved in your care or payment for your care
- Emergency contacts you designate
In emergencies, we may share relevant PHI if it is in your best interest and permitted by law.
7. Electronic Communications
We may use email, text messaging, and the patient portal to communicate with you regarding scheduling, medical updates, or administrative matters.
While reasonable safeguards are used, these methods may not be fully secure.
You may opt out of these communication methods at any time.
8. Other Uses Require Written Authorization
Any use or disclosure of your PHI not described in this Notice requires your explicit written authorization.
You may revoke an authorization at any time in writing, except to the extent that PHI has already been used or disclosed.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights under HIPAA:
1. Right to Request Restrictions
You may request limitations on how we use or disclose your PHI for treatment, operations, or to individuals involved in your care.
We are not required to agree, but if we do, we will honor the restriction unless prohibited by law or necessary for emergency care.
2. Right to Request Confidential Communications
You may request to be contacted at a specific phone number, email, or mailing address.
3. Right to Access Your Medical Record
You may inspect or request an electronic or paper copy of your PHI.
Requests will be completed within 30 days unless an extension is permitted by law.
A reasonable cost-based fee may apply.
4. Right to Request an Amendment
If you believe your PHI is incorrect or incomplete, you may request an amendment.
Requests must be made in writing and include a reason for the amendment.
We may deny certain requests but will provide a written explanation if we do so.
5. Right to an Accounting of Disclosures
You may request a list of certain disclosures we have made of your PHI in the past six years, excluding those made for treatment, operations, or any disclosures you authorized.
6. Right to a Copy of This Notice
You may request a paper or electronic copy of this Notice at any time, even if you have agreed to electronic delivery.
OUR RESPONSIBILITIES
The Village Family Medicine is legally required to:
- Maintain the privacy and security of your PHI
- Provide you with this Notice of Privacy Practices
- Notify you following a breach of unsecured PHI
- Follow the terms of this Notice
- Provide updates if this Notice changes
We reserve the right to revise this Notice at any time in compliance with applicable law.
Any updated Notice will be available on request and posted in our office and/or website.
QUESTIONS OR COMPLAINTS
If you have questions, concerns, or believe your privacy rights have been violated, you may contact:
The Village Family Medicine, PLLC
Attn: Privacy Officer
120 Storage Solutions Ln, Suite 123
White Post, VA 22663
You may also file a complaint with the U.S. Department of Health and Human Services (HHS). You will not be penalized for filing a complaint.