Effective October 1, 2021
Your Information. Your Rights. Our Responsibilities.
IDG appreciates the importance of your privacy, and protects your personal information from
any inappropriate, unauthorized uses or disclosures. This notice describes how your medical
information may be used and disclosed, and how you can get access to this information. Please
review it carefully.
Your Rights
You have the right to:
- Get a copy of your paper or electronic medical record
- Request corrections to your paper or electronic medical record
- Request confidential communications
- Ask us to limit the information we share
- Get a list of those with whom we’ve shared your information
- Get a copy of this privacy notice
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Market our services
Our Uses and Disclosures
We may use and share your information as we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Work with a medical examiner or funeral director
- Address workers’ compensation, law enforcement, and other government requests
- Respond to lawsuits and legal actions
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 an electronic or paper copy of your medical record
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 a summary of your health
information, usually within 30 days of your request. We may charge a reasonable, cost-based
fee.
Ask us to correct your medical record
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’ll tell you why in writing within 60 days.
Request confidential communications
You can ask us to contact you in a specific way or place (for example, home or office, mail or
telephone). We will say “yes” to all reasonable requests.
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 health care item out-of-pocket in full, you can ask us not to share
that information for the purpose of payment or our operations with your health insurer. We
will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared your health information for six
years prior to the date you ask, who we shared it with, and why. We will include all the
disclosures except for those about treatment, payment, and health care operations, and certain
other disclosures (such as any you asked us to make). We’ll provide one accounting a 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 privacy 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 complain if you feel we have violated your rights. Please contact our Privacy
Officer at 561-448-9517, IDGCompliance@mydermgroup.com or at 4700 Exchange Court,
Suite 110, Boca Raton, Florida 33431. - You may also file a complaint with the U.S. Department of Health and Human Services
Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington,
D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. - We take all complaints seriously, and will look into it immediately. 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, talk to
us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious, we may go
ahead and share your information if we believe it is in your best interest. We may also share
your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of mental health-related notes
How do we Typically Use or Share your Health Information?
We typically use or share your health information in the following ways:
Treat you
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health
condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and
contact you when necessary. Example: We use health information about you to manage your
treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or
other entities. Example: We give information about you to your health insurance plan so it will
pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that
contribute to the public good, such as public health and research. We have to meet many
conditions in the law before we can share your information for these purposes.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research.
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’re complying with federal
privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an
individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential
protective services
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.
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. Let us know
in writing if you change your mind.
Changes to the Terms of 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, in our office, and on our web site.
