NOTICE OF PRIVACY PRACTICES
TOTAL INJURY CARE (TIC)

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.

OUR COMMITMENT TO YOUR MEDICAL INFORMATION

Total Injury Care is committed to protecting the privacy of medical information we create or obtain about you. This Notice explains how we may use and disclose medical information about you and describes your rights and our obligations regarding the use and disclosure of your medical information. We are required by law to: (i) ensure your medical information is protected; (ii) provide you with this Notice describing our legal duties and privacy practices; and (iii) follow the terms of this Notice currently in effect.

WHO WILL FOLLOW THIS NOTICE

The privacy practices described in this Notice will be followed by all physicians, healthcare professionals, and employees of Total Injury Care.

What is Protected Health Information?

“Protected Health Information” is information that identifies you and relates to (1) your past, present, or future physical or mental health or condition; (2) the provision of health care to you; or (3) the past, present, or future payment for your health care. This information may be created by Total Injury Care or received from other health care providers, health plans, employers, or health care clearinghouses.

How We May Use and Disclose Your Protected Health Information

The following categories describe different ways we may use and disclose your medical information. Not every use or disclosure will be listed, but all permitted uses and disclosures fall within one of these categories.

• Treatment. We may use or disclose your Protected Health Information to provide, coordinate, or manage your health care. This may include sharing information with physicians, specialists, imaging centers, or laboratories involved in your care.
• Payment. We may use and disclose your Protected Health Information to bill and collect payment for services provided to you. This may include sharing information with insurance plans or third parties to determine coverage, eligibility, or medical necessity.
• Health Care Operations. We may use and disclose Protected Health Information for operational purposes such as quality assessment, staff training, licensing, credentialing, and internal management activities.
• Appointment Reminders and Health Information. We may use and disclose Protected Health Information to contact you regarding appointments, treatment alternatives, or other health-related benefits and services that may be of interest to you.
• Minors. We may disclose Protected Health Information of minor children to their parents or legal guardians unless otherwise prohibited by law.
• Research. We may use or disclose Protected Health Information for research purposes when approved by an authorized review board. Limited data sets that do not directly identify you may be disclosed under legally required safeguards.
• Required by Law. We will disclose Protected Health Information when required by federal, state, or local law.
• Serious Threat to Health or Safety. We may use or disclose Protected Health Information when necessary to prevent a serious threat to your health or safety or the health or safety of others.
• Business Associates. We may disclose Protected Health Information to third-party vendors who perform services on our behalf, such as billing or IT support. These parties are required by contract to protect your information.
• Workers’ Compensation. We may use or disclose Protected Health Information for workers’ compensation or similar programs related to work-related injuries.
• Public Health Activities. We may disclose Protected Health Information for public health purposes, including reporting disease, injury, abuse, neglect, or adverse reactions to medications.
• Health Oversight Activities. We may disclose Protected Health Information to government agencies for audits, investigations, inspections, or compliance reviews.
• Legal Proceedings and Law Enforcement. We may disclose Protected Health Information in response to court orders, subpoenas, or other lawful requests.
• Coroners, Medical Examiners, and Funeral Directors. We may disclose Protected Health Information as necessary for official duties related to death investigations.
• Inmates. If you are incarcerated or in law enforcement custody, we may disclose Protected Health Information as necessary for health care or institutional safety.

Uses and Disclosures Requiring Opportunity to Object

• Individuals Involved in Your Care. Unless you object, we may disclose Protected Health Information to family members or others involved in your care or payment.
• Disaster Relief. We may disclose Protected Health Information to disaster relief organizations to coordinate care or notify others of your condition.
• Fundraising Activities. We may contact you for fundraising purposes. You have the right to opt out.

Uses Requiring Written Authorization

We will obtain your written authorization before using or disclosing Protected Health Information for marketing purposes, sale of information, or other uses not described in this Notice. You may revoke authorization in writing at any time.

Your Rights Regarding Your Protected Health Information

You have the right to:

• Inspect and obtain copies of your medical records
• Receive electronic copies of electronic health records
• Request corrections to your records
• Receive an accounting of certain disclosures
• Request restrictions on use or disclosure
• Request confidential communications
• Be notified of a breach of unsecured information
• Obtain a paper copy of this Notice

How to Exercise Your Rights

To exercise your rights, submit a written request to our Privacy Officer. We may require you to complete a request form. You may also contact your provider directly for record access requests.

Changes to This Notice

We reserve the right to change this Notice at any time. Changes will apply to all Protected Health Information we maintain. The current Notice will be available in our offices and on our website.

Questions or Complaints

If you believe your privacy rights have been violated, you may file a complaint with Total Injury Care or with the U.S. Department of Health and Human Services. Complaints must be submitted in writing within 180 days of the suspected violation. There will be no retaliation for filing a complaint.

Total Injury Care (TIC)
Phoenix Clinics: Ph | 602.610.7635 Fax | 480.452.0487

Tucson Clinics: Ph | 520.230.8232 Fax | 520.600.3206