Privacy Policy

NOTICE OF PRIVACY PRACTICES OF BETHANY MEDICAL

PRIVACY POLICY: THIS NOTICE DESCRIBES HOW MEDICAL AND HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. 

THIS NOTICE ALSO DESCRIBES 

• YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

• HOW TO FILE A COMPLAINT CONCERNING A VIOLATION OF THE PRIVACY OR SECURITY OF YOUR HEALTH INFORMATION, OR OF YOUR RIGHTS CONCERNING YOUR INFORMATION

PLEASE REVIEW IT CAREFULLY.

YOU HAVE A RIGHT TO A COPY OF THIS NOTICE (IN PAPER OR ELECTRONIC FORM) AND TO DISCUSS IT WITH OUR PRIVACY OFFICER AT 833-639-4877 AND bethanymedical@compliancehotline.com IF YOU HAVE ANY QUESTIONS.

Introduction

We are required by law to maintain the privacy of protected health information. Protected health information includes any identifiable information that we obtain from you or others that relates to your physical or mental health, the health care you have received, or payment for your health care. For simplicity, we may refer to protected health information simply as “health information” in this Notice.

As required by law, this notice provides you with information about your rights and our legal duties and privacy practices with respect to the privacy of protected health information. This notice also discusses the uses and disclosures we will make of your protected health information. We must comply with the provisions of this notice currently in effect. We will provide notice of a breach of unsecured health information. You can always request a copy of our most current privacy notice from us.

The terms of this Notice applies to Bethany Medical Center, P.A., Peters Endoscopy Center, LLC and their HIPAA workforces (collectively the “Practice” or “Bethany Medical”).  We refer to the Practice in this Notice as “we” or “us” from time to time. 

Permitted Uses and Disclosures

We can use or disclose your protected health information for purposes of treatment, payment and health care operations.

• Treatment means the provision, coordination or management of your health care, including consultations between health care providers regarding your care and referrals for health care from one health care provider to another. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Therefore, the doctor may review your medical records to assess whether you have potentially complicating conditions like diabetes.
• Payment means activities we undertake to obtain reimbursement for the health care provided to you, including determinations of eligibility and coverage and other utilization review activities. For example, prior to providing health care services, we may need to provide to your insurance carrier (or other third party payor) information about your medical condition to determine whether the proposed course of treatment will be covered. When we subsequently bill the carrier or other third party payor for the services rendered to you, we can provide the carrier or other third party payor with information regarding your care if necessary to obtain payment.
• Health Care Operations mean the support functions of our practice related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient complaints, physician reviews, compliance programs, audits, business planning, development, management and administrative activities. For example, we may use your medical information to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what services are not needed, and whether certain new treatments are effective.

Our use and disclosure for treatment, payment and health care operations is limited by the requirements applicable to certain substance use disorder treatment records as discussed below.

Disclosures Related To Communications With You Or Your Family

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you or relate specifically to your medical care through our office. For example, we may leave appointment reminders on your answering machine or with a family member or other person who may answer the telephone at the number that you have given us in order to contact you.

We may disclose your protected health information to your family or friends or any other individual identified by you when they are involved in your care or the payment for your care. We will only disclose the protected health information directly relevant to their involvement in your care or payment. We may also use or disclose your protected health information to notify, or assist in the notification of, a family member, a personal representative, or another person responsible for your care of your location, general condition or death. If you are available, we will give you an opportunity to object to these disclosures, and we will not make these disclosures if you object. If you are not available, we will determine whether a disclosure to your family or friends is in your best interest, and we will disclose only the protected health information that is directly relevant to their involvement in your care.

We will allow your family and friends to act on your behalf to pick up prescriptions, medical supplies, X-rays, and similar forms of protected health information, when we determine, in our professional judgment, that it is in your best interest to make such disclosures.

Our use and disclosure described here is limited by the requirements applicable to certain substance use disorder treatment records as discussed below.

SMS/Text Messaging

We may contact you by SMS (text message) to provide appointment reminders, information about treatment, and other health-related services. By providing your phone number, you consent to receive such communications from us. We will use your phone number only for purposes related to your care and services and do not sell or share it with third parties for marketing purposes. SMS consent is not shared with third parties or affiliates. You may opt out of receiving SMS messages at any time by replying “STOP” to any message. Standard message and data rates may apply.

Other Situations

We may use and disclose health information under other circumstances without your authorization. The law provides that we may use/disclose your health information without consent or authorization in the following circumstances:

Business associates: There are some services provided by us through contracts with business associates which are vendors, professionals and others who perform some treatment, payment, or health care operations function on behalf of us or who otherwise provide services and have access to or use your health information. Examples include software vendors. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information by requiring that they enter into an appropriate agreement with us.

De-identified Health Information: We may use your health information to create “de-identified” information that is not identifiable to any individual in accordance with HIPAA. We may also disclose your health information to a business associate for the purpose of creating de-identified information, regardless of whether we will use the de-identified information. 

Treatment Alternatives: We may use and disclose your health information to manage and coordinate your healthcare and inform you of treatment alternatives and other health related benefits that may be of interest to you. This may include telling you about treatments, services, products and/or other healthcare providers. 

Incidental Uses and Disclosures: We are permitted to use and disclose information incident to another use or disclosure of your health information permitted or required by law.

Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Military and Veterans. If you are a member of the Armed Forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:

• To prevent or control disease, injury or disability
• To report births and deaths
• To report victim of abuse, neglect, or domestic violence
• To report reactions to medications
• To notify people of product, recalls, repairs or replacements
• To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition

Health Oversight Activities. We may disclose medical information to federal or state agencies that oversee our activities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. We may disclose protected health information to persons under the Food and Drug Administration’s jurisdiction to track products or to conduct post-marketing surveillance.

Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in a response to a subpoena, discovery request or other lawful process by someone else involved in the dispute.

Law Enforcement. We may release medical information if asked to do so by a law enforcement official:

• In response to a court order, subpoena, warrant, summons or similar process
• To identify or locate a suspect, fugitive, material witness, or missing person
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’ agreement
• About a death we believe may be the result of a criminal conduct
• About criminal conduct on our premises
• In emergency circumstances to report a crime; the location of the crime or victims or the identity, description or location of the person who committed the crime

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary for the institution to provide you with health care, to protect your health and safety or the health and safety of others, or for the safety and security of the correctional institution.

Serious Threats. As permitted by applicable law and standards of ethical conduct, we may use and disclose protected health information if we, in good faith, believe that the use of disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Disaster Relief. When permitted by law, we may coordinate our uses and disclosures of protected health information with public or private entities authorized by law or by charter to assist in disaster relief efforts.

Health Information Exchanges: Health information exchanges (HIEs) are networks of electronic health information contributed by various providers. By seeing records of past care received at other locations in a HIE, providers can make more informed decisions about care plans and avoid duplicative or unnecessary treatment. We participate in one or more HIEs, including NC Health Connex (click on name to access site and opt out form). You do not have to participate in an HIE to receive care from us, though note that opting out of an HIE does not stop us from using or sharing your information as described in the Notice. Visit the HIE site(s) listed above to learn more about how they share your information. The forms to opt out of participating in the HIEs are posted on each of their sites, as are the “rescind” forms if you later decide you want to re-engage in the HIE. We may update this list from time to time.  

Limited Data Sets: We may use or disclose a limited data set (i.e., in which certain identifying information has been removed) of your health information for purposes of research, public health, or health care operations. We may also disclose your health information to a business associate for the purpose of creating a limited data set, regardless of whether we will use the limited data set. Any recipient of that limited data set must agree to appropriately safeguard your information.

Our use and disclosure described here is limited by the requirements applicable to certain substance use disorder treatment records as discussed below.

More Stringent Protection for Certain Substance Use Disorder Treatment Records and Other Records. 

Certain substance use disorder treatment records are subject to enhanced federal protection.  Not all information related to substance use disorder treatment is subject to these restrictions. If we create, receive or maintain records subject to enhanced federal protection, our ability to use and disclose such records is more limited in accordance with the requirements of federal law. We discuss these restrictions below. 

In the event that North Carolina law requires us to give more protection to your health information than stated in this Notice or required by federal law, we will give that additional protection to your health information. We will also comply with additional state law confidentiality protections relating to treatment for mental health or drugs, alcohol or other substance abuse. 

Other Uses Or Disclosures. 

We may not make any other uses and disclosures of your health information without your written authorization. We will ask your written permission before we use or disclose health information, for example, for the following purposes:

• Psychotherapy notes made by your individual mental health professional documenting or analyzing the contents of conversation during a counseling session and that are separated from the rest of your medical record, except for certain limited purposes related to treatment, payment and health care operations, or other limited exceptions, including government oversight and safety.
• Certain marketing activities, including if we are paid by a third party for marketing statements as described in your executed authorization. More specifically, we will need your written authorization to use and disclose your health information for marketing purposes, except if the marketing is a face-to-face communication or if it involves a promotional gift of nominal value. “Marketing” includes a communication about a product or service that encourages you to purchase or use the product or service. It also includes an arrangement whereby we discloses your health information to another entity, in exchange for compensation, and the other entity communicates about its own product or service to encourage purchase or use of that product or service. Marketing does not include our describing a health-related product or service (or payment for such product or service) that we provide. Marketing also does not include our communication for your treatment, or to direct or recommend to you alternative treatments, therapies, health care providers, or settings of care.
• Sale of your health information except certain purposes permitted under the law.

You may revoke your authorization at any time if you provide written notice to us. If you revoke your permission, we will no longer use or disclose your health information for the reasons covered by your written authorization. We are unable to take back any disclosures we have already made with your permission. We are required to retain records of the care that we provided to you.

Your Rights

1. You have the right to request restrictions on our uses and disclosures of protected health information for treatment, payment and health care operations. However, we are not required to agree to your request.  We are required to agree to a request to restrict disclosure of your protected health information to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and the protected health information pertains solely to a health care item or service for which you, or a person other than the health plan on your behalf, has paid the Practice in full.
2. You have the right to reasonably request to receive communications of protected health information by alternative means or at alternative locations.
3. Subject to payment of a reasonable copying charge as provided by state law, you have the right to inspect or obtain a copy of the protected health information contained in your medical and billing records and in any other practice records used by us to make decisions about you, except for:
   • Psychotherapy notes, which are notes recorded by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint or family counseling session and that have been separated from the rest of your medical record
   • Information compiled in a reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.
   • Protected health information involving laboratory tests when your access is restricted by law
   • If you are a prison inmate and obtaining such information would jeopardize your health, safety, security, custody, or rehabilitation or that of other inmates, or the safety of any officer, employee, or other person at the correctional institution or person responsible for transporting you
   • If we obtained or created protected health information as part of a research study for as long as the research is in progress, provided that you agreed to the temporary denial of access when consenting to participate in the research
   • Your protected health information is contained in records kept by a federal agency or contractor when your access is restricted by law
   • If the protected health information was obtained from someone other than us under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information

We may also deny a request for access to protected health information if:

1. • A licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger your life or physical safety or that of another person
   • The protected health information makes reference to another person (unless such other person is a health care provider) and a licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to cause substantial harm to such other person
   • The request for access is made by the individual’s personal representative and a licensed health care professional has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to you or another person

If we deny a request for access for any of the three reasons described above, then you have the right to have our denial reviewed in accordance with the requirements of applicable law.

4. You have the right to request a correction to your protected health information, but we may deny your request for correction, if we determine that the protected health information or record that is the subject of the request:

1. • Was not created by us, unless you provide a reasonable basis to believe that the originator of protected health information is no longer available to act on the requested amendment
   • Is not part of your medical or billing records
   • Is not available for inspection as set forth above
   • Is accurate and complete

In any event, any agreed upon correction will be included as an addition to, and not a replacement of, already existing records.

5. You have the right to receive an accounting of disclosures of protected health information made by us to individuals or entities other than to you for the period provided by law, except for disclosures:

1. • To carry out treatment, payment and health care operations as provided above
   • To persons involved in your care or for other notification purposes as provided by law
   • For national security or intelligence purposes as provided by law
   • To correctional institutions or law enforcement officials as provided by law
   • That occurred prior to April 14, 2003
   • That are otherwise not required by law to be included in the accounting

6. You have the right to request and receive a paper or electronic copy of this notice from us.
7. The above rights may be exercised only by written physical or electronic communication to us.  Any revocation or other modification of consent must be in writing delivered to us in the same manner.

• Phone: 833-639-4877

Notice of Redisclosure. 

Health information, including the substance use disorder-related records discussed below, that are disclosed pursuant to this Notice may be subject to redisclosure by the recipient and no longer protected by HIPAA, 42 C.F.R. Part 2, or other applicable law. Federal or state law applicable to the recipient may limit their ability to use or disclose the medical information received, such as if the recipient is another health care provider subject to HIPAA or a program or entity subject to 42 C.F.R. Part 2.

Amendments.

We reserve the right to amend the terms of this Notice at any time and to apply the revised Notice to all health information that we maintain. The revised Notice will be posted at our facilities, be available on our website, https://mybethanymedical.com/ and will be available upon request from our facilities.  

This Notice is effective on April 14, 2003

This Notice was last revised on February 11, 2026