Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Effective Date: March 13th, 2019
Services Provided
Defy Medical, LLC provides medical treatments and therapies for its patients by licensed medical
providers, laboratory testing services, as well as advice-only consultations.
Collection of Personal Information
Defy Medical, LLC collects and maintains personal information provided by the patient.
Please review it carefully
If you have any questions about this notice, please contact Defy Medical management at 813-445-7342.
Who Will Follow This Notice
This notice describes the practices of:
- Defy Medical.
- Any health care professional authorized to enter information into your medical record maintained by
Defy Medical.
- Any persons or companies with whom Defy Medical contracts for services to help operate the
practice and who have access to your medical information.
- All these persons, entities, sites, and locations follow the terms of this notice. In addition, these
persons, entities, sites, and locations may share medical information with each other for treatment,
payment, or health care operations purposes and other purposes described in this notice.
Our pledge regarding medical information
Defy Medical believes that protecting your private information is one of our top priorities. From the
moment you contact us, whether by phone, in person, or online, we do everything possible to guard your
personal information. We abide by all state and federal laws regulating medical privacy including HIPAA
and HITECH. We understand that medical information about you and your health is personal. We are
committed to protecting medical information about you. We create a record of the care and services you receive from Defy Medical. We need this record to provide you with quality care and to comply with
certain legal requirements. This notice applies to all the records of your care and billing for that care that
are generated or maintained by Defy Medical, whether made by Defy Medical personnel or other health
care providers. Other health care providers may have different policies or notices about confidentiality
and disclosure that apply to your medical information that is created in their offices or at locations other
than Defy Medical. This notice will tell you about the ways in which we may use and disclose medical
information about you. We also describe your rights and certain obligations we have regarding the use
and disclosure of your medical information. By using our services, you consent to the data practices
described in this statement.
We are required by law to:
- Make sure that medical information that identifies you is kept private;
- Give you this notice of our legal duties and privacy practices at Defy Medical, and your legal rights,
with respect to medical information about you; and
- Follow the terms of the notice that is currently in effect.
How we may use and disclose medical information about you
The following categories describe different ways that we use and disclose medical information. For each
category of uses or disclosures we will explain what we mean and try to give some examples. Not every
use or disclosure in a category will be listed. However, all of the ways we are permitted to use and
disclose information will fall within one of these categories.
For Treatment.We may use medical information about you to provide you with medical treatment or
services. We may disclose medical information about you to doctors, nurses, technicians, medical
students, volunteers, or other personnel who are involved in taking care of you at Defy Medical. For
example, a practitioner treating you for a testosterone deficiency may need to know if you have diabetes
because diabetes may affect the treatment plan. We also may disclose medical information about you to
people outside Defy Medical who may be involved in your medical care after you have been treated by
Defy Medical, such as friends, family members, or employees or medical staff members of any hospital or
skilled nursing facility to which you are transferred or subsequently admitted. After receiving your written
consent for release of records to the parties that you specify, or as required by law.
For Payment. We may use and disclose medical information about you so that the treatment and
services you receive from Defy Medical may be billed by Defy Medical and payment may be collected from
you, an insurance company, or a third party. For example, we may disclose information about you to
another health care provider, such as a hospital or skilled nursing facility to which you are admitted, for
their payment activities concerning you. After receiving your written consent for release of records to the
parties that you specify, or as required by law. Currently, Defy Medical does not accept insurance of any
kind.
For Health Care Operations. We and our business associates may use and disclose medical
information about you for health care operations. These uses and disclosures are necessary to run Defy
Medical and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for
you. We may also combine medical information about many patients to decide what additional services
Defy Medical should offer, and what services are not needed. We may also disclose information to
doctors, nurses, technicians, and other personnel affiliated with Defy Medical for review and learning
purposes. We may also combine the medical information we have with medical information from other
health care providers to compare how we are doing and see where we can make improvements in the
care and services we offer. We may remove information that identifies you from this set of medical
information so others may use it to study health care and health care delivery without learning the
identities of specific patients. We also may disclose information about you to another health care provider
for its health care operations purposes if you also have received care from that provider. After receiving
your written consent for release of records to the parties that you specify, or as required by law.
Appointment Reminders. We may use and disclose your medical information to notify you of upcoming
appointments. Unless you object, these reminders may be communicated by phone, text, or email.
Treatment Alternatives. We may use and disclose medical information to tell you about or recommend
different ways to treat you.
Research. Under certain circumstances, we may use and disclose medical information about you for
research purposes. For example, a research project may involve comparing the health and recovery of all
patients who received one medication to those who received another for the same condition. Medical
information about you that has had identifying information removed may be used for research without
your consent. We also may disclose medical information about you to people preparing to conduct a
research project (for example, to help them look for patients with specific medical needs), so long as the
medical information they review does not leave Defy Medical. If the researcher will have information
about your mental health treatment that reveals who you are, we will seek your consent before disclosing
that information to the researcher. Unless we notify you in advance and you give us written permission,
we will not receive any money or other thing of value in connection for using or disclosing your medical
information for research purposes except for money to cover the costs of preparing and sending the
medical information to the researcher.
Individuals Involved in Your Care or Payment for Your Care. We may release medical information
about you to a friend or family member who is involved in your medical care. This would include persons
named in any durable health care power of attorney or similar document provided to us. We may also give
information to someone who helps pay for some or all of your care. In addition, we may disclose medical
information about you to an entity assisting in a disaster relief effort so that your family can be notified
about your condition, status, and location. You can object to these releases by telling us that you do not
wish any or all individuals involved in your care to receive this information. If you are not present or
cannot agree or object, we will use our professional judgment to decide whether it is in your best interest
to release relevant information to someone who is involved in your care or to an entity assisting in a
disaster relief effort.
Health Oversight: We may disclose protected health information to a health oversight agency for
activities authorized by law, such as audits, investigations and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit
programs, other government regulatory programs and civil rights laws.
Abuse or Neglect:We may disclose your protected health information to a public health authority that is
authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected
health information if we believe that you have been a victim of abuse, neglect or domestic violence to the
governmental entity or agency authorized to receive such information. In this case, the disclosure will be
made consistent with the requirements of applicable federal and state laws.
Food and Drug Administration:We may disclose your protected health information to a person or
company required by the Food and Drug Administration to report adverse events, product defects or
problems, biologic product deviations; to track products; to enable product recalls; to make repairs or
replacements; or to conduct post marketing surveillance, as required.
Required by Law:We may use or disclose your protected health information when we are required to do
so by law. For example, we must disclose your protected health information to the U.S. Department of
Health and Human Services upon request for purposes of determining whether we are in compliance with
federal privacy laws. We may disclose your protected health information when authorized by workers'
compensation or similar laws.
Special Situations
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.
Active Duty Military Personnel and Veterans. If you are an active duty member of the armed forces or
Coast Guard, we must give certain information about you to your commanding officer or other command
authority so that your fitness for duty or for a particular mission may be determined. We may also release
medical information about foreign military personnel to the appropriate foreign military authority. We
may use and disclose to components of the Department of Veterans Affairs medical information about
you to determine whether you are eligible for certain benefits.
Workers’ Compensation. In accordance with state law, we may release without your consent medical
information about your treatment for a work-related injury or illness or for which you claim workers’
compensation to your employer, insurer, or care manager paying for that treatment under a workers’
compensation program that provides benefits for work-related injuries or illness.
Public Health Risks. We may disclose without your consent medical information about you for public
health activities. These activities generally include but are not limited to the following:
To report, prevent or control disease, injury, or disability;
To report births and deaths;
To report reactions to medications or problems with products;
To notify people of recalls of products they may be using;
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; and
To report suspected abuse or neglect as required by law.
Health Oversight Activities. We may disclose without your consent medical information to a health
oversight agency for activities authorized by law. These oversight activities include, for example, audits,
investigations, inspections, and licensure. The government uses these activities to monitor the health care
system, government programs, and compliance with civil rights laws.
Your Rights Regarding Medical Information
- Inspect and copy your medical information.
- Request amendments to your medical information.
- Request restrictions on uses and disclosures.
- Request confidential communications.
- Right to a paper copy of this notice.
Changes to This Notice
We reserve the right to change this notice and will post the updated notice on our website.
Investigations of Breaches
We will investigate unauthorized uses or disclosures of your medical information and notify you of any breaches.
Complaints
Complaints regarding violations of privacy rights can be filed with Defy Medical or the U.S. Department of Health and Human Services.
