Notice of Privacy Practices

Our commitment to your privacy

Leroy Butler, DO PLLC ("we," "us," or "the practice") is committed to protecting the privacy of your protected health information ("PHI") — the health information we collect and maintain about you in the course of providing care. We are required by law to maintain the privacy of your PHI, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and disclose your health information

The following describes the ways we may use and disclose your PHI without a separate authorization from you.

For treatment

We use your PHI to provide, coordinate, and manage your care — for example, sharing your imaging and surgical plan with other physicians, physical therapists, anesthesiologists, or the surgical facility involved in your treatment.

For payment

We use and disclose your PHI to bill and obtain payment for the care we provide — for example, submitting claims to your insurer or verifying coverage before a procedure.

For health care operations

We use your PHI to run the practice — for example, quality review, staff training, scheduling, and business management.

Appointment reminders and care-related communications

We may contact you (by phone, text, mail, or the number you provide) to remind you of appointments, follow-ups, or treatment alternatives.

Others involved in your care

Unless you object, we may share relevant PHI with a family member, friend, or other person you identify as involved in your care.

Uses and disclosures that require your written authorization

The following uses and disclosures will be made only with your written authorization, which you may revoke in writing at any time:

• Most uses and disclosures of psychotherapy notes (if any are maintained).
• Uses and disclosures for marketing purposes.
• Disclosures that constitute a sale of your PHI.
• Most other uses and disclosures not described in this notice.

Uses and disclosures we may make without your authorization

We may use or disclose your PHI without your authorization in the following circumstances, as permitted or required by law:

• When required by federal, state, or local law.
• For public health activities, such as reporting disease or reactions to medications.
• To report suspected abuse, neglect, or domestic violence.
• For health oversight activities authorized by law (audits, investigations, inspections).
• In response to a court or administrative order, subpoena, or discovery request.
• For law enforcement purposes as permitted by law.
• To coroners, medical examiners, and funeral directors.
• For organ, eye, or tissue donation.
• For approved research under established privacy protections.
• To avert a serious and imminent threat to health or safety.
• For specialized government functions, including military and veterans' activities.
• For workers' compensation as authorized by law.

Your rights regarding your health information

• Access. You may inspect and obtain a copy of your PHI, in the form you request when feasible. We may charge a reasonable, cost-based fee.
• Amendment. You may request that we correct PHI you believe is inaccurate or incomplete. We may deny the request under certain conditions and will explain why.
• Accounting of disclosures. You may request a list of certain disclosures we made of your PHI.
• Restrictions. You may request that we limit how we use or disclose your PHI. We are not required to agree, except where the disclosure is to a health plan for a service you paid for in full out of pocket.
• Confidential communications. You may ask us to contact you in a specific way or at a specific location.
• Paper copy. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Breach notification. You have the right to be notified if a breach of your unsecured PHI occurs.
• Revoke authorization. You may revoke a prior written authorization at any time, except to the extent we have already acted on it.

To exercise any of these rights, contact our Privacy Officer using the information below. Some requests must be made in writing.

Our responsibilities

• We are required by law to maintain the privacy and security of your PHI.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your PHI.
• 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 PHI other than as described here unless you tell us we may in writing.

Changes to this notice

We reserve the right to change this notice and to make the revised notice effective for PHI we already have as well as any information we receive in the future. The current notice will be posted in the practice and on this website, with its effective date.

How to file a complaint

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
1-877-696-6775 · www.hhs.gov/ocr