HIPAA 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. PLEASE REVIEW IT CAREFULLY.

At Breathe Right Pulmonary, we take the privacy of your health information seriously. This Notice of Privacy Practices (Notice) explains how we use and disclose protected health information (PHI) of current and former Breathe Right Pulmonary patients. By law, we must maintain the privacy of your PHI. We must also provide you with a description of our legal duties and privacy practices. We must abide by the terms of this Notice and notify you if your PHI is subject to a breach.

This Notice describes the privacy practices of Breathe Right Pulmonary. In this Notice, when we say “we,” “us,” or “our,” we mean Breathe Right Pulmonary.

This Notice describes health information we collect about you and how it may be used or shared with others in compliance with the Health Insurance Portability and Accountability Act (HIPAA), the federal health privacy law. For example, we may get information related to medical treatment, test results, insurance information and demographic data. We may also collect information about your race, ethnicity, language, sexual orientation and gender identity. In some cases, once PHI is disclosed as permitted by this Notice, HIPAA may no longer provide protection of that information from further disclosure.

How will we use and disclose information about you?

Treatment. Breathe Right Pulmonary may use and disclose your PHI for your medical treatment.

Breathe Right Pulmonary will make your PHI available to others who need it for your medical treatment. For example, we might share your PHI with your doctors, nurses, pharmacies and hospitals.
Breathe Right Pulmonary may allow your physician to have access to your PHI for follow-up care.

Payment. Breathe Right Pulmonary may use and disclose your PHI to pay or arrange payment for medical services and supplies provided to you. For example, your PHI may be used:

To support payment for your medical care by your health plan
To ensure you are billed for medical services correctly

Health Care Operations. Breathe Right Pulmonary may use and disclose your PHI to support its health care operations, including:

To create programs to improve health outcomes
To make sure you get the care you need
To contact you about treatment options
To contact you about health-related services available to you

Family Members and Others Involved in Your Care. Unless you communicate otherwise, we may also share your PHI with friends or family members who help take care of you or with your legal representative, including in certain emergency situations. In the event of a disaster, we might share your information if needed to help disaster relief agencies to help you or others.

Research. Breathe Right Pulmonary might use or disclose PHI for medical research. For example, we might study how well a drug, medical device, or type of medical treatment works. Before we use or disclose your PHI for research, it goes through a special review process. This process makes sure your information stays private and protected.

Required by Law. Breathe Right Pulmonary shares your PHI when the law requires it. For example, Breathe Right Pulmonary is required to report certain things, such as:

Reporting child abuse to state authorities
Reporting gunshot wounds to law enforcement
Reporting information about work-related injuries to the state workers’ compensation authorities

Public Health. Breathe Right Pulmonary may report PHI for public health purposes. For example, we are required to tell the state about certain diseases that can spread to others, such as measles. We must also tell the Food and Drug Administration (FDA) if a medicine or medical product caused problems for you. This helps protect everyone’s health in our community.

Public Safety. Breathe Right Pulmonary may share PHI to keep the public safe. For example, we may share information for purposes, such as:

To help law enforcement find a missing person or a suspect in a crime
To stop a serious threat to a person’s health or safety

Health Oversight Activities. We may share PHI with government agencies that oversee us to make sure we are providing good services, such as with:

The state’s health department
The Centers for Medicare and Medicaid Services
The state agencies that oversee doctors and other health workers

Coroners, Medical Examiners and Funeral Directors. When a person dies, Breathe Right Pulmonary may need to share their PHI with coroners, medical examiners or funeral directors. We share this information to assist their job, such as finding out why someone died or to plan the funeral properly.

Health Information Exchanges. We may share information that we obtain or create about you with other health care providers or other health care entities, as permitted by law, through health information exchanges (HIEs) in which we participate.

Organ and Tissue Donation. Breathe Right Pulmonary may share PHI with groups that help with organ or tissue donation. These groups find people who need new organs and tissues. They also help get organs and tissues from donors to the people who need them.

Law Enforcement Officials. We may disclose PHI to the police or other law enforcement officials as required by law in response to a court order, subpoena, warrant or similar written request.

Military, Veterans and National Security. If you are in the military, Breathe Right Pulmonary may share your PHI with your command authorities. We might share your PHI with the Department of Veterans Affairs (VA) to help veterans or with government authorities for national security purposes.

Judicial and Administrative Proceedings. We may disclose PHI in the course of a legal proceeding, such as to comply with a court order.

Special Protection for Certain Health Information. Some types of health information have extra protection under the law. For example, Breathe Right Pulmonary may be required to obtain your authorization to use or disclose information about:

HIV/AIDS
Drug or alcohol treatment
Mental health treatment
Genetic information
Reproductive healthcare

Victims of Abuse, Neglect or Domestic Violence. We may disclose PHI if we reasonably believe you are a victim of abuse, neglect, or domestic violence to a government authority authorized by law to receive reports of such abuse, neglect, or domestic violence.

When is your written authorization required?

In some cases, we are required to collect your authorization to use or disclose your PHI. You are permitted, however, to revoke a written authorization you’ve given to us. Examples of where your written authorization is required include the following:

Marketing. We will obtain your written authorization to use your PHI for marketing activities. For example, we will not accept any payments from other organizations or individuals in exchange for making communications to you about treatments, therapies, health care providers, products or services unless you have given us your authorization, or it is permitted by law.

Sale of Protected Health Information. We will not sell your PHI without your written authorization.

Substance Use Disorder (SUD) Records. In some cases, information about substance use disorder treatment cannot be used or shared without your permission. Breathe Right Pulmonary must ask for your permission to allow us to use or disclose some SUD records for certain treatment purposes, payment purposes, or for operating our business. This information may not be used or disclosed in legal proceedings against you unless you’ve given permission or a court order requires it.

Psychotherapy Notes. We will not use or disclose psychotherapy notes about you without your authorization except to support mental health and other treatment to you or necessary to defend Breathe Right Pulmonary in a legal proceeding brought by you.

What are your rights?

Your Right to Access Your Information. You can ask to see or get your PHI. This includes your medical records and billing information. You can ask for paper or electronic copies of your records. In some cases, we may charge you a fee.

Your Right to Request that we Amend Your Information. If you find wrong or missing information in your health records, you may ask Breathe Right Pulmonary to fix it. You can ask Breathe Right Pulmonary to update your medical record or to add information that is missing. Breathe Right Pulmonary will look at your request and make changes if needed.

Your Right to an Accounting of Your Disclosures. You can ask for a list of who Breathe Right Pulmonary shared your PHI with, going back up to six years. The list will tell you who saw your information and when. Some things will not be on this list, like when Breathe Right Pulmonary shares your information to support your medical care, payment of medical services, or to run the health care business. Additionally, the list will not show when you asked us to share your information. We will give you one list per year at no charge. We may request a fee if you ask for a list more than once in a year.

Right to Request Restrictions on How Breathe Right Pulmonary Health Will Use or Disclose Information About You. You can ask Breathe Right Pulmonary to limit how we use or share your PHI. For example, you can ask us not to share certain information:

For treatment, payment, or health care operations
With family members or friends

Breathe Right Pulmonary does not have to agree to all requests. If we do agree to your request, we may still be able to use your PHI to give emergency treatment or to allow a physician or other health care worker to provide medical care to you. If you pay Breathe Right Pulmonary yourself for medical treatment we provide, you may ask us not to tell your health insurance plan about it. Breathe Right Pulmonary must agree if you have already paid in full.

Right to Request Confidential Communications. You can ask Breathe Right Pulmonary to talk to you in ways that feel more private to you. For example, you can ask to talk with your doctors in private, away from other patients. You can ask Breathe Right Pulmonary not to call your home phone or only send information by mail. You can also ask Breathe Right Pulmonary to use a different address when communicating with you. Breathe Right Pulmonary will try to follow your wishes when they are reasonable.

Your Right to a Copy this Notice. You can request a copy of this Notice at any time. You can request a paper copy or find it on Breathe Right Pulmonary’s website at https://www.breatherightpulmonary.com/legal-and-privacy-notices.

Changes to These Privacy Rules. Within legal requirements, Breathe Right Pulmonary may change the privacy rules in this Notice from time to time. This means we might change how we use or share your PHI. Additionally, we could change how you can access your information. If Breathe Right Pulmonary makes any changes, we will create a new version of this Notice and publish it.

How to Share Your Concerns or Complaints. We want to hear from you if you have questions about your privacy or how Breathe Right Pulmonary uses PHI. We will not retaliate against you for making a complaint, and we will not treat you differently for speaking up. We take your privacy concerns seriously. For questions, concerns, or complaints, please contact Breathe Right Pulmonary by calling 480-584-4712 or emailing info@brpulmonary.com.

For more information or to make a complaint to U.S. Department of Health & Human Services, Office for Civil Rights.

You can find more information about your privacy rights at:

www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

You can file a complaint at www.hhs.gov/ocr.

November 2025