Your Information. Your Rights. Our Responsibilities.

Notice of Privacy Practices of Southeast Medical Group and Affiliated Practices

Effective Date 6/4/2022; Current as of 6/23/2026

This notice describes:

• How health information about you may be used and disclosed
• How you can get access to your medical
• 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

You have a right to a copy of this notice in paper or electronic form and to discuss it with Southeast Primary Care Partners Chief Compliance Officer Jennifer Aloisio by phone at (678) 288-5403 or via email at jaloisio@southeastpcp.com if you have any questions. Please review this notice carefully.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

You have the right to:

Get a copy of your paper or electronic medical record

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. All Southeast Medical Group-affiliated practices use a secure records request service to ensure that all medical records are handled with the utmost care and concern for your privacy. Please visit medicopy.net/roi for further instructions or ask a Patient Service Representative in your preferred clinic for a fillable form.
• Our partners at MRO Corp and MediCopy will fulfill all medical records requests. They may charge a reasonable, cost-based fee. If you have any additional questions, please call MediCopy at +1 (866) 587-6274.
• You may also access your medical information by visiting your patient portal online at mysemg.com/resources. Your portal does not store a comprehensive collection of your medical record.

Correct your paper or electronic medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete by contacting SPCP Chief Compliance Officer Jennifer Aloisio at (678) 288-5403 or via email at jaloisio@southeastpcp.com
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communication

• You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address as indicated on the release of information forms you complete before an appointment at your preferred clinic. If you do not have an appointment, you may still walk into your preferred clinic, and a Patient Service Representative will help you update your communication preferences.
• We will say “yes” to all reasonable requests.

Ask us to limit the information we share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no,” for example, if it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared your information

• You can ask our secure records request service for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why by visiting medicopy.net/roi.
• We will include all the disclosures except for those about treatment, payment, and health care operations and certain other disclosures (such as any you asked us to make). Our secure records request partner will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

• If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action by requiring adequate documentation that you designated this person as your representation.

File a complaint if you believe your privacy rights have been violated

• You can file a complaint if you feel we have violated your rights by contacting SPCP Chief Compliance Officer Jennifer Aloisio by phone at (678) 288-5403 or via email at jaloisio@southeastpcp.com
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share.

You have some choices in the way that we use and share information as we:

• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care or payment for your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again.

Federal law protects the confidentiality of your substance use disorder patient records, subject to 42 CFR part 2. If we have your substance use disorder patient records, we will give you clear and obvious notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information. We will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

To treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

• We can share health information about you in response to a court or administrative order or in response to a subpoena.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• 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 information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
• We will never market or sell your personal information.

For more information, please see:

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

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request in our office and on our website.