Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND ABOUT HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The policy of Gastroenterology Associates, N.A., P.C. is to protect the confidentiality, integrity and security of the protected health and personal information of our patients and to prevent unauthorized access to, or the use or disclosure of such information. We are required by law to maintain the privacy of your health information and provide you with this notice of our duties and obligations. This policy applies to patients who are current or former patients of Gastroenterology Associates, N.A., P.C.

Individually identifiable health and personal information are any information obtained by Gastroenterology Associates, N.A., P.C. in connection with providing healthcare treatment, obtaining payment, and related health care operations. This relates to past, present or future information that Gastroenterology Associates, N.A., P.C. receives from you as our patient.

Gastroenterology Associates, N.A., P.C. collects personal information in order to learn about your medical history, medical conditions, render treatment and collect payment for our services. We gather this information from your patient forms, health questionnaires and other forms you will be asked to complete from time to time. In addition, we will assemble information based on our discussions and conversations with you, your personal representative and your family members. Your healthcare plan or insurance carrier may provide information to our office.

We will use this information to provide caring and quality medical care to you. Examples include diagnosis, treatment and communications such as follow-up and appointment reminders, as well as treatment alternatives or other health-related benefits. As part of our standard treatment and healthcare operations, we may share information with a facility such as a hospital, laboratory, diagnostic service or healthcare provider to efficiently coordinate your treatment plan. For contracted insurers, your information will be used for claims management and to obtain payment from your insurance carrier. As required by your insurance contractor, we will exchange data with your insurance carrier for activities such as eligibility, benefit and coverage determinations, precertification and utilization review. For worker’s compensation, information about a work-related condition can be exchanged with the employer.

Your information is maintained in our office in our practice management computer system. We also maintain information about you in your medical chart. Gastroenterology Associates, N.A., P.C. limits the access to your protected health information to those employees and business associates who need to know that information. With some limitations, you have the right to inspect, amend, copy and receive an accounting of disclosures of your medical and billing records.

We do not disclose personal information to third parties unless one of the following exceptions applies:
• We received explicit authorization from you to release individually identifiable information. This authorization must be in writing and give exact details regarding to whom the disclosure applies, the nature of the data to be released, applicable dates and signed by the patient (or guardian). You may revoke this authorization by providing a written statement to the Privacy Officer of Gastroenterology Associates, N.A., P.C.
• Federal, state or other applicable law requires us to share protected information or records.

We are obligated to abide by the terms of this notice. If, at any time in the future, it is necessary to disclose any of your personal information in a way that is materially different from this policy, Gastroenterology Associates, N.A., P.C. will give you notice of the change through a mailed announcement or on your visit following the change.

With some exceptions, you have the right to review and obtain a copy of your heath information. This request must be in writing and there will be a reasonable charge to provide you with a copy of your information. You also have the right to request your records be amended, to request special accommodations and restrictions of your health information and to receive an accounting of the disclosures of your information. Gastroenterology Associates, N.A., P.C. is not obligated to agree to a requested restriction. We must receive a written request from you to administer these rights. Please speak to the receptionist for further information or to begin the process to exercise any of these rights.

If you have a complaint about the management of your health information or believe your privacy rights have been violated, contact our Brookwood Office at (205) 870-0256. You have the right to file a complaint with the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. There will be no retaliation for filing a complaint.

Other uses of Protected Health Information:
• Your medical information may be reviewed by our medical staff for possible inclusion and referral in research studies. You will be contacted prior to the use of your information in a research study.
• We may leave a message on your answering machine or voice mail to contact you about appointments or to have you call our office.

Effective Date: April 14, 2003