Your Privacy Matters at Muncy Medical LLC

Privacy policy

NOTICE OF PRIVACY PRACTICES

Muncy Medical LLC

MuncyMedical.Com

TaKara@MuncyMedical.Com

Effective Date: April 16th 2026

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.

Our Commitment to Your Privacy

Muncy Medical LLC is committed to protecting the privacy of your protected health information (PHI). PHI includes any information about your past, present, or future physical or mental health or condition, the provision of health care to you, or payment for that care, that can identify you. We are required by law (including the Health Insurance Portability and Accountability Act of 1996, or HIPAA) to maintain the privacy of your PHI, to provide you with 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 PHI

We may use and disclose your PHI without your authorization for the following purposes:

1. Treatment, Payment, and Health Care Operations (TPO)

•  Treatment: To provide, coordinate, or manage your health care. For example, we may share your information with other providers involved in your care, including telehealth consultations or referrals.

•  Payment: To obtain payment for services we provide. For example, we may share information with your insurance company to process claims or determine coverage.

•  Health Care Operations: To support the business activities of our practice, such as quality improvement, staff training, licensing, or conducting audits.

2. Other Permitted or Required Disclosures (Without Authorization)

We may use or disclose your PHI without your authorization in these situations (as permitted or required by law):

•  As required by law (e.g., reporting certain communicable diseases or to comply with court orders).

•  For public health activities (e.g., reporting to health authorities).

•  To report abuse, neglect, or domestic violence.

•  For health oversight activities (e.g., audits by government agencies).

•  For judicial and administrative proceedings.

•  For law enforcement purposes (in limited circumstances).

•  To coroners, medical examiners, or funeral directors.

•  For organ, eye, or tissue donation.

•  For research purposes (under certain protections).

•  To avert a serious threat to health or safety.

•  For workers’ compensation or similar programs.

•  For military, national security, or veterans’ affairs purposes.

3. Uses and Disclosures Requiring Your Authorization

For any other uses or disclosures not described above (e.g., marketing, sale of your PHI, or most sharing of psychotherapy notes), we will obtain your written authorization. You may revoke your authorization in writing at any time, except to the extent we have already acted on it.

Your Rights Regarding Your PHI

You have the following rights (subject to certain limitations under HIPAA and state law):

•  Right to Request Restrictions: You may request that we restrict certain uses or disclosures of your PHI. We are not required to agree to all requests, but we will consider them.

•  Right to Request Confidential Communications: You may request that we communicate with you in a specific way (e.g., by email or at a different address) to protect your privacy. We will accommodate reasonable requests.

•  Right to Access and Copy: You have the right to inspect and obtain a copy of your PHI (in paper or electronic form, where available). We may charge a reasonable fee for copies.

•  Right to Amend: You may request that we amend your PHI if you believe it is incorrect or incomplete. We may deny the request in certain cases.

•  Right to an Accounting of Disclosures: You may request a list of certain disclosures we have made of your PHI (excluding those for TPO or made with your authorization).

•  Right to Receive a Paper Copy of This Notice: You may request a paper copy at any time, even if you have agreed to receive it electronically.

•  Right to Breach Notification: You will be notified in the event of a breach of your unsecured PHI, as required by law.

Our Duties

We are required by law to:

•  Maintain the privacy of your PHI.

•  Follow the terms of this notice.

•  Notify you if we cannot agree to a requested restriction.

•  Abide by the terms of the current notice and notify you of any material changes.

We reserve the right to change our privacy practices and the terms of this notice. Any changes will apply to all PHI we maintain. The revised notice will be posted [on our website / in our office] and made available upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

To file a complaint with us, contact:

Privacy Officer

Muncy Medical LLC

TaKara@MuncyMedical.Com

For more information or to file with HHS: Visit www.hhs.gov/ocr/privacy or call 1-800-368-1019.

Acknowledgment

By receiving care from Muncy Medical LLC, you acknowledge receipt of this Notice of Privacy Practices (or that you were offered a copy and had the opportunity to review it).