HIPAA Notice of Privacy Practices
Effective Date: January 1, 2025
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Duty to Protect Your Health Information
Grace Pediatrics is required by federal and state law to maintain the privacy of your child's Protected Health Information (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. We are required to notify you if a breach of your unsecured PHI occurs.
How We May Use and Disclose Your Health Information
The following describes the ways we may use and disclose your child's health information:
- Treatment: We may use and disclose PHI to provide, coordinate, or manage your child's health care. For example, we may share information with specialists, hospitals, pharmacies, or other providers involved in your child's care.
- Payment: We may use and disclose PHI to bill and collect payment for services provided. This includes sharing information with your insurance company, Medicaid, or other third-party payers to obtain prior authorization or to determine eligibility for benefits.
- Health Care Operations: We may use and disclose PHI for our practice's operational purposes, such as quality improvement, staff training, compliance activities, audits, and business management.
- Appointment Reminders and Health-Related Communications: We may contact you to provide appointment reminders, test results, or information about treatment alternatives or other health-related services that may be of interest to you.
- Family and Friends Involved in Care: With your permission, we may disclose PHI to a family member, guardian, or other person you identify as involved in your child's care or payment for care.
- As Required by Law: We will disclose PHI when required to do so by federal, state, or local law, including reporting child abuse or neglect as mandated by Florida law (F.S. § 39.201).
- Public Health Activities: We may disclose PHI for public health purposes such as reporting communicable diseases, adverse drug reactions, or product defects to the appropriate authorities.
- Legal Proceedings: We may disclose PHI in response to a court order, subpoena, or other lawful process.
- Law Enforcement: We may disclose PHI for law enforcement purposes as required by law or in response to a valid court order.
- Workers' Compensation: We may disclose PHI as authorized by workers' compensation or similar laws.
- Coroners, Medical Examiners, and Funeral Directors: We may disclose PHI to coroners, medical examiners, or funeral directors as necessary for them to carry out their duties.
All other uses and disclosures of PHI not described in this Notice will be made only with your written authorization. You may revoke any such authorization at any time by submitting a written request to our Privacy Officer.
Your Rights Regarding Your Health Information
You have the following rights with respect to your child's PHI:
- Right to Access: You have the right to inspect and obtain a copy of your child's medical records and billing records. Requests must be made in writing. We may charge a reasonable fee for copying as permitted under Florida law (F.S. § 456.057).
- Right to Request Amendment: You may request in writing that we amend your child's health information if you believe it is incorrect or incomplete. We may deny the request under certain circumstances, but we will provide a written explanation if we do.
- Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures of your child's PHI that we have made. This does not include disclosures for treatment, payment, or health care operations.
- Right to Request Restrictions: You may request restrictions on how we use or disclose your child's PHI for treatment, payment, or health care operations. We are not required to agree to such restrictions unless the disclosure is to a health plan for services you have paid for in full out-of-pocket.
- Right to Confidential Communications: You may request that we communicate with you about health matters in a specific way or at a specific location. For example, you may ask that we contact you only at a certain phone number.
- Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of this Notice at any time by contacting our office.
- Right to Be Notified of a Breach: You have the right to be notified in the event that we discover a breach of your unsecured PHI.
How to Exercise Your Rights
To exercise any of the rights described above, please submit a written request to our Privacy Officer at the address listed below. We will respond to your request within 30 days as required by law.
Filing a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our practice 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.
- Grace Pediatrics Privacy Officer: Shawn Gillyard, Chief Privacy Officer
4196 W US Hwy 90 ST 105, Lake City, FL 32055
Phone: (386) 243-8474 | Fax: (386) 438-5945
- U.S. Department of Health and Human Services:
Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
Toll-free: 1-877-696-6775 | www.hhs.gov/hipaa
Changes to This Notice
We reserve the right to change the terms of this Notice at any time. Any revised Notice will be effective for all PHI we maintain. The current Notice will be posted in our office and on our website at www.gracepediatrics.net.
Website Privacy Policy
Effective Date: January 1, 2025
Grace Pediatrics ("we," "us," or "our") operates the website at www.gracepediatrics.net. This Website Privacy Policy explains how we collect, use, and protect information when you visit our website.
Information We Collect
Information You Provide: When you submit information through our online New Patient Packet form or contact forms, you voluntarily provide personal information such as your name, your child's name, date of birth, address, phone number, email address, insurance information, and health-related information. This information is used solely for the purpose of establishing care at our practice.
Automatically Collected Information: Our website may automatically collect limited technical information such as your browser type, device type, and general geographic region. This information is used to improve website performance and is not linked to your personal identity.
How We Use Your Information
- To process new patient registration forms submitted through our website
- To respond to inquiries submitted through contact forms
- To improve our website's functionality and user experience
- To comply with legal obligations
We do not sell, rent, or share your personal information with third parties for marketing purposes.
New Patient Packet Form
Our online New Patient Packet allows you to fill out registration forms and consent documents electronically. When you use this feature:
- PDF documents are generated directly in your browser and are not stored on our servers
- If you choose to email the completed form to our office, it is sent directly to our front office staff at a secured email address
- Electronic signatures on forms are legally valid under Florida Statute § 668.50 (Uniform Electronic Transaction Act) and 15 U.S.C. § 7001(a) (Federal ESIGN Act)
- Once received, your information becomes part of your child's medical record and is protected under HIPAA as described in our Notice of Privacy Practices above
Cookies and Tracking
Our website may use cookies (small text files stored on your device) to improve functionality. We do not use cookies for advertising or behavioral tracking. You may disable cookies in your browser settings, though some website features may not function properly without them.
Third-Party Services
Our website may link to or integrate with the following third-party services, each of which has its own privacy policy:
- Patient Portal (Follow My Health): Used for secure patient communication, appointment scheduling, and medical record access. Information entered through the portal is governed by Follow My Health's privacy policy and HIPAA regulations.
- Google Fonts: We use Google Fonts for website typography. Google may collect limited technical data as described in their privacy policy.
- HealthyChildren.org: Our symptom checker links to resources provided by the American Academy of Pediatrics. We are not responsible for the content or privacy practices of external websites.
Children's Privacy
As a pediatric practice, we are committed to protecting children's privacy. Our website does not knowingly collect personal information directly from children under 13. All information submitted through our forms is provided by a parent or legal guardian on behalf of their child.
Data Security
We take reasonable measures to protect information transmitted through our website. However, no method of electronic transmission or storage is 100% secure. We encourage you to use our secure patient portal for transmitting sensitive health information whenever possible.
Your Rights Under Florida Law
Under Florida's Information Protection Act (F.S. § 501.171), you have the right to be notified in the event of a data breach involving your personal information. We will comply with all applicable Florida and federal notification requirements.
Changes to This Policy
We may update this Website Privacy Policy from time to time. Any changes will be posted on this page with an updated effective date.
Contact Us
If you have questions about this Privacy Policy or our privacy practices, please contact us:
Grace Pediatrics
4196 W US Hwy 90 ST 105, Lake City, FL 32055
Phone: (386) 243-8474
Fax: (386) 438-5945
