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disclaimer
Telehealth Disclaimer
Welcome to South Shore Wellness Family Health Nurse Practitioner, PLLC, a telehealth medical practice operated by a board-certified family nurse practitioner, Carleen Conde, FNP-BC,MSN.
By accessing and using my telehealth services, you acknowledge that this service is not a substitute for in-person medical care and should not be used in an emergency situation. In case of an emergency or if you require immediate medical attention, call 911 or go to the nearest emergency facility.
The information and services provided during telehealth sessions are for general informational and healthcare purposes only. Telehealth is not a substitute for in-person medical care, diagnosis, or treatment. Always consult your primary care provider or another qualified healthcare professional for personalized medical advice.
By participating in telehealth services, you acknowledge and accept the limitations of virtual consultations, including but not limited to potential technical issues and the lack of physical examination.
My telehealth services are provided to you via secure and encrypted technology, which meets the standards for privacy and confidentiality required by law. I follow all state and federal laws and regulations regarding the practice of telehealth, and all medical services provided via telehealth are subject to the same standards of care as in-person medical care.
It is important to note that telehealth services may have certain limitations, including the inability to perform certain parts of a physical examination, which may result in difficulty making a precise diagnosis or providing treatment. Additionally, certain medications, for example, controlled substances, may not be prescribed through telehealth services.
I cannot guarantee the availability of my services at all times, and I reserve the right to deny services to any patient at any time.
By accessing and using my telehealth services, you agree to the terms and conditions of our practice and understand the limitations and potential risks of telehealth services. If you have any questions or concerns, please do not hesitate to contact me.
privacy policy/HIPPA NOTICE
HIPAA Notice – NOTICE OF PRIVACY PRACTICES
This HIPAA notice explains in detail how your medical information may be used. South Shore Wellness Family Health Nurse Practitioner, PLLC, is required to disclose how you can access your data. It is up to you to review this information in full, and if you have any questions or concerns, contact South Shore Wellness Family Health Nurse Practitioner, PLLC, to discuss them. This Privacy Notice explains how South Shore Wellness Family Health Nurse Practitioner, PLLC ("we," "our," or "us") collects, uses, and protects your health information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This notice describes how your personal and health information (also known as Protected Health Information or PHI) may be used and disclosed, and how you can access your information.
Legal Obligations
Federal and state laws require South Shore Wellness Family Health Nurse Practitioner, PLLC, to keep your health information private. These same laws also mandate that South Shore Wellness Family Health Nurse Practitioner, PLLC, provide you with full notification about all practices that apply to your privacy. This includes legal obligations and your rights pertaining to your personal health information. Therefore, all privacy practices are included in this notice and remain in effect from January 15,2025, until the date South Shore Wellness Family Health Nurse Practitioner, PLLC, updates this notice.
How we use your health information
Your health information may be disclosed for treatment, payment, or various healthcare operations. For example, information may be used as follows:
To provide optimal goods or services, your information may be provided to a healthcare provider for treatment. In addition, this information would be disclosed to coordinate all related services, consultations, or referring to another professional. It may also be used during a recall of a product.
Appointments and treatment options may also require South Shore Wellness Family Health Nurse Practitioner, PLLC, to disclose information. This may include emails, texts, phone calls, or voicemails to other parties. In addition, South Shore Wellness Family Health Nurse Practitioner, PLLC, may offer additional benefit options or other services that would be of value to you. These may require South Shore Wellness Family Health Nurse Practitioner, PLLC, to share your health information.
South Shore Wellness Family Health Nurse Practitioner, PLLC, reserves the right to review all client records concerning these activities as part of these processes. In addition, as part of the overall operation, South Shore Wellness Family Health Nurse Practitioner, PLLC, may need to disclose your information to other companies with your relationships, such as your health insurance providers.
From time to time, South Shore Wellness Family Health Nurse Practitioner, PLLC, may be required by law to disclose your health information. For example, we must use it in administrative proceedings when requested by a court or other law enforcement official. South Shore Wellness Family Health Nurse Practitioner, PLLC, will also disclose this information if we have reason to believe you are a potential victim of domestic abuse, neglect, or a possible victim of other crimes or if you appear to be a danger to yourself or others.
Suppose South Shore Wellness Family Health Nurse Practitioner, PLLC, believes your information is required for public health activities. In that case, Workers’ compensation matters, or other health oversight activities, South Shore Wellness Family Health Nurse Practitioner, PLLC, will disclose your information if South Shore Wellness Family Health Nurse Practitioner, PLLC, believes it is necessary for your health and the safety of others.
Without your written consent, South Shore Wellness Family Health Nurse Practitioner, PLLC, cannot utilize your personal health information for any reason except those disclosed in this HIPAA policy.
Your Rights
- Under HIPAA disclosures, South Shore Wellness Family Health Nurse Practitioner, PLLC, owns all records relating to the goods and services you obtain from us. You have the right to the following:
- Right to request the restriction of use South Shore Wellness Family Health Nurse Practitioner, PLLC, is not required to honor such request)
- Right to confidentiality – you may ask that South Shore Wellness Family Health Nurse Practitioner, PLLC, contact you only at work or by mail (request must be in writing)
- Right to copy or review – you may request in writing a copy of all information or review of your information in South Shore Wellness Family Health Nurse Practitioner, PLLC.
- Right to change – you have the right to request that information be changed that you feel inaccurate or incomplete. This request must be made in writing with an explanation.
- Right to summary – you have the right to request in writing a copy of whom your information has been disclosed.
- Right to Physical copy – You can request a paper copy of this notice.
Security
We have implemented procedures to help protect the personal information that you provide to us. However, no method of transmitting or storing electronic data is ever completely secure, and we cannot guarantee that such information will never be accessed, used, or released in a manner that is inconsistent with this Privacy Statement.
Children's Privacy
We do not knowingly collect personal information from children under 13. Should we learn that a child under 13 has provided us with personal information we will delete that information from our database.
Changes to this Privacy Statement
We may update this Privacy Statement in the future. We will notify you about material changes to this Privacy Statement by sending a notice to the e-mail address you provided to us or by placing a prominent notice on the Sites.
To report a problem
If you believe your privacy rights have been violated, you may file a complaint with South Shore Wellness Family Health Nurse Practitioner, PLLC, or the Secretary of the Department of Health and Human Services, Office of Civil Rights, HIPAA, 200 Independence Avenue, S.W., Washington, DC 20201. We are bound by law not to retaliate should you file a complaint.
FINANCIAL RESPONSIBILITIES
FEES AND PAYMENTS:
The practice DOES NOT file for insurance reimbursement. All services are paid for by the patient at the time of service. You may pay electronically, debit card, credit card.
Please know that we are here to help you if you have any questions. We are happy to help you learn how to file your own claim using the superbill we provide.
All outstanding balances must be paid in full prior to the next office visit or receiving supplements.
MISSED APPOINTMENT POLICY
We understand that life can be unpredictable, and occasionally, appointments may need to be rescheduled. However, we kindly ask that you notify us at least 12 hours in advance if you are unable to make your scheduled appointment.
Please note: No refunds will be issued for missed appointments.
If you need to reschedule, we will be happy to assist in finding a new time, but the missed appointment fee will still apply.
Thank you for your understanding and cooperation.
PHONE CALLS - Phone calls requiring 30 minutes or more of the provider's time will be charged as a minimum visit ($40/15 minutes).
COPIES - The cost for copies of chart notes, and invoices will be 50 cents per page, EXCEPT if requested at the time of the visit. Chart notes, and invoices pertinent to the visit will be provided free of charge on the day of the visit. Most documents will also be available for you on the patient portal.
SPECIAL LETTERS, FORMS, and DOCUMENTS - Completing workplace documentation, writing letters of medical necessity, etc. require significant provider time and will be charged an administrative fee of $10 per document/letter. Fees must be paid in advance. Some documentation may require extensive time / complexity and may justify a higher fee. If so, this fee will be disclosed to you prior to preparing the documents.
SouthShore Wellness Family Health NP
173 N Main Street #179
Sayville, New York
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