Notice of Privacy Practices

Required by HIPAA (45 CFR §164.520), as amended by HITECH

Altru Telehealth, LLC (“Altru,” “we,” “us,” or “our”) is a telehealth practice providing urgent care and weight management services through licensed nurse practitioners. This Notice applies to all health information created, received, maintained, or transmitted by Altru Telehealth, LLC and its workforce members in the course of providing care to you.

We are required by law to:

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• Maintain the privacy and security of your protected health information (PHI);

• Provide you with notice of our legal duties and privacy practices with respect to PHI;

• Notify you following a breach of your unsecured PHI; and

• Abide by the terms of the Notice currently in effect.

The following describes the ways we may use and disclose your PHI. Not every use or disclosure will be listed here, but all ways in which we may use or disclose your PHI will fall within one of the following categories.

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Treatment: We may use your PHI to provide, coordinate, or manage your healthcare and related services. For example, we may share your information with a specialist, compounding pharmacy, or laboratory as part of your care.

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Payment: We may use and disclose your PHI to obtain payment for services we provide to you. This may include submitting claims to your health insurance, verifying coverage, or collecting payment from you directly.

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Health Care Operations: We may use and disclose your PHI for our own internal operations, including quality assessment, training, licensing activities, legal and compliance functions, and business management.

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As Required by Law: We will disclose your PHI when required to do so by federal, state, or local law, including disclosures to regulatory agencies and public health authorities.

Public Health Activities: We may disclose your PHI to public health authorities for activities such as reporting communicable diseases, adverse drug events, or suspected abuse or neglect as required by applicable law.

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Health Oversight Activities: We may disclose PHI to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, licensure, and disciplinary proceedings.

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Judicial and Administrative Proceedings: We may disclose PHI in response to a court or administrative order, or in response to a subpoena, discovery request, or other lawful process.

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Law Enforcement: We may disclose PHI to law enforcement officials for specific law enforcement purposes as permitted by HIPAA and applicable law.

Serious Threats to Health or Safety: We may use or disclose your PHI if we believe in good faith that doing so is necessary to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of the public.

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Business Associates: We share PHI with certain third-party vendors, known as business associates, who perform services on our behalf, such as our patient portal, billing platform, and compounding pharmacy. We require all business associates to safeguard your PHI through written business associate agreements in compliance with HIPAA.

Workers’ Compensation: We may disclose your PHI as authorized by and as necessary to comply with workers’ compensation laws and other similar programs.

The following uses and disclosures will only be made with your written authorization: most uses of psychotherapy notes; uses and disclosures for marketing purposes; sale of your PHI; and other uses and disclosures not described in this Notice. You may revoke an authorization in writing at any time, except where we have already acted in reliance on it.

Right to Access Your PHI: You have the right to inspect and obtain a copy of your PHI. We may charge a reasonable cost-based fee. We will respond within 30 days.

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Right to Request Amendment: If you believe PHI we maintain is inaccurate or incomplete, you may request amendment. If denied, you may submit a statement of disagreement for inclusion in your record.

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Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures of your PHI made in the six years prior to your request, excluding disclosures for treatment, payment, or health care operations.

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Right to Request Restrictions: You may request restrictions on certain uses and disclosures of your PHI. We must agree to restrict disclosures to a health plan for services you paid for out of pocket in full.

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Right to Request Confidential Communications: You have the right to request we communicate with you in a certain way or at a certain location. We will accommodate reasonable requests.

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Right to a Paper Copy of This Notice: You have the right to receive a paper copy of this Notice upon request, even if you have received it electronically.

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Right to Notification of a Breach: You have the right to be notified in the event of a breach of your unsecured PHI in accordance with HIPAA and applicable state law.

We reserve the right to change the terms of this Notice at any time. Any revised Notice will apply to PHI we already maintain. We will post the current Notice on our website and make it available at your first service visit after any revision.

If you believe we have violated your privacy rights, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) at www.hhs.gov/ocr or 1-800-368-1019. You will not be penalized or retaliated against for filing a complaint.

For questions about this Notice, to exercise your rights, or to file a complaint with us, please contact our Privacy Officer through the contact channels provided on our website.