RSG HEALTHCARE
NOTICE OF PRIVACY PRACTICES
Effective Date: April 2, 2026
YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.
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.
RSG Healthcare is committed to protecting the privacy of your protected health information (“PHI”). This Notice of Privacy Practices describes how we may use and disclose your PHI, your rights regarding your PHI, and our legal duties with respect to your PHI.
For purposes of this Notice, “we,” “us,” and “our” mean RSG Healthcare and its workforce members acting within the scope of their duties.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get a copy of your medical record
You can ask to inspect or obtain an electronic or paper copy of your medical record and other health information we maintain about you, subject to limited exceptions allowed by law. Ask us how to do this.
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee as permitted by law.
Ask us to correct your medical record
You can ask us to amend your health information if you believe it is incorrect or incomplete. Ask us how to do this.
We may deny your request in certain circumstances, but if we do, we will tell you why in writing within the time required by law.
Request confidential communications
You can ask us to contact you in a specific way or at a specific location. For example, you can ask that we call only a particular phone number, send mail to a specific address, or communicate through the patient portal where available.
We will accommodate all reasonable requests.
Ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or health care operations. We are not required to agree to every request, and we may deny a request if it would affect your care or if the law allows us to do so.
If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health plan for payment or health care operations, and we will honor that request unless a law requires us to share the information.
Get a list of certain disclosures
You can ask for an accounting of certain disclosures of your health information made during the six years before the date of your request.
This accounting will not include disclosures for treatment, payment, health care operations, and certain other disclosures that are excluded by law. We will provide one accounting in any 12-month period free of charge; we may charge a reasonable, cost-based fee for additional requests within the same 12-month period.
Get a copy of this notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
If someone has legal authority to act for you regarding your health care or health information, such as a health care decision maker, legal guardian, or person holding a valid medical power of attorney, that person may exercise your rights and make choices about your health information, to the extent permitted by law.
We may ask for documentation before acting on such a request.
File a complaint
You can complain if you believe we have violated your privacy rights. You may contact us using the information at the end of this notice.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference, please tell us.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care or payment for your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious or otherwise unable to communicate, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we will not use or share your information unless you give us written permission:
- Marketing purposes, except as otherwise permitted by law
- Sale of your information
- Most sharing of psychotherapy notes
If you give us written authorization to use or disclose your information, you may revoke that authorization at any time in writing, except to the extent we have already acted in reliance on it.
Our Uses and Disclosures
How do we typically use or share your health information?
Treatment
We may use and disclose your health information to provide, coordinate, or manage your care.
For example, a clinician treating you may share relevant information with another health care provider, specialist, laboratory, pharmacy, imaging provider, hospital, or other provider involved in your treatment.
Payment
We may use and disclose your health information to bill and collect payment for the services we provide to you.
For example, we may send information to your health plan or another payer so that it will pay for your care, determine coverage, or review claims.
Health care operations
We may use and disclose your health information to run our practice, improve the quality of care, train staff, conduct audits, manage risk, perform compliance activities, and contact you when necessary.
For example, we may use health information to review quality of care, evaluate provider performance, conduct credentialing, manage business operations, and improve patient services.
Appointment reminders, treatment alternatives, and health-related services
We may use and disclose your health information to contact you with appointment reminders, follow-up information, information about treatment options, and information about health-related benefits or services that may be of interest to you.
Care coordination
We may use and disclose your health information to coordinate your care with other providers, care managers, health plans, pharmacies, laboratories, and organizations involved in improving care quality, safety, or outcomes.
Telehealth
We may provide care through telehealth or other electronic means. In doing so, we may use and disclose your health information through secure electronic systems to support diagnosis, treatment, documentation, scheduling, billing, follow-up, and care coordination.
Electronic communications and patient portal
We may communicate with you by phone, voicemail, text message, email, and through our patient portal, as allowed by law and consistent with your communication preferences.
These communications may include appointment reminders, follow-up communications, billing information, and other health care-related information. You may request alternative methods of communication.
Business associates and service providers
We may share your health information with third parties who perform services on our behalf, such as billing companies, technology vendors, EHR and patient-portal vendors, scheduling vendors, consultants, legal counsel, accountants, data storage providers, transcription or documentation support providers, and other service providers. These parties are required by law and contract to protect your information.
Technology tools used in care and operations
We may use secure electronic systems and technology tools to assist with treatment, documentation, quality review, scheduling, billing, and other health care operations. We use these tools in a manner consistent with applicable privacy and security requirements.
How else may we use or share your health information?
We may use or disclose your health information without your written authorization in certain additional situations allowed or required by law.
Public health and safety
We may share health information about you for public health or safety purposes, such as:
- Preventing or controlling disease, injury, or disability
- Reporting births or deaths where required by law
- Reporting adverse reactions to medications or problems with products
- Helping with product recalls
- Reporting suspected abuse, neglect, or domestic violence where permitted or required by law
- Preventing or reducing a serious threat to health or safety
Research
We may use or disclose your information for research, subject to the requirements of applicable law.
Compliance with the law
We will share information about you if federal or Arizona law requires us to do so, including with the Department of Health and Human Services if it seeks information to determine our compliance with federal privacy law.
Health oversight activities
We may disclose your information to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, licensure matters, and regulatory oversight.
Judicial and administrative proceedings
We may disclose your health information in response to a court order, administrative order, subpoena, discovery request, or other lawful process, when the applicable legal requirements are met.
Law enforcement
We may disclose your health information to law enforcement officials in certain situations permitted or required by law.
Coroners, medical examiners, and funeral directors
We may disclose health information to a coroner, medical examiner, or funeral director as authorized by law.
Organ and tissue donation
If you are an organ donor, we may share health information with organizations involved in organ procurement, transplantation, or tissue donation.
Workers’ compensation
We may disclose your health information as authorized by workers’ compensation laws and similar programs.
Specialized government functions
We may disclose health information for certain specialized government functions, such as military, national security, correctional, or protective services activities, where authorized by law.
Personal representatives and others involved in your care
We may disclose relevant information to a person authorized to act for you or, in limited circumstances permitted by law, to family members or others involved in your care or payment for your care.
Deceased individuals
We may disclose information about a deceased person as authorized or required by law.
Additional Privacy Protections
If Arizona law or another applicable law provides greater privacy protection than HIPAA for certain information, we will follow the more stringent law.
Arizona law generally treats medical records and payment records as privileged and confidential, and Arizona telehealth law preserves those confidentiality protections for telehealth services and telehealth-generated records.
Our Responsibilities
We are required by law to:
- Maintain the privacy and security of your protected health information
- Provide you with this notice of our legal duties and privacy practices
- Follow the terms of the notice currently in effect
- Notify affected individuals following a breach of unsecured protected health information when required by law
We will not use or disclose your health information in a manner inconsistent with this notice unless you authorize us to do so or the law permits or requires the use or disclosure.
We reserve the right to change the terms of this notice and to make the revised notice effective for all protected health information we maintain, including information created or received before the change. If we make a material change to this notice, the revised notice will be available in our office, upon request, and on our website.
To the extent we create or maintain substance use disorder patient records subject to 42 C.F.R. Part 2, those records are subject to additional federal confidentiality protections.
We will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you unless we have:
- Your written consent; or
- A court order and a subpoena, as required by applicable law.
If we use Part 2 records for fundraising, we will first provide clear and conspicuous notice and an opportunity for you to opt out before using those records for fundraising communications.
Arizona Health Information Organization (HIO) Participation
If we participate in an Arizona health information organization or health information exchange, your health information may be made available through that system as permitted by law to support treatment, payment, and health care operations. If applicable, you will receive the separate Arizona Notice of Health Information Practices, including information about your Arizona opt-out rights.
Contact Information / Questions / Complaints
If you have questions about this notice, want to exercise your rights, or want to file a complaint with us, contact:
RSG Healthcare, PLLC
11209 N. Tatum Blvd., Suite 185
Phoenix, Arizona 85028
Phone: 602-669-2585
Privacy Officer: Randy Gelow
Email: info@rsghealthcare.com
Website: www.rsghealthcare.com
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by mail, phone, or through the OCR complaint portal. We will not retaliate against you for filing a complaint.
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