NOTICE OF PRIVACY PRACTICES (HIPAA)

NOTICE OF PRIVACY PRACTICES

Effective September 1, 2026

This Notice applies to protected health information maintained by MJT Podiatry S.C. DBA Dr. Bunionmaster (the “Practice”), including information created or received in connection with in-person care, telehealth, patient-portal communications, diagnostic imaging, surgical planning, treatment, billing, and care coordination.

Your Rights

You have the right to:

Inspect or obtain an electronic or paper copy of your medical record and other health information we maintain about you.

Ask us to correct health information that you believe is incorrect or incomplete.

Ask us to communicate with you in a particular way or at a particular location.

Ask us to limit certain uses or disclosures of your health information.

Receive an accounting of certain disclosures we have made.

Obtain a paper copy of this Notice, even if you previously agreed to receive it electronically.

Choose a personal representative who may exercise your privacy rights when legally authorized.

File a complaint if you believe your privacy rights have been violated.

How to Exercise Your Rights

Access or obtain a copy of your record

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will ordinarily provide a copy or summary within 30 days after receiving a valid request. We may charge a reasonable, cost-based fee as permitted by law. In limited circumstances, we may deny access; when review of a denial is available, we will explain how to request it.

Ask us to correct your record

You may ask us in writing to amend information that you believe is incorrect or incomplete. We may deny the request in circumstances permitted by law, but we will explain the reason in writing, ordinarily within 60 days, and describe any additional rights you may have.

Request confidential communications

You may ask us to contact you in a specific way—for example, only through the patient portal or at a particular telephone number—or to send mail to a different address. We will accommodate reasonable requests. Please tell us if a communication method becomes unsafe or should no longer be used.

Ask us to limit what we use or disclose

You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations. We are not required to agree to every request, and we may decline when the restriction could affect your care or cannot reasonably be implemented. If we agree, we will follow the restriction except when the information is needed for emergency treatment or when disclosure is otherwise required by law.

If you pay out of pocket in full for a particular service or healthcare item, you may ask us not to disclose information about that service or item to your health plan for payment or healthcare operations. We will honor that request unless the disclosure is required by law.

Receive an accounting of disclosures

You may ask for a list of certain disclosures of your health information made during the six years before your request. The accounting does not include every disclosure, such as most disclosures for treatment, payment, or healthcare operations and disclosures you specifically authorized. One accounting during any 12-month period is provided without charge; we may charge a reasonable, cost-based fee for an additional accounting during the same period.

Choose someone to act for you

A person who has legal authority to act for you—such as a healthcare power of attorney, parent or guardian, or other authorized personal representative—may exercise your rights and make choices about your health information. We will verify the person’s authority before acting on a request.

Your Choices

When appropriate, you may tell us whether and how to:

Share relevant information with family members, close friends, caregivers, or others involved in your care or payment for your care.

Share information with a disaster-relief organization to help notify others about your condition, location, or safety.

If you cannot tell us your preference—for example, because you are unconscious—we may disclose limited information when we believe it is in your best interest. We may also disclose information when necessary to prevent or lessen a serious and imminent threat to health or safety.

We do not maintain a hospital directory. We do not sell your protected health information. We do not use protected health information for fundraising. We will obtain your written authorization before using or disclosing protected health information for marketing when HIPAA requires authorization, before selling protected health information, and before most uses or disclosures of psychotherapy notes. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

How We Typically Use and Disclose Health Information

Treatment

We may use and disclose your health information to provide, coordinate, or manage your care. For example, we may share relevant information with a primary care physician, imaging facility, laboratory, pharmacy, surgical facility, therapist, or another clinician involved in your care.

Payment

We may use and disclose health information to obtain payment, process patient payments, provide requested billing documentation or superbills, respond to coverage or reimbursement questions, and conduct related billing activities. For example, at your request or when otherwise permitted, we may provide information needed for an out-of-network claim. Our use of health information for payment does not change the Practice’s cash-pay or out-of-network status.

Healthcare operations

We may use and disclose health information to operate the Practice, maintain and improve quality, train or evaluate personnel, conduct compliance and risk-management activities, support secure technology, coordinate business functions, and communicate with you about your care. For example, we may review records to evaluate treatment outcomes or improve patient instructions.

Other Uses and Disclosures Allowed or Required by Law

We may use or disclose health information without your written authorization when the law permits or requires it. We must meet applicable legal conditions before doing so. These purposes may include:

Public-health and safety activities, including disease prevention, product recalls, reporting adverse events, reporting suspected abuse or neglect, and preventing or reducing a serious threat to health or safety.

Health oversight activities authorized by law, including audits, investigations, inspections, licensing, and disciplinary proceedings.

Research that has been approved through a process permitted by law or that otherwise meets applicable privacy requirements.

Compliance with federal, state, or local law, including disclosures to the U.S. Department of Health and Human Services for HIPAA compliance review.

Organ and tissue donation activities.

Disclosures to a coroner, medical examiner, or funeral director when an individual dies.

Workers’ compensation and similar programs authorized by law.

Certain law-enforcement, correctional-institution, military, national-security, intelligence, and protective-service purposes.

Judicial or administrative proceedings, including responses to qualifying court orders, administrative orders, subpoenas, discovery requests, or other lawful process.

Specially Protected Information

Some categories of information may receive greater protection under federal or Illinois law. When another law is more protective than HIPAA, we follow the more protective law. This may include certain information concerning mental health, substance-use-disorder treatment, HIV/AIDS and other communicable diseases, genetic testing, sexual assault, and reproductive healthcare. We will obtain authorization or satisfy another legal basis before using or disclosing specially protected information when required.

Reproductive Healthcare Privacy

HIPAA prohibits us from using or disclosing protected health information for a criminal, civil, or administrative investigation into, or proceeding against, a person for seeking, obtaining, providing, or facilitating reproductive healthcare when the healthcare was lawful under the circumstances in which it was provided, or for identifying a person for such an investigation or proceeding. For certain requests involving health oversight, judicial or administrative proceedings, law enforcement, or coroners or medical examiners, we may be required to obtain a signed attestation that the requested use or disclosure is not for a prohibited purpose.

Substance-Use-Disorder Records

To the extent that we receive or maintain substance-use-disorder patient records protected by 42 CFR part 2, those records receive additional protection. Such records, or testimony describing their contents, generally may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you without your written consent or an appropriate court order and subpoena or other legal requirement. Information disclosed as permitted by HIPAA may sometimes be redisclosed by the recipient and may no longer be protected by HIPAA; additional federal or state protections may still apply.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We must provide you with this Notice describing our legal duties and privacy practices.

We must follow the terms of the Notice currently in effect.

We will notify affected individuals following a breach of unsecured protected health information as required by law.

We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or the law otherwise permits or requires the use or disclosure.

Changes to This Notice

We may change the terms of this Notice and make the revised Notice effective for all protected health information we maintain, including information created or received before the revision. When we make a material change, the revised Notice will be available upon request, at our service location, and on our website at https://drbunionmaster.com/notice-of-privacy-practices-hipaa/

Questions or Complaints

If you have questions, want to exercise a privacy right, or believe your privacy rights have been violated, contact:

Privacy Officer: Michael Tagge, DPM
MJT Podiatry S.C. DBA Dr. Bunionmaster
2333 N. Harlem Avenue, Chicago, Illinois 60707
Phone: 224-328-6466
Email: contact@drbunionmaster.com
Website: https://drbunionmaster.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201; calling 1-877-696-6775; or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html.

Availability of This Notice

You may request a paper copy at any time. The current electronic version is available at https://drbunionmaster.com/notice-of-privacy-practices-hipaa/ The Practice will make the Notice available at its service location and will provide or offer it no later than the first service delivery, including when the first service is provided electronically, as required by law.