SYRACUSE OTOLARYNGOLOGY, PLLC
Effective Date: February 9, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU GET ACCESS TO YOUR INDIVIDUAL IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
SYRACUSE OTOLARYNGOLOGY, PLLC (“SOP”), is dedicated to maintaining the privacy of your protected health information (“PHI”). In conducting our practice, we will create records regarding you and the service(s) we provide to you. We are required by law to maintain the confidentiality of health information that identifies you, and to provide you with this Notice of our legal duties and the privacy practices that we maintain in our office concerning your PHI. By federal and state law, we must follow the terms of the Notice that we have in effect at the time of your care.
HOW WE MAY USE AND DISCLOSE YOUR PHI
1. Treatment. Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
- Note on Substance Use Disorder (SUD) Records: If your records include SUD information protected by 42 CFR Part 2, we will obtain your written consent before disclosing that information for treatment, payment, or health care operations, except in permitted emergencies.
2. Payment. Our practice may use and disclose your PHI in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits, and we may provide your insurer with details regarding your treatment to determine if your insurer will cover your treatment. We may also use and disclose your PHI to obtain payment from third parties that may be responsible for such costs, such as family members. We are required to agree to your request to restrict disclosure of your PHI to a health plan, where the disclosure is for payment or healthcare operations pertaining to an item or service for which you have paid out of pocket in full.
3. Health Care Operations. Our practice may use and disclose your PHI to operate our business. Our practice may use your PHI to evaluate the quality of care you received from us, or to conduct cost management and business planning activities for our practice.
4. Appointment Reminders. Our practice may use and disclose your PHI to contact you and remind you of an appointment.
5. Release of Information to Family/Friends. Our practice may release your PHI to friends or family members that are involved in your care, or who assist in taking care of you. Some of your PHI may be shared with them at that time.
6. Public Health Risks. Your PHI may be disclosed to public health authorities as required by law. For example, we are required to report certain communicable diseases to the New York State Public Health Department.
7. Law Enforcement and Legal Proceedings. We may release your PHI if asked to do so by a law enforcement official to support government audits and inspections, to facilitate law enforcement investigations, and to comply with government mandated reporting when served with a warrant, summons, court order or subpoena.
- Restriction on SUD Records: We are prohibited from using or disclosing your SUD records (protected by 42 CFR Part 2) in any civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a specialized court order.
8. Deceased Patients. Our practice may release your PHI to a medical examiner or coroner to identify a deceased individual or identify the cause of death. If necessary, we may also release information in order for funeral directors to perform their job.
9. Organ and Tissue Donation. Our practice may release your PHI to organizations that handle organ, eye, or tissue procurement or transplantation if you are an organ donor.
10. Research. Our practice may use and disclosure your PHI for research purposes in certain limited circumstances. If a research project were to take place, a separate authorization will be given to you for signature.
11. Marketing. The use and disclosure of PHI for marketing purposes or for the sale of PHI will not be done without your individual written consent.
12. Fundraising. If SOP conducts fundraising, we may use your PHI for these efforts; however, you have the right to, and will be provided with, a clear opportunity to opt out of receiving any further fundraising communications.
13. Potential for Redisclosure. Any PHI disclosed pursuant to this Notice may be subject to redisclosure by the recipient and may no longer be protected by federal privacy regulations.
14. Use and Disclosure Not Described Above. Uses and disclosures not described in this Notice will not be done without your individual written authorization.
YOUR RIGHTS REGARDING YOUR PHI
1. Confidential Communications. You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. You do not need to give a reason for your request.
2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your PHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care. We are not required to agree to your request; however, if we do agree, we are bound by our agreement.
3. Inspection and Copies. You have the right to inspect and obtain a copy of the PHI that may be used to make decisions about you, including patient medical records and billing records. You have the right to receive electronic copies of your health information within thirty (30) days of your request.
4. Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is maintained by our practice.
5. Accounting of Disclosures. You have the right to request an “accounting of disclosures,” which is a list of certain non-routine disclosures our practice has made of your PHI for non-treatment, non-payment or non-operations purposes.
6. Right to a Paper Copy of this Notice. You are entitled to receive a paper copy of our Notice of Privacy Practices at any time.
7. Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.
8. Right to Provide an Authorization. Our practice will obtain your written authorization for uses and disclosures that are not identified by this Notice. Any authorization may be revoked at any time, in writing.
9. Breach Notification. You have a right to, and will receive, notification of any breaches of your unsecured health information, if any such breach should occur.
Privacy Officer Contact:
Dr. Parul Goyal, Privacy Officer at Syracuse Otolaryngology, PLLC
101 Richmond Ave Ste 320, Syracuse, New York 13210 Ph: (315) 254-2030