Notice of Privacy Practices

Who this notice covers

This notice applies to Natural Pediatrics, Cengiz Yucel, M.D., at 155 Polifly Road, Suite 204, Hackensack, New Jersey, and to everyone who works in the practice.

Our duties

We are required by law to keep your child's protected health information private, to give you this notice describing our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and disclose health information

For treatment

We use health information to provide your child's care and to coordinate it with other people who treat your child, including specialists, the hospital, laboratories and pharmacies.

For payment

We use and disclose health information to bill and collect payment from you, your health plan, or another payer.

For healthcare operations

We use health information to run the practice: quality review, training, licensing, and business management.

Other uses and disclosures permitted or required by law

• Appointment reminders and information about treatment alternatives
• Public health activities, including reporting immunizations to the New Jersey Immunization Information System
• Reporting suspected child abuse or neglect, as required of physicians in New Jersey
• Health oversight activities, judicial and administrative proceedings, and law enforcement, within the limits the law sets
• To avert a serious and imminent threat to health or safety
• Workers' compensation, coroners and medical examiners, and specialized government functions

Fundraising and marketing

If we ever contact you for fundraising, you have the right to tell us to stop, and we will tell you how each time we make contact. We do not sell your child's health information and we do not use it for marketing without your written authorization.

Uses that always require your written authorization

We will not use or disclose your child's health information for marketing, we will not sell it, and we will not disclose psychotherapy notes, without your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Special rules for adolescents

Parents and legal guardians usually have the right to see and control the health information of a child under 18, and for most of what happens in this office that is exactly how it works.

New Jersey law creates some exceptions. A minor can consent on their own to certain categories of care, which include treatment for sexually transmitted infections, HIV testing and treatment, substance use treatment, pregnancy-related care, and some mental health care. Where a minor lawfully consents to their own care, we may be required to keep those specific records confidential from a parent, and in some circumstances we may not release them without the young person's permission.

Separately, federal law gives a physician limited discretion to withhold information where releasing it could reasonably endanger the patient.

Two practical points for parents of teenagers:

• At 18 your child becomes an adult in their own right. From that birthday we need their authorization to discuss their care with you, even though this practice continues to see patients through age 20.
• Dr. Yucel would rather talk to you about how this works before it comes up than after. Please ask at a visit.

Your rights

• Inspect and copy. You may ask to see and get a copy of your child's medical and billing records, including an electronic copy where we hold them electronically.
• Amend. You may ask us to correct information you believe is wrong or incomplete. We may decline, and we will tell you why in writing.
• Accounting of disclosures. You may ask for a list of certain disclosures we have made.
• Request restrictions. You may ask us to limit how we use or disclose information. We are not required to agree, except that we must agree to withhold information from a health plan for care you paid for in full yourself.
• Confidential communications. You may ask us to contact you in a particular way or at a particular address.
• Paper copy. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Breach notification. You will be notified if there is a breach that compromises the privacy or security of your child's information.

To exercise any of these rights, call the office at (201) 525-0214 or write to us at the address below.

Complaints

If you believe your privacy rights have been violated, you may complain to the practice and you may complain to the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

To complain to the practice, or to ask any question about privacy, contact our Privacy Officer:

Privacy Officer, Natural Pediatrics, 155 Polifly Road, Suite 204, Hackensack, NJ 07601. Telephone (201) 525-0214. Email dryucel@naturalpediatric.com. Please put your complaint in writing where you can.

To complain to the federal government: U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, D.C. 20201, or by telephone on 1-800-368-1019 (TDD 1-800-537-7697), or online at hhs.gov/ocr/complaints.

Changes to this notice

We may change this notice and make the new terms apply to information we already hold as well as information we receive in the future. The current notice is posted here and a copy is available in the office.