Notice of Privacy Practices & Patient Rights

As a patient being treated at Peachtree Spine & Sports Physicians, you have the right to:

• Respectful care with concern for your dignity and comfort, provided by competent personnel in a safe and sanitary environment
• Consideration of your personal privacy concerning your own medical care
• Know the names and credentials of all physicians and staff directly assisting in your care
• Have your medical records treated as confidential, except as required by law or third-party contractual agreements
• Receive information about our practice rules and regulations that apply to you as a patient
• Information regarding provisions for after-hours and emergency care
• Receive emergency procedures implemented without delay
• Receive good quality care with high professional standards and infection control
• Learn what services are available at our organization
• Receive full information in layman's terms concerning diagnosis, treatment, prognosis, and possible complications, including written discharge instructions
• Be advised of participation in medical research or donor programs and give informed consent
• Refuse treatment, including drugs or procedures, within the confines of the law
• Receive care without discrimination based on age, race, color, religion, national origin, handicap, disability, or source of payment
• Access to an interpreter whenever possible
• Access all information in your medical record within a reasonable time (unless restricted by your physician)
• Have your time managed efficiently to avoid unnecessary discomfort
• Receive information about fees for services and our payment policies
• Examine and receive a detailed evaluation of your bill
• Change physicians if desired and another qualified provider is available
• Be free from abuse, neglect, harassment, and exploitation
• Receive appropriate and professional care related to physician orders
• Receive information necessary to make informed decisions before any procedure or treatment
• Have personal data privacy and confidentiality
• Have your rights extended to an authorized representative or surrogate
• Voice grievances and receive a written response within 30 days

The care you receive depends on your participation. In addition to your rights, you have certain responsibilities outlined in the spirit of mutual trust and respect:

• Provide complete and accurate information about your health, medications (including over-the-counter products), and any allergies or sensitivities
• Follow the treatment plan prescribed by your provider and participate actively in your care
• Provide a responsible adult to transport you home from the facility and remain with you for 24 hours, as required by your provider
• Accept personal financial responsibility for charges not covered by insurance
• Behave respectfully toward all healthcare professionals, staff, and other patients

Peachtree Spine & Sports Physicians respects patient rights regarding advance directives. Based on organizational conscience, our medical team will provide comprehensive resuscitative care to every patient.

We will:

• File a copy of your existing advance directive upon your request
• Document receipt in a prominent and uniform location in your patient record
• Provide information regarding advance directives and approved state-specific forms upon request

Federal and state regulations require that we inform you that Dr. Matthew Richardson and Jeffrey Grossman have a financial interest in Peachtree Spine & Sports Physicians. This involvement helps us ensure high-quality surgical care for all patients.

We value your feedback. You may contact us directly if you have compliments, comments, grievances, or concerns about the quality of our care and services:

You may also contact:

• Accreditation Association for Ambulatory Health Care: 847-853-6060 | 3 Parkway North Blvd, Deerfield, IL 60015-2537
• Georgia Department of Health: 800-878-6442 | 2 Martin Luther King Jr. Drive SE, East Tower, Atlanta, GA 30334
• Georgia Composite Medical Board: 404-656-3913

We recognize you have a choice for healthcare services, and we are grateful you have chosen us as your provider.

Your Information. Your Rights. Our Responsibilities.

This section explains how your health information may be used and disclosed, and how you can access it.

For certain health information, you can tell us your choices about what we share:

You may authorize or restrict sharing with:

• Family or friends involved in your care
• Disaster relief organizations
• Hospital directories (if applicable)
• Fundraising communications

In fundraising cases, we may contact you, but you can request not to be contacted again.

Treatment – We share information with medical professionals involved in your care.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Health Care Operations – We use information to run our practice, improve care, and contact you when necessary.

Example: We use health information to manage your treatment and services.

Billing – We can use and share information to bill and get payment from health plans or other entities.

Example: We give information to your health insurance plan so it will pay for your services.

Additional Ways We May Share Your Information

We are allowed or required to share information in other ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before sharing. We may share information when permitted or required by law, including for:

• Public health and safety
• Disease prevention
• Product recalls
• Medication-related adverse events
• Abuse, neglect, or domestic violence reports
• Research under approved conditions
• Organ and tissue donation
• Coroners, medical examiners, and funeral directors
• Workers' compensation
• Law enforcement
• Government functions (military, national security)
• Court orders, subpoenas, and legal proceedings

By providing your mobile number and opting in to receive SMS messages from Peachtree Spine & Sports Physicians, you agree to:

• Receive appointment reminders and service-related messages
• Your number will not be sold or shared with third parties for marketing
• Message frequency may vary; standard message and data rates may apply
• You may opt out at any time by replying STOP or contacting our office
• For questions, contact our office or review our full Privacy Policy

Our practice may use AI-assisted tools solely to improve efficiency in creating and organizing clinical documentation. These tools support the documentation workflow only and are used in full compliance with all privacy and security requirements.

All information processed through these tools remains protected and is handled in full compliance with HIPAA.

• We are required by law to maintain the security and privacy of your protected health information
• We will notify you promptly if a breach occurs that may compromise your privacy
• We must follow the duties and privacy practices described in this notice
• We will not use or share your information without written authorization unless allowed by law
• If you grant authorization, you may revoke it at any time in writing

We may update this notice at any time. Changes will apply to all information we maintain. The latest version will always be available in our office and on our website.

This Notice of Privacy Practices applies to Peachtree Spine & Sports Physicians and all locations, unless otherwise stated.