Notice of Privacy Practices

Last Revised and Effective: August 26, 2026

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.

INTRODUCTION

Allied Digestive Health is an integrated network of gastroenterology care centers providing high-quality, comprehensive digestive healthcare. We are committed to protecting the privacy and confidentiality of your health information.

This Notice of Privacy Practices (“Notice”) describes how we may use and disclose your protected health information (“PHI”) to carry out treatment, payment, or health care operations, and for other purposes that are permitted or required by law. It also describes your rights regarding your health information and how you can exercise those rights.

PHI is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health condition, the provision of health care to you, or payment for that health care. Some examples of PHI include information indicating that you are a patient of our medical group or receiving health-related services from our facilities, information about your health condition, genetic information, or information about your healthcare benefits under an insurance plan, each when combined with identifying information, such as your name, address, social security number, or phone number.

We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices with respect to your PHI, and to abide by the terms of this Notice currently in effect. This Notice applies to our medical staff and affiliated health care providers who jointly perform healthcare services with our medical group, including physicians and physician groups who provide services at our facilities (collectively, “ADH”), and to the records we create, maintain, or receive.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following categories describe the ways we may use and share your health information without your written authorization:

Treatment. We will use and disclose your health information to provide, coordinate, or manage your digestive health care and any related services. This includes coordination or management of your health care with a third party. Example: We may share your health information with providers at ADH who are involved in taking care of you, and they may in turn use that information to diagnose or treat you. A provider in our medical group may also share your health information with another provider to whom you have been referred for further health care.
Payment: We may use your health information or share it with others so that we may obtain payment for your health care services. Example: we may send a claim to your health insurance company in order to obtain reimbursement after we have treated you. In some cases, we may share information about you with your health insurance company to determine whether it will cover your treatment.
Health Care Operations: We may use your health information or share it with others in order to conduct our health care operations, which are activities necessary to run our practice and to ensure that all of our patients receive quality care. Example: we may use your health information to evaluate the performance of our staff in caring for you, or to educate our staff on how to improve the care they provide for you, or to conduct internal quality improvement activities.
Appointment reminders, treatment alternatives, benefits and services. In the course of providing treatment to you, we may use your health information to contact you with a reminder that you have an appointment for treatment, services, or refills, or in order to recommend possible treatment alternatives or health-related benefits and services that may be of interest to you.

OTHER PERMITTED OR REQUIRED USES OR DISCLOSURES

Generally, we will obtain your written authorization before using your health information or sharing it with others outside of our medical group. However, we may use or disclose your PHI in certain situations that are either permitted or required by law. These include:

Emergencies or as Required by Law: We may use or disclose your health information if you need emergency treatment or if we are required by law to treat you. We may also use or disclose your health information if we are required by law to do so, and we will notify you of these uses and disclosures if notice is required by law.
Public Health Activities: We may disclose your health information to authorized public health officials so they may carry out their public health activities under law, including maintaining vital records, such as births and deaths, notifying a person regarding potential exposure to a communicable disease, notifying a person regarding a potential risk for spreading or contracting a disease or condition, reporting reactions to drugs or problems with products or devices, notifying individuals if a product or device they may be using has been recalled, and notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
Victims of Abuse, Neglect or Domestic Violence: We may release your health information to a public health authority authorized to receive reports of abuse, neglect, or domestic violence.
Health Oversight Activities: We may release your health information to government agencies authorized to conduct audits, investigations, and inspections of our facilities. These government agencies monitor the operation of the health care system, government benefit programs such as Medicare and Medicaid, and compliance with government regulatory programs and civil rights laws.
Judicial and Administrative Proceedings: We may disclose your health information if we are ordered to do so by a court or administrative tribunal that is handling a lawsuit or other dispute. We may also disclose your information in response to a subpoena, discovery request, or other lawful request by someone else involved in the dispute, but only if required judicial or other approval or necessary authorization is obtained.
Law Enforcement Purposes: We may disclose your health information to law enforcement officials for certain reasons, such as complying with court orders, assisting in the identification of fugitives or the location of missing persons, if we suspect that your death resulted from a crime, or if necessary, to report a crime that occurred on our property or off-site in a medical emergency.
To Avert a Serious and Imminent Threat to Health or Safety: We may use your health information or share it with others when necessary to prevent a serious and imminent threat to your health or safety, or the health or safety of another person or the public. In such cases, we will only share your information with someone able to help prevent the threat. We may also disclose your health information to law enforcement officers if you tell us that you participated in a violent crime that may have caused serious physical harm to another person (unless you admitted that fact while in counseling), or if we determine that you escaped from lawful custody (such as a prison or mental health institution).
Specialized Government Functions: We may disclose your health information to authorized federal officials who are conducting national security and intelligence activities or providing protective services to the President or other important officials. If you are in the Armed Forces, we may disclose health information about you to appropriate military command authorities for activities they deem necessary to carry out their military mission. We may also release health information about foreign military personnel to the appropriate foreign military authority.
Inmates and Correctional Institutions: If you are an inmate or you are detained by a law enforcement officer, we may disclose your health information to the prison officers or law enforcement officers if necessary to provide you with health care, or to maintain safety, security and good order at the place where you are confined. This includes sharing information that is necessary to protect the health and safety of other inmates or persons involved in supervising or transporting inmates.
Workers’ Compensation: We may disclose your health information for workers’ compensation or similar programs that provide benefits for work-related injuries.
Coroners, Medical Examiners and Funeral Directors. In the event of your death, we may disclose your health information to a coroner or medical examiner. We may also release this information to funeral directors as necessary to carry out their duties.
Organ and Tissue Donation: If you are an organ donor, in the event of your death or impending death, we may disclose your health information to organizations that procure or store organs, eyes or other tissues so that these organizations may investigate whether donation or transplantation is possible under applicable laws.
Research. Under certain circumstances, we may use and disclose your PHI for research purposes, provided that the research has been approved by an institutional review board or a privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information. For example, a research study may involve comparing the outcomes of patients who received one type of treatment versus another.

USES OR DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION

There are certain situations where we must obtain your written authorization before using your health information or sharing it, including:

Most uses and disclosures of your psychotherapy notes.
Uses and disclosures for marketing purposes if ADH will receive direct or indirect financial payment not reasonably related to our medical group’s cost of making the communication. Written authorization is not required for marketing communications made face-to-face, or when in the form of a promotional gift of nominal value.
Disclosures that constitute a sale of PHI. The sale of PHI, however, does not include a disclosure for public health purposes, for research purposes where our medical group will only receive payment for our costs to prepare and transmit the health information, for treatment and payment purposes, for the sale, transfer, merger or consolidation of all or part of our medical group, to a business associate or its subcontractor to perform health care functions on our medical group’s behalf, or for other purposes as required and permitted by law.
Any other uses or disclosures not described in this Notice.

If you provide us with written authorization, you may revoke that authorization at any time, in writing, except to the extent that we have already relied upon it. To revoke a written authorization, please write to the Privacy Officer using the contact information below. You may also initiate the transfer of your records to another person by completing a written authorization form. If you revoke your authorization, we will no longer use or disclose your health information for the reasons covered by your written authorization. You understand, however, that we are unable to take back any disclosures already made with your prior authorization, and that we are required to retain records of the care that we have provided to you.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights with respect to your PHI:

Right to Request Restrictions: You have the right to request restrictions on certain uses or disclosures of your health information. For example, you may ask us not to use or disclose information about a particular diagnosis or treatment to a family member. You also have the right to request that your health information not be disclosed to a health plan if you have paid for the services out of pocket and in full, and the disclosure is not otherwise required by law. To request restrictions, please write to our Privacy Officer using the information provided below. We are not required to agree to your request for a restriction, and in some cases the restriction you request may not be permitted under law. However, if we do agree, we will be bound by our agreement unless the information is needed to provide you with emergency treatment or comply with the law.
Right to Request Confidential Communications: You have the right to request that we contact you about your health matters in a certain, more confidential way, such as calling you at work instead of at home, or at a specific phone number. To make such a request, please write our Privacy Officer and specify how you wish to be contacted. We will not ask you the reason for your request, and we will try to accommodate all reasonable requests.
Right to Inspect and Copy Records: You have the right to inspect and obtain a copy of any of your health information that may be used to make decisions about you and your treatment for as long as we maintain this information in our records, including medical and billing records. To inspect or obtain a copy of your health information, please submit your request in writing to our Privacy Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies we use to fulfill your request. If you would like an electronic copy of your health information, we will provide you a copy in the form and format requested as long as we can readily produce such information in the form requested. Otherwise, we will cooperate with you to provide a readable electronic form and format as agreed. In some limited circumstances, we may deny the request.
Right to Amend Records. If you believe that the health information we have about you is incorrect or incomplete, you may ask us to amend the information. Your request should be in writing to our Privacy Officer and include the reasons why you think we should make the amendment. If we deny any part of or your entire request, we will provide a written notice that explains our reasons for doing so. You will have the right to have certain information related to your requested amendment included in your records.
Right to an Accounting of Disclosures: You have a right to request an “accounting of disclosures,” which is a list with information about how we have shared your health information with others. This accounting will not include disclosures made for treatment, payment, or health care operations purposes; disclosures made directly to you; or disclosures made pursuant to your authorization. To request an accounting of disclosures, please write to our Privacy Officer. You have a right to receive one disclosure list every 12-month period for free. However, we may charge you for the cost of providing any additional lists in that same 12-month period.
Right to Receive Notification of a Breach: You have the right to be notified in the event that there is a breach of your unsecured PHI. We are required to notify you without unreasonable delay, and no later sixty (60) days of the discovery of such breach. The notice will include a description of what happened, including the date, the type of information involved in the breach, steps you should take to protect yourself from potential harm, a brief description of the investigation into the breach, what we’re doing to mitigate potential harm to you, how we are going to protect against further breaches, and contact procedures to answer your questions.
Right to Have Someone Act on Your Behalf: You have the right to name a personal representative who may act on your behalf to control the privacy of your health information. Parents and guardians will generally have the right to control the privacy of health information about minors unless the minors are permitted by law to act on their own behalf.
Right to Obtain a Paper Copy of This Notice: If you are receiving this Notice electronically, you have the right to obtain a paper copy of this Notice. You can request a paper copy by contacting our Privacy Officer.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time. Any revision or amendment to this Notice will be effective for all of your records we have created or maintained in the past, and for any of your records we may create or maintain in the future. When we make a material change to this Notice, we will post the revised Notice in our office, make the revised Notice available upon request, and post it on our website. The revised Notice will contain the effective date on the first page.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer, or you can file a complaint with the Secretary of the Department of Health and Human Services. We will not withhold treatment or take action against you for filing a complaint.

To file a complaint with ADH, contact our Privacy Officer at the address or phone number listed below.

To file a complaint with the Secretary of HHS, you may write to:

Office for Civil Rights, U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Telephone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/

SPECIAL PROTECTIONS

Some kinds of information, such as HIV-related information, alcohol and substance abuse treatment information, mental health information, and genetic information, are considered so sensitive that state or federal laws provide special protections for them. Therefore, some parts of this Notice of Privacy Practices may not apply to these types of information. If you have questions or concerns about the ways these types of information may be used or disclosed, please speak with your health care provider or contact our Privacy Officer.

CONTACT INFORMATION

If you have questions about this Notice or wish to exercise any of your rights described in this Notice, please contact:

Allied Digestive Health
Monmouth Corporate Park 1
187 Highway 36, Suite 230
West Long Branch, New Jersey 07764
compliance@hcompliance.com
844-932-6675
Attn: Privacy Officer