Notice of Privacy Practices
Notice of Privacy Practices
Effective date: August 16, 2026
Health Builders PC
7540-H Little River Turnpike
Annandale, VA 22003
Telephone: 703-256-2600
Email: info@nvhb.org
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.
You have a right to a paper or electronic copy of this Notice and to discuss it with the Health Builders PC Privacy Contact at 703-256-2600 or info@nvhb.org.
Your Information. Your Rights. Our Responsibilities.
This Notice applies to protected health information maintained by Health Builders PC in its role as a healthcare provider. Protected health information includes identifiable information about your health, healthcare, or payment for healthcare that is protected by applicable law.
This Notice explains common uses and disclosures. It does not list every possible use or disclosure. Health Builders PC will follow the law and the Notice currently in effect.
Your Rights
Get an Electronic or Paper Copy of Your Medical Record
You may ask to inspect or obtain an electronic or paper copy of your medical record and other health information Health Builders PC maintains about you in a designated record set.
Health Builders PC will usually provide access within the period required by law. A reasonable, cost-based fee may apply. Access can be limited or denied in circumstances permitted by law, and review rights may apply to certain denials.
Contact Health Builders PC for instructions. Do not send a complete medical-record request through an ordinary public website form.
Ask Health Builders PC to Correct Your Record
You may ask Health Builders PC to amend health information you believe is incorrect or incomplete. Health Builders PC may deny the request in circumstances permitted by law and will explain a denial in writing. You may have a right to submit a statement of disagreement.
Request Confidential Communications
You may ask Health Builders PC to contact you in a particular way or at a particular location, such as by telephone at a specified number or by mail at a specified address. Reasonable requests will be accommodated as required by law.
Tell Health Builders PC about communication restrictions before leaving voicemail, email, text, or mailed information. Health Builders PC cannot control access to a device, account, mailbox, or address you provide.
Ask Health Builders PC to Limit Uses or Disclosures
You may ask Health Builders PC not to use or disclose certain health information for treatment, payment, or healthcare operations. Health Builders PC is generally not required to agree, except where the law requires agreement.
If you pay in full out of pocket for a healthcare item or service, you may ask Health Builders PC not to disclose information about that item or service to a health plan for payment or healthcare operations. Health Builders PC will agree when the legal requirements are met, unless disclosure is required by law.
Get a List of Certain Disclosures
You may request an accounting of certain disclosures of your protected health information made during the period permitted by law. The accounting does not include every disclosure. For example, treatment, payment, healthcare operations, disclosures authorized by you, and some other disclosures are generally excluded.
One accounting in a twelve-month period is generally provided without charge. A reasonable fee may apply to additional requests after advance notice and an opportunity to withdraw or modify the request.
Get a Copy of This Notice
You may request a paper copy at any time, even if you agreed to receive the Notice electronically. The current Notice is also available on the Health Builders PC website.
Choose Someone to Act for You
If you have given a person medical power of attorney, if a person is your legal guardian, or if another person has legal authority to act for you, that person may exercise rights and make choices about your health information as permitted by law. Health Builders PC will verify the person’s authority before acting.
Rights involving a minor can depend on parental authority, the minor’s legal authority to consent, the type of care, and federal and Virginia law.
File a Complaint
You may file a complaint with Health Builders PC if you believe your privacy rights were violated. Contact the Privacy Contact using the information at the end of this Notice.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, through the OCR complaint portal, by mail, or by calling 1-800-368-1019. TDD: 1-800-537-7697.
Health Builders PC will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell Health Builders PC your choices about what is shared. Tell Health Builders PC if you have a clear preference concerning:
sharing information with family members, friends, or others involved in your care or payment for care;
sharing information in a disaster-relief situation; or
contacting you about health-related services, treatment alternatives, or benefits.
If you are unable to communicate a preference, Health Builders PC may share information when it believes disclosure is in your best interest and the law permits it. Health Builders PC may also disclose information when needed to lessen a serious and imminent threat to health or safety.
Most marketing uses, the sale of protected health information, and most uses or disclosures of psychotherapy notes require written authorization when applicable. Health Builders PC will obtain an authorization when the law requires one.
You may revoke an authorization in writing. Revocation does not affect action already taken in reliance on the authorization and can be subject to other legal limits.
How Health Builders PC May Use and Disclose Your Information
Treatment
Health Builders PC may use and disclose your health information to provide, coordinate, or manage your healthcare. Information may be shared with physicians, nurse practitioners, chiropractors, nurses, medical assistants, laboratories, pharmacies, imaging providers, specialists, hospitals, emergency services, or others involved in your care.
Example: A provider may share relevant information with a specialist asked to evaluate a condition.
Payment
Health Builders PC may use and disclose health information to bill and obtain payment for services, determine eligibility, coordinate benefits, provide a superbill, collect an amount due, or address billing questions.
Example: Information may be used to prepare a bill or superbill for an eligible service.
Healthcare Operations
Health Builders PC may use and disclose health information for activities needed to operate the practice. These can include quality assessment, training, credentialing, licensing, auditing, legal services, compliance, patient safety, care coordination, business planning, information technology, security, and customer service.
Example: Health Builders PC may review records to evaluate quality and improve clinic processes.
Business Associates
Health Builders PC may disclose protected health information to a business associate that performs a function or service involving that information, when permitted by law and subject to a business associate agreement when required.
Business associates can include billing, records, information-technology, hosting, cloud, legal, accounting, transcription, and other service providers. Health Builders PC must evaluate each relationship and cannot treat a general vendor privacy statement as a substitute for a required business associate agreement.
Appointment Reminders and Health-Related Communications
Health Builders PC may contact you about appointments, follow-up, treatment alternatives, health-related benefits, or services that may interest you when permitted by law. Tell Health Builders PC if a communication method creates a privacy risk.
Public Health and Safety
Health Builders PC may disclose health information for public-health and safety purposes permitted or required by law, including:
preventing or controlling disease, injury, or disability;
reporting births or deaths when required;
reporting suspected abuse, neglect, or domestic violence when required or permitted;
reporting adverse events, product defects, or problems with medications or devices;
notifying a person who may have been exposed to a communicable disease when permitted;
preventing or lessening a serious and imminent threat to health or safety; and
supporting lawful public-health investigations and interventions.
Health Oversight
Health Builders PC may disclose information to health-oversight agencies for lawful activities such as audits, investigations, inspections, licensure, disciplinary proceedings, and civil, administrative, or criminal actions.
Research
Health Builders PC may use or disclose health information for research when the law permits, including with an authorization, an Institutional Review Board or privacy-board waiver, a limited data set subject to an agreement, or another legally permitted basis.
Website education and quality-improvement activities are handled according to the legal rules that apply to the activity. Health Builders PC will use patient information for research only through a legally permitted process.
Legal Proceedings and Law Enforcement
Health Builders PC may disclose health information in response to a court or administrative order, subpoena, discovery request, warrant, summons, or other lawful process when the legal requirements are met.
Information may be disclosed to law enforcement for purposes permitted by law, such as identifying or locating a person, reporting certain wounds or crimes, responding to lawful process, or reporting a death suspected to result from criminal conduct.
Medical Examiners, Funeral Directors, and Organ Donation
Health Builders PC may disclose information to a coroner, medical examiner, funeral director, or organ-procurement organization as permitted by law.
Workers’ Compensation
Health Builders PC may disclose health information as authorized by and necessary to comply with workers’ compensation and similar programs.
Government Functions
Health Builders PC may disclose information for specialized government functions permitted by law, including military and veterans activities, national security, protective services, correctional institutions, and custodial situations.
Required by Law
Health Builders PC will disclose health information when federal or state law requires it. The disclosure will be limited as required by the applicable law.
Substance Use Disorder Records
Federal law provides special protection for records created or maintained by a federally assisted substance use disorder program subject to 42 CFR Part 2. These protections apply when Health Builders PC is a Part 2 program or receives Part 2 records.
When Health Builders PC receives Part 2 records under a consent that permits treatment, payment, and healthcare operations, uses and redisclosures can be governed by HIPAA and Part 2. Part 2 records generally cannot be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against the patient without the patient’s written consent or a court order and a subpoena, as required by law.
A person receiving Part 2 records must comply with the applicable prohibition on use and disclosure in proceedings. Health Builders PC will obtain consent when Part 2 requires it and will follow the stricter applicable rule when multiple privacy laws protect the information.
Uses and Disclosures Requiring Written Authorization
Health Builders PC will obtain your written authorization for uses or disclosures that are not otherwise permitted or required by law. Authorization is generally required for:
most uses and disclosures of psychotherapy notes, when applicable;
most marketing communications involving protected health information, subject to statutory exceptions;
a sale of protected health information, subject to statutory exceptions;
public use of an identifiable patient photograph, testimonial, story, or review that reveals protected health information, when HIPAA applies; and
another use or disclosure that HIPAA requires to be authorized.
A patient’s voluntary public review does not automatically authorize Health Builders PC to republish protected health information on its website or in advertising.
Health Builders PC Responsibilities
Health Builders PC is required to:
maintain the privacy and security of protected health information;
provide this Notice describing legal duties and privacy practices;
follow the Notice currently in effect;
notify affected individuals following a breach of unsecured protected health information when required by law;
provide access, amendment, accounting, restriction, and confidential-communication rights as required by law;
obtain authorization when required; and
avoid retaliation for a privacy complaint or exercise of rights.
Health Builders PC does not guarantee that every security incident can be prevented. It maintains safeguards and responds to suspected incidents according to applicable law and approved policies.
Electronic Health Information
You may have rights concerning electronic health information, including timely access, electronic copies, transmission to another person or application at your direction, and protection against practices that unlawfully interfere with access, exchange, or use.
Health Builders PC may verify identity, apply permitted fees, protect another person’s information, and use secure methods appropriate to the request. A request to send information to an unsecured destination can involve risks that Health Builders PC will explain when required.
Changes to This Notice
Health Builders PC may change this Notice and its privacy practices. A revised Notice may apply to health information already maintained and information received in the future. The current Notice will be posted on the website and made available at the clinic. The effective date will appear at the top.
Language Assistance and Accessible Formats
Free language assistance and appropriate auxiliary aids and services are available when required. Call 703-256-2600 or email info@nvhb.org to request assistance or this Notice in an accessible format.
Privacy Contact
Questions, requests, or complaints may be directed to:
Privacy Contact
Health Builders PC
7540-H Little River Turnpike
Annandale, VA 22003
Telephone: 703-256-2600
Email: info@nvhb.org