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Privacy Policy and Terms of Service

Welcome! Below is a copy of our Terms and Conditions.  Please note that our registration forms are sent in electronic format during the registration process.

                                                     HIPAA ACKNOWLEDGEMENT

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  A) I understand that, under the Health Insurance Portability & Accountability Act of 1996 (HIPAA), I have certain rights to privacy regarding my protected health information. I understand that this information can and will be used, but is not mandatory for me to sign to: Conduct, plan and direct my treatment and follow-up among the multiple healthcare providers who may be involved in that treatment directly and indirectly. Obtain payment from third-party payers, process billing and customary financial operations. Conduct normal healthcare operations such as quality assessments and health certifications

 

  B) I have been informed by you of your Notice of Privacy Practices containing a more complete description of the uses and disclosures of my health information. I have been given a copy of your Notice of Privacy Practices prior to signing this consent. I understand that this office has the right to change its Notice of Privacy Practices from time to time and that I may contact this office at any time at the above address to obtain a current copy of the Notice of Privacy Practices.

 

  C) I understand that I may request in writing that you restrict how my private information is used or disclosed to carry out treatment, payment, or health operations. I also understand you are not required to agree to my requested restrictions, but if you do agree then you are bound to abide by such restrictions.

 

  D) I understand that I may revoke this consent in writing at any time, except to the extent that you have taken action relying on this consent.

 

  Effective Date This notice is in effect as of September 29, 2014

                                             Text Message Terms and Conditions

 

Alliance Clinics Text Message Terms and Conditions

By opting into our text message service, you agree to the following terms and conditions:

  1. Service Description

    • Alliance Clinics may send you appointment reminders, health-related updates, billing information, or other important notifications via text messages.

  2. Consent

    • By providing your mobile phone number and opting in, you consent to receive text messages from Alliance Clinics. Your consent is not a condition of receiving services.

  3. Message Frequency

    • Message frequency may vary based on your healthcare needs and interactions with the clinic.

  4. Fees and Charges

    • Standard message and data rates may apply depending on your mobile carrier and plan.

  5. Opt-Out

    • By providing your phone number you agree to receive text messages from Alliance Foot & Ankle Clinics. Message & data rates may apply. Message frequency varies. Reply HELP for help and STOP to cancel. View Terms of Service and Privacy Policy.

  6. Help and Support

    • For assistance,  contact our office directly.

  7. Privacy

    • Your privacy is important to us. We will never share or sell your information for marketing purposes. However, we may share your information as permitted under HIPAA regulations. Please note that text messages may not be fully secure, so contact the clinic directly for sensitive matters.

  8. Disclaimer

    • Alliance Clinics is not responsible for any delays or failures in message delivery caused by your mobile carrier or other factors.

  9. Changes to Terms

    • Alliance Clinics reserves the right to modify these terms and conditions at any time. Updates will be communicated through our website or other appropriate means.

By continuing to use this service, you acknowledge and agree to these terms and conditions.

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                                                        Service and Privacy Policy

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                                                        Alliance Foot & Ankle Clinics

Effective Date: 09/29/2014

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                                                                 Service Policy

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Scope of Services

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At Alliance Foot & Ankle Clinics, we are committed to providing comprehensive care for all foot and ankle conditions. Our services include but are not limited to:

  • Diagnostic evaluations and imaging

  • Podiatric surgeries

  • Wound care management

  • Biomechanical assessments and orthotic fittings

  • Treatment of nail and skin conditions

  • Diabetic foot care

We strive to deliver high-quality care tailored to each patient’s needs, ensuring patient safety, comfort, and satisfaction.

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                                                         Appointment Policies

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  1. Scheduling: Appointments can be scheduled via phone, online portal, or in person at any of our clinics.

  2. Cancellations: Patients must notify us at least 24 hours in advance if they need to cancel or reschedule an appointment. Repeated no-shows may result in a cancellation fee. Please refer to our financial Policy.

  3. Late Arrivals: Patients arriving more than 15 minutes late may need to reschedule, depending on the clinic’s schedule availability.

  4. Emergency Care: We offer priority scheduling for urgent foot and ankle conditions. Please contact us directly for emergency appointments.

  Financial Policy Summary. (Refer to our complete Financial Policy at time of registration)

  1. Insurance Coverage: We accept most major insurance plans. Patients are responsible for verifying their coverage prior to their appointment.

  2. Co-Payments and Deductibles: Co-pays, deductibles, and any out-of-pocket expenses are due at the time of service.

  3. Payment Plans: Payment plans may be available for uninsured or underinsured patients. Please speak with our billing department for more details.

  4. Outstanding Balances: Failure to pay outstanding balances may result in referral to a collection agency.

                                                         Patient Responsibilities

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  1. Provide accurate and complete medical history and information.

  2. Follow the treatment plan and notify the clinic of any changes in symptoms or conditions.

  3. Treat staff and other patients with respect.

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                                                               Privacy Policy

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Purpose

Alliance Foot & Ankle Clinics are dedicated to protecting the privacy of your health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws.

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Information We Collect

We may collect the following types of personal and medical information:

  • Personal identification information (e.g., name, address, date of birth, contact details)

  • Insurance and billing information

  • Medical history and treatment information

  • Diagnostic imaging and test results.

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How We Use Your Information

Your information is used for:

  1. Treatment: To provide, coordinate, and manage your care.

  2. Payment: To process billing and insurance claims.

  3. Healthcare Operations: To ensure quality and improve the efficiency of our services.

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Sharing Your Information

We may share your health information with:

  • Healthcare providers involved in your care

  • Insurance companies for claims processing

  • Public health authorities when required by law

  • Third-party vendors who support our operations (e.g., billing services) under strict confidentiality agreements

We will not sell your personal or medical information to any third parties.

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Your Rights

  1. Access to Records: You may request a copy of your medical records at any time.

  2. Correction of Information: You can request corrections to inaccurate or incomplete information.

  3. Restriction Requests: You may request limitations on the use or disclosure of your information.

  4. Confidential Communications: You can specify how you prefer to be contacted (e.g., phone, email, or mail).

  5. Complaint Filing: If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Department of Health and Human Services.

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Data Security

We use secure systems and protocols to protect your information, including:

  • Encrypted electronic health record systems

  • Password-protected access for authorized staff only

  • Regular audits of data security protocols.

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Retention of Records

We retain medical records as required by state and federal laws and securely dispose of them when no longer needed.

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Updates to This Policy

We reserve the right to modify this policy at any time. Any updates will be communicated to patients via our website and posted notices in our clinics.

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Contact Information

If you have questions about our Service or Privacy Policy, please contact us:

Alliance Foot & Ankle Clinics
Address: 6510 W Layton Ave. Ste 102 Greenfield, WI 53220
Phone: (414) 282-7209
Info@allianceclinics.com


Thank you for choosing Alliance Foot & Ankle Clinics for your podiatric care.

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