Privacy Policy & Notice of Privacy Practices

Effective Date: 08/19/2025

Michigan Clinic Neurosurgery (Schell Spinal) respects your privacy and is committed to protecting your personal and health information. This Privacy Policy and Notice of Privacy Practices explains how we collect, use, disclose, and safeguard your information in compliance with HIPAA, applicable state laws, and carrier requirements.

Scope of This Notice

This Notice applies to the use and disclosure of your protected health information (PHI) by the following organizations and individuals:

• Michigan Clinic Neurosurgery (Schell Spinal) and the members of our workforce – including employees, volunteers, and trainees – at our physician offices and centers.

Information We Collect

We may collect the following types of information:

• Personal Identifiers: Name, address, date of birth, phone number, email, and insurance details.
• Protected Health Information (PHI): Medical history, test results, diagnoses, treatments, and related care information.
• Payment Information: Billing, insurance claims, and payment method details.
• Communication Preferences: Your consent for receiving emails, calls, or SMS text messages.

How We Use and Disclose Information

Your PHI may be used or disclosed without your written authorization for:

• Treatment: To provide, coordinate, and manage your healthcare.
• Payment: To bill and collect payment from you, your insurance, or other responsible parties.
• Healthcare Operations: For quality improvement, staff education, audits, business planning, and legal compliance.

Other permitted uses/disclosures without prior authorization include:

• Public health activities (e.g., disease control, reporting to registries).
• Regulatory and legal requirements (e.g., court orders, law enforcement).
• Health oversight activities (e.g., audits, inspections, licensure).
• Workers’ compensation
• Appointment reminders, treatment alternatives, and health-related services.

Certain sensitive information (e.g., HIV/AIDS, substance use disorder treatment, or genetic testing results) may require your written authorization before disclosure.

Uses and Disclosures That Require Your Authorization

We will obtain your written authorization before using or disclosing PHI for:

• Psychotherapy notes (in most cases).
• Marketing activities beyond those permitted by HIPAA.
• Sale of PHI.
• Any other use or disclosure not described in this Notice.

You may revoke your authorization at any time in writing.

SMS Communications

• If you provide your mobile number, you may receive appointment reminders and care-related messages.
• SMS consent is not shared with third parties.
• Standard text/data rates may apply. You may opt out at any time by letting the office know you would like to opt out.

Your Rights Regarding PHI

You have the right to:

• Access & Copies: Inspect and obtain a copy of your PHI (including electronic format if available).
• Amendments: Request corrections to your medical record.
• Accounting: Request a list of disclosures of your PHI for the last six years (excluding those for treatment, payment, or operations).
• Restrictions: Request limits on how your PHI is used or disclosed.
• Confidential Communications: Request alternative methods or locations for communications.
• Breach Notice: Receive notice of any unauthorized disclosure of your unsecured PHI.
• Paper Copy: Request a paper copy of this Notice at any time.

Our Legal Duties

We are required by law to:

• Maintain the privacy of your PHI.
• Provide you with this Notice of Privacy Practices.
• Follow the terms of the Notice currently in effect.
• Notify you if a breach of unsecured PHI occurs.

Security of Your Information

We use administrative, technical, and physical safeguards (such as secure servers and encryption) to protect your information. No system is 100% secure, but we take all reasonable measures to safeguard your data.

Accessibility of This Policy

• This Privacy Policy/Notice will be linked on the webpage under Patient Resources – General Information.
• It will also be available in the footer of every page of our website.
• A printed copy is available upon request.

Changes to This Notice

We may change this Privacy Policy & Notice of Privacy Practices at any time. Updates will apply to all existing and future PHI. The “Effective Date” at the top of this Notice reflects the latest version.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Privacy Officer
Jennifer West
3160 Cabaret Tr. South, Saginaw, MI 48603
989-799-8712
jwest@michiganneuro.com

Or with the U.S. Department of Health & Human Services, Office for Civil Rights:

• Mail: 200 Independence Avenue, SW, Washington, DC 20201
• Phone: 1-877-696-6775
• Website: https://www.hhs.gov/hipaa/filing-a-complaint

You will not be retaliated against for filing a complaint.

> File a HIPAA Complaint

LEGAL ASSIGNMENT OF BENEFITS AND RELEASE OF MEDICAL AND PLAN DOCUMENT

In considering the amount of medical expenses to be incurred, I, the undersigned, have insurance and/or employee health care benefits coverage with the above captioned, and hereby assign and convey directly (to the insurance company listed below) benefits and/or insurance reimbursement, if any, otherwise payable to me for services rendered from such doctor and clinic.I understand that I am financially responsible for all charges regardless of any applicable insurance or benefit payments.

I hereby authorize the doctor to release all medical information necessary to process this claim. I hereby authorize any plan administrator or fiduciary, insurer and my attorney to release to such doctor and clinic any and all plan documents, insurance policy and/or settlement information upon written request from such doctor and clinic in order to claim such medical benefits, reimbursement or any applicable remedies. I authorize the use of this signature on all my insurance and/or employee health benefits claim submissions.

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I hereby convey to the above named provider to the full extent permissible under the law and under the any applicable insurance policies and/or employee health care plan any claim, chose in action, or other right I may have to such insurance and/or employee health care benefits coverage under any applicable insurance policies and/or employee health care plan with respect to medical expenses incurred as a result of the medical services I received from the above named doctor and clinic and to the extent permissible under the law to claim such medical benefits, insurance reimbursement and any applicable remedies. Further, in response to any reasonable request for cooperation, I agree to cooperate with such doctor in any attempts by such doctor and clinic to pursue such claim, chose in action or right against my insurers and/or employee health care plan, including, if necessary, bring suit with such doctor and clinic against such insurers and/or employee health care plan in my name but at such doctor’s expenses.

This lifetime assignment will remain in effect until revoked by me in writing. A photocopy of this assignment is to be considered as valid as the original. I have read and fully understand this agreement.

Dear Valued Patient,

We are committed to being transparent with our patients and are writing to share important information about the ownership of our practice and related facilities.

Ownership of Our Clinics and Facilities
Our neurosurgical services are provided through Schell Spinal, which operates multiple clinic locations in Michigan, including:

• Schell Spinal – Saginaw Clinic (3160 Cabaret Trail S, Saginaw, MI 48603)
• Schell Spinal – Flint Clinic (2300 Austins Pkwy, Flint, MI 48507)
• Schell Spinal – Tawas Clinic (200 Hemlock Rd, Tawas City, MI 48763)
• Schell Spinal – Alpena Clinic (2079 US Hwy 23 South, Alpena, MI 49707)
• Schell Spinal – Bay City Clinic (200 South Wenona Dr, Bay City, MI 48706)
• In addition, surgical services may be provided at the Flint Region ASC (2300 Austins Pkwy, Flint, MI 48507).

All of these facilities are owned and operated by Dr. Gerald R. Schell, MD, Medical Director and Neurosurgeon.

Why This Matters to You
This disclosure is made in compliance with federal and state requirements. It is important for you to know that Dr. Schell holds ownership in the facilities where you may receive treatment. You always have the right to choose where you receive care, and your decision will not affect the quality of your treatment or your relationship with our physicians.

Our Commitment to You
Regardless of ownership, our mission remains unchanged:

• To provide safe, high-quality, patient-centered neurosurgical care.
• To maintain the highest ethical and professional standards.
• To ensure that your health, privacy, and well-being are our top priorities.

If you have any questions about this ownership disclosure or would like more information about your options for care, please contact us at 989-799-8712.

Thank you for trusting us with your care.

Sincerely,
Gerald R. Schell, MD
Medical Director & Owner
Schell Spinal and Flint Region ASC