Privacy policy
NOTICE OF PRIVACY PRACTICES Effective November 2022 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO SUCH INFORMATION. PLEASE REVIEW IT CAREFULLY. We understand are committed to ensuring your privacy and maintaining the confidentiality of your medical information. We make a record of all medical care we provide and may receive similar records from others. We use these records to provide or enable other health care providers to provide quality medical care and to enable us to meet our professional and legal obligations to operate our medical clinic. We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following any unauthorize release of protected health information. This notice describes how we use and disclose your medical information as well as your rights and our legal obligations with respect to your medical information. TABLE OF CONTENTS A. How This Medical Clinic May Use or Disclose Your Health Information B. When This Medical Clinic May Not Use or Disclose Your Health Information C. Your Health Information Rights
1. Right to Request Special Privacy Protections
2. Right to Request Confidential Communications
3. Right to Inspect and Copy
4. Right to Amend or Supplement
5. Right to an Accounting of Disclosures
6. Right to a Paper or Electronic Copy of this Notice D. Changes to this
Notice of Privacy Practices E. Complaints A. How This Medical Clinic May Use or Disclose Your Health Information Our clinic collects health information about you and stores it electronically. This information is your medical record, and while it is the property of this clinic, the information in these records belongs to you. The law permits us to use or disclose your health information for the following purposes:
1. Treatment. We use your medical information to provide you medical care. We disclose medical information to our staff and others who are involved in providing your care. For example, we may share your medical information with other physicians or other health care providers who will provide services that we do not provide. We may also share this information with a laboratory that performs a test for you.
2. Payment. We use medical information about you to obtain payment for the services we provide. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to you.
3. Health Care Operations. We may use and disclose medical information about you to operate our medical clinic. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this information to get your health plan to authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may also share your medical information with our “business associates,” such as our billing service, that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your protected health information. We may also share your information with other health care providers, health care clearinghouses or health plans that have a relationship with you, when they request this information to help them with their quality assessment and improvement activities, their patient-safety activities, their population-based efforts to improve health or reduce health care costs, their protocol development, case management or care-coordination activities, their review of competence, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, or their health care fraud and abuse detection and compliance efforts. We may also share medical information about you with the other health care providers, health care clearinghouses and health plans that participate with us in “organized health care arrangements” (OHCAs) for any of the OHCAs’ health care operations. OHCAs include hospitals, physician organizations, health plans, and other entities which collectively provide health care services. A listing of the OHCAs we participate in is available from the Privacy Official.
4. Sign In Sheet. We may use and disclose medical information about you by having you sign in when you arrive at our office. We may also call out your name when we are ready to see you.
5. Notification and Communication with Family. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or, unless you had instructed us otherwise, in the event of your death. In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts. We may also disclose information to someone who is involved with your care or helps pay for your care. If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures, although we may disclose this information in a disaster even over your objection if we believe it is necessary to respond to the emergency circumstances. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
6. Marketing. Provided we do not receive any payment for making these communications, we may contact you to give you information about products or services related to your treatment or care coordination, or to direct or recommend other treatments, therapies, health care providers or settings of care that may be of interest to you. We may also encourage you to maintain a healthy lifestyle and get recommended tests, participate in a disease management program, provide you with small gifts, tell you about government sponsored health programs or encourage you to purchase a product or service when we see you, for which we may be paid. We may receive compensation which covers our cost of communicating with you about a drug or biologic that is currently prescribed for you. We will not otherwise use or disclose your medical information for marketing purposes or accept any payment for other marketing communications without your prior written authorization, and we will stop any future marketing activity to the extent you revoke that authorization.
7. Sale of Health Information. We will not sell your health information without your prior written authorization. The authorization will disclose that we will receive compensation for your health information if you authorize us to sell it, and we will stop any future sales of your information to the extent that you revoke that authorization.
8. Workers’ Compensation. We may disclose your health information as necessary to comply with workers’ compensation laws. For example, to the extent your care is covered by workers’ compensation, we will make periodic reports to your employer or workers compensation insurer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or workers’ compensation insurer.
9. Change of Ownership. In the event that this medical clinic is sold or merged with another organization, your health information/record will become the property of the new owner, though you will maintain the right to request that copies of your health information be transferred to another medical group.
10. Breach Disclosure. In the case of a breach of unsecured protected health information, we will notify you as required by law. If you have provided us with a current e-mail address, we may use that e-mail address to contact you. We may also provide notification by other appropriate methods.
11. Legal Requirements. As required by law, we will use and disclose your health information, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.
12. Public Health. We may, and are sometimes required by law, to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.
13. Health Oversight Activities. We may, and are sometimes required by law, to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by law.
14. Judicial and Administrative Proceedings. We may, and are sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.
15. Law Enforcement. We may, and are sometimes required by law to, disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order, warrant, grand jury subpoena and other law enforcement purposes.
16. Coroners. We may, and are often required by law, to disclose your health information to coroners in connection with their investigations of deaths.
17. Public Safety. We may, and are sometimes required by law, to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public. B. When This Clinic May Not Use or Disclose Your Health Information. Except as described in this Notice of Privacy Practices, this medical clinic will, consistent with its legal obligations, not use or disclose health information which identifies you without your written authorization. If you do authorize this clinic to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time. C. Your Health Information Rights
1. Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information by a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed. If you tell us not to disclose information to a commercial health plan concerning health care items or services for which you paid for in full out-of-pocket, we will abide by your request, unless we must disclose the information for treatment or legal reasons. We reserve the right to accept or reject any other request and will notify you of our decision.
2. Right to Request Confidential Communications. You have the right to request that you receive your health information in a specific way or at a specific location. For example, you may ask that we send information to a particular e-mail account or to your work address. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
3. Right to Inspect and Copy. You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request detailing what information you want access to, whether you want to inspect it and/or receive a copy, and if you want a copy, your preferred form and format. We will provide copies in your requested form and format if it is readily producible, or we will provide you with an alternative format you find acceptable, or if we can’t agree and we maintain the record in an electronic format, your choice of a readable electronic or hardcopy format. We will also send a copy to any other person you designate in writing. We will charge a reasonable fee which covers our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an explanation or summary. We may deny your request under limited circumstances. If we deny your request to access your child’s records or the records of an incapacitated adult you are representing because we believe allowing access would be reasonably likely to cause substantial harm to the patient, you will have a right to appeal our decision.
4. Right to Amend or Supplement. You have a right to request that we amend any part of your health information that you believe is incorrect or incomplete. Any such request must be made in writing and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information as you instruct us, and should we determine your changes are not appropriate and accurate, we will provide you with the reasons for our denial and how you can disagree with that denial. We may deny your request if we do not have the information, if we did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is. If we deny your request, you may submit a written statement of your disagreement with that decision, and we may, in turn, prepare a written rebuttal. All information related to any request to amend will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.
5. Right to an Accounting of Disclosures. You have a right to receive an accounting of disclosures of your health information made by this clinic with the following exceptions where we do not have to account for the disclosures provided to you or pursuant to your written authorization, or as described in this notice in (i) the paragraphs addressing Treatment, Payment, Health Care Operations, Notification and Communication with Family and Public Health, all within Section A of this Notice of Privacy Practices, (ii) disclosures for purposes of research or public health which exclude direct patient identifiers, (iii) which are incident to a use or disclosure otherwise permitted or authorized by law or (iv) the disclosures to a health oversight agency or law enforcement official to the extent this clinic has received notice from such agency or official that providing this accounting would be reasonably likely to impede their activities.
6. Right to a Paper or Electronic Copy of this Notice. You have a right to receive a notice of our legal duties and privacy practices with respect to your health information, including a right to a paper copy or electronic copy of this Notice of Privacy Practices, even if you have previously requested its receipt by e-mail. D. Changes to this Notice of Privacy Practices We reserve the right to amend this Notice of Privacy Practices at any time in accordance with applicable law. Until such amendment is made, we are required by law to comply with the terms of this Notice as they currently exist. After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received. We will keep a copy of the current notice and it will be available to you at each appointment. We will also post the current notice on our website. E. Complaints Complaints about this Notice of Privacy Practices or how this clinic handles your health information may be directed to Dr. Carissa Abe, D.C. or James Van Doren, our principal manager. Both can be reached through the clinic’s primary phone number (602-975-0529) or by email at info@peakInjuryandwellness.com. If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to: OCRMail@hhs.gov The form for such requests may be found at: www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf. You may not be penalized in any way for filing a complaint.