HIPAA / Notice of Privacy PracticesLyn Lake Chiropractic Clinic
Effective Date of Notice: 02/01/2022
HIPAA / NOTICE of PRIVACY PRACTICES
Our Responsibilities. Your Information. Your Rights.
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.
WE ARE REQUIRED BY LAW TO PROTECT MEDICAL INFORMATION ABOUT YOU
We are required by law to protect the privacy of medical information about you and that identifies you. This medical information may be information about health care we provide to you or payment for health care provided to you. It may also be information about your past, present, or future medical condition.
We are also required by law to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices with respect to medical information. We are required by law to notify you following a breach of unsecured protected health information. We are legally required to follow the terms of this Notice. In other words, we are only allowed to use and disclose medical information in the manner that we have described in this Notice.
We may change the terms of this Notice in the future. We reserve the right to make changes and to make the new Notice effective for all medical information that we maintain. If we make changes to the Notice, we will:
- Post the new Notice in our waiting area.
- Have copies of the new Notice available upon request (you may always contact our Privacy Officer at this Clinic’s main phone number to obtain a copy of the current Notice).
- Discuss how we may use and disclose medical information about you.
- Explain your rights with respect to medical information about you.
- Describe how and where you may file a privacy-related complaint.
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU IN SEVERAL CIRCUMSTANCES
We use and disclose medical information about patients every day. This section of our Notice explains in some detail how we may use and disclose medical information about you to provide health care, obtain payment for that health care, and operate our business efficiently. This section then briefly mentions several other circumstances in which we may use or disclose medical information about you.
For more information about any of these uses or disclosures, or about any of our privacy policies, procedures, or practices, contact our Privacy Officer at this Clinic’s main phone number.
YOUR RIGHTS: When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
- Get a copy of your paper or electronic medical record o You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
- Ask us to Correct your medical record o You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
- Request confidential communication o You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
- Ask us to limit the information we share o You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
- Get a list of those with whom we’ve shared your information o You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
- Get a copy of this privacy notice o You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
- Choose someone to act for you o If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
- File a complaint if you believe your privacy rights have been violated o You can complain if you feel we have violated your rights by contacting us using the information on page 1.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
- Tell family, close friends, or others involved in your care and about your condition
- Share information in a disaster relief situation
- Include your information in a hospital directory
YOUR CHOICES: For certain health information, you have some choices in the way we use and share information and you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to: HIPAA / Notice of Privacy Practices
- Provide mental health care / psychotherapy notes
- Market our services and sell your information
- We may contact you for fund raising efforts, but you can tell us not to contact you again.
- We can use your health information and share it with other professionals who are treating you. Communications of case management or care coordination for the treatment of the individual. This includes directed or recommended alternative treatments, therapies, health care providers, or care settings to the individual.
- We can use and share your health information to run our practice, improve your care, and contact you when necessary. Communications about participating providers in a provider or health plan network, placement of or enhancements to a health plan, and health related products of services available only to a health plans enrollees that add value to, but are not part of, the benefit plan.
- We can use and share your health information to bill and get payment from health plans or other entities. Communications about participating providers in a provider or health plan network, placement of or enhancements to a health plan, and health related products of services available only to a health plans enrollees that add value to, but are not part of, the benefit plan.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
In the case of fundraising:
OUR USES AND DISCLOSURES: How do we typically use or share your health information? We typically use or share your health information I the following ways.
Example: A doctor treating you for an injury asks another doctor about your overall health condition
Run our organization
Example: We use health information about you to manage your treatment and services.
Bill for your services
Example: We give information about you to your health insurance plan so it will pay for your services. HIPAA / Notice of Privacy Practices
HOW ELSE CAN WE USE OR SHARE YOUR HEALTH INFORMATION?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
- We can share health information about you for certain situations such as: o Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
- We can use or share your information for health research
- We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with the federal privacy law
- We can share health information about you with the organ procurement organizations.
- We can share health information with the coroner, medical examiner, or funeral director when an individual dies.
- We can use or share health information about you: o For workers compensation claims
- for law enforcement purposes or with a law enforcement official
- with health oversight agencies for activities authorized by law
- for special government functions such as military, national security, and presidential Protective Services
- we can share health information about you in response to a court or administrative order, or in response to a subpoena.
Or you can always. . . .
Call for an Appointment:
|Monday|| 8:30 am - 1:00 pm
2:30 pm - 6:00 pm
|Tuesday||2:00 pm - 6:00 pm|
|Wednesday||8:30 am - 1:00 pm
2:30 pm - 6:00 pm
|Thursday||2:00 pm - 6:00 pm|
|Friday||8:00 am - 1:00 pm|