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HIPAA Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

 

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.

 

Gorski Chiropractic Center is committed to protecting the privacy and security of your health information.

This Notice of Privacy Practices (“Notice”) describes how we may use and disclose your Protected Health Information (“PHI”), explains your rights regarding your health information, and describes our legal responsibilities under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and other applicable laws.

 

Your Rights

You have certain rights regarding your health information.

 

Get an Electronic or Paper Copy of Your Medical Record

You may ask to see or obtain an electronic or paper copy of your medical record and other health information we maintain about you.

We will provide a copy or summary of your health information as required by applicable law. We may charge a reasonable, cost-based fee when permitted by law.

Contact our office to learn how to request your records.

 

Ask Us to Correct Your Medical Record

If you believe health information we maintain about you is incorrect or incomplete, you may ask us to correct it.

We may deny your request under certain circumstances. If we deny your request, we will provide an explanation as required by law.

 

Request Confidential Communications

You may ask us to contact you in a particular way or at a particular location.

For example, you may ask us to contact you only on your mobile phone, at your office, or through another reasonable method.

We will accommodate reasonable requests as required by law.

 

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations.

We are generally not required to agree to all requested restrictions.

However, if you pay for a healthcare service or item completely out-of-pocket, you may ask us not to disclose information about that service to your health plan for payment or healthcare operations purposes. We will comply with the request when required by law unless disclosure is otherwise required by law.

 

Get a List of Certain Disclosures

You may request an accounting of certain disclosures of your health information.

The accounting generally covers certain disclosures made during the six years before the date of your request.

Certain disclosures, including many disclosures made for treatment, payment, and healthcare operations, may not be included.

We will provide one accounting within a 12-month period without charge. We may charge a reasonable, cost-based fee for additional requests when permitted by law.

 

Get a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive the Notice electronically.

A current copy is also available on our website.

 

Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian or otherwise legally authorized to act for you, that person may exercise your rights and make decisions regarding your health information.

We may verify that the individual has appropriate legal authority before taking action.

 

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint directly with Gorski Chiropractic Center by contacting our Privacy Officer.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

We will not retaliate against you for filing a complaint.

 

Your Choices

For certain health information, you may tell us your preferences regarding what we share.

 

Family Members and Others Involved in Your Care

You may tell us whether we may share relevant information with family members, friends, caregivers, or other individuals involved in your care or payment for your care.

If you are unable to communicate your preference, such as during an emergency, we may share information when we believe disclosure is in your best interest and is permitted by law.

 

Disaster Relief

We may share information with organizations assisting with disaster relief when permitted by law and appropriate under the circumstances.

 

Marketing

We will obtain your written authorization before using or disclosing your PHI for marketing purposes when HIPAA requires authorization.

 

Sale of Health Information

We will not sell your PHI without authorization when authorization is required by law.

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance upon it.

 

How We May Use and Disclose Your Health Information

HIPAA permits us to use and disclose your PHI for certain purposes without obtaining your written authorization.

 

Treatment

We may use and disclose your health information to provide, coordinate, or manage your healthcare.

For example, we may share relevant health information with another healthcare provider, physician, physical therapist, diagnostic imaging provider, or specialist involved in your treatment.

 

Payment

We may use and disclose your health information to bill and receive payment for healthcare services provided to you.

For example, we may provide necessary information to your health insurance company to obtain payment or determine coverage for services.

 

Healthcare Operations

We may use and disclose your health information to operate our practice and improve the quality of care we provide.

Examples may include:

  • Quality assessment and improvement
  • Staff training
  • Business management
  • Compliance activities
  • Auditing
  • Credentialing
  • Customer service
  • Legal and professional services

 

Business Associates

We may disclose health information to companies or individuals that perform services on our behalf when those services involve PHI.

When required by HIPAA, these Business Associates must enter into agreements requiring them to appropriately safeguard PHI.

 

Appointment Reminders

We may use your health information to contact you regarding appointments, appointment changes, follow-up care, or other healthcare-related communications.

 

Treatment Alternatives and Health-Related Services

We may contact you regarding treatment alternatives or other health-related services that may be relevant to your care when permitted by law.

 

Required by Law

We may disclose health information when federal, state, or local law requires us to do so.

 

Public Health and Safety

We may disclose health information for certain public health and safety activities permitted or required by law, including:

  • Preventing or controlling disease
  • Reporting certain injuries or conditions
  • Reporting suspected abuse, neglect, or domestic violence when authorized or required by law
  • Preventing or reducing a serious threat to health or safety

 

Health Oversight Activities

We may disclose health information to authorized health oversight agencies for activities such as audits, investigations, inspections, licensing, and other activities authorized by law.

 

Workers’ Compensation

We may disclose health information as authorized or required for workers’ compensation claims or similar programs.

 

Law Enforcement

We may disclose health information to law enforcement officials when permitted or required by applicable law.

 

Judicial and Administrative Proceedings

We may disclose health information in response to a valid court order, administrative order, subpoena, discovery request, or other lawful process when HIPAA and other applicable requirements are satisfied.

 

Coroners, Medical Examiners, and Funeral Directors

We may disclose health information to coroners, medical examiners, or funeral directors when permitted or required by law.

 

Government Functions

Under certain circumstances, we may disclose health information for specialized government functions as permitted by law.

 

Uses and Disclosures Requiring Authorization

For uses and disclosures not otherwise permitted or required by law, we will obtain your written authorization.

You may revoke an authorization in writing at any time. Revocation will not affect actions we already took based upon a valid authorization before receiving the revocation.

Certain uses and disclosures, including some marketing activities, sale of PHI, and other uses specifically identified by HIPAA, require authorization.

 

Reproductive Health Information

We will handle requests involving reproductive healthcare information in accordance with applicable federal and state privacy requirements.

Where applicable law requires additional safeguards, representations, attestations, authorizations, or restrictions before health information may be used or disclosed, we will follow those requirements.

 

Substance Use Disorder Records

Certain records concerning substance use disorder treatment may receive additional privacy protections under federal law, including 42 CFR Part 2.

When such protections apply to information maintained by or disclosed to Gorski Chiropractic Center, we will use and disclose that information only as permitted by applicable law.

 

Our Responsibilities

Gorski Chiropractic Center is required by law to:

  • Maintain the privacy and security of your Protected Health Information.
  • Provide you with this Notice describing our legal duties and privacy practices.
  • Follow the terms of the Notice currently in effect.
  • Notify affected individuals as required by law if a breach occurs that may have compromised the privacy or security of their information.
  • Use and disclose only the health information permitted by law.
  • Respect your rights concerning your health information.

We will not use or disclose your information for purposes other than those described in this Notice unless you authorize us in writing or another use or disclosure is permitted or required by law.

 

Electronic Communications and Website Information

Gorski Chiropractic Center may use electronic systems to communicate with patients, schedule appointments, maintain records, process payments, or perform other healthcare activities.

When electronic Protected Health Information is created, received, maintained, or transmitted by us or our Business Associates, appropriate safeguards will be used as required by applicable law.

Patients should avoid sending sensitive medical information through ordinary, unsecured email or general website contact forms unless instructed by our office to use that communication method.

 

Changes to This Notice

We reserve the right to change this Notice and our privacy practices.

Changes may apply to health information we already maintain as well as information we receive in the future.

When material changes are made, the updated Notice will be available:

  • At our office upon request
  • On our website
  • In other locations or formats required by applicable law

 

 

Questions or Complaints

If you have questions about this Notice, wish to exercise your privacy rights, or believe your privacy rights have been violated, contact us here

You may also submit a complaint to the:

U.S. Department of Health and Human Services Office for Civil Rights

Information about filing a HIPAA complaint is available through the U.S. Department of Health and Human Services.

Gorski Chiropractic Center will not retaliate against you for exercising your privacy rights or filing a complaint.