Notice of Privacy Practices
This notice describes how your protected health information may be used and disclosed and how you can get access to this information. Please review it carefully. If you have any questions about this Notice please contact us.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices.
Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your practitioners, office staff and others outside of our office involved in your care and treatment for the purpose of providing health care services to you. Examples cited below further explain the use and disclosure process.
Treatment: Use and disclosure of your protected health information may be provided to other healthcare practitioners to provide, coordinate or manage your health care. However, this information will not be provided without your consent.
Payment: Your protected health information will be used, as needed, to obtain payment for your health care services
Healthcare and Business Operations: We may use and disclose your health information in connection with our healthcare and business operations. These operations include, but are not limited to, quality assessment and improvement activities, evaluating practitioner performance, marketing activities, and conducting or arranging for other business activities. For example, we may call you by name in the waiting room when your practitioner is ready to see you. We may use or disclose your protected health information, as necessary, to contact you with appointment reminders (such as voicemails, e-mails or letters). We may use or disclose your protected health information, as necessary, to provide you with information about treatments and services that may be of interest to you. We may also use and disclose your protected health information for other marketing activities. For example, your name and address may be used to send you a newsletter about our practice and the services we offer. You may contact us to request that these materials not be sent to you.
Uses and Disclosures of Protected Health Information with Your Written Authorization
At any time, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.
Other Permitted and Required Uses and Disclosures
Person Involved in Care: In order to accommodate the notification of your location, your general condition, or death, your protected health information maybe used or disclosed to a family member, your personal representative, or another person responsible for your care. If you are present and wish to object to such disclosures of your protected health information, you may do so. To the extent you are incapacitated or emergency circumstances exist, we will disclose protected health information using our professional judgment disclosing only protected health information that is directly relevant to the person’s involvement in your healthcare. We will use our professional judgment and our experience with common practices to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, or other similar forms of protected health information.
Required by Law: We may disclose protected health information when law requires it.
Public Health: We may disclose protected health information for public health purposes to an authority permitted by law to collect or receive the information. The disclosure will be made for this purpose of controlling disease, injury or disability.
Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Abuse or Neglect: We may disclose protected health information to a public health authority authorized by law to receive reports of child abuse or neglect. We may disclose your information to the governmental entity authorized to receive such information if we believe you have been a victim of abuse, neglect or domestic violence. The disclosure will be made consistent with requirements of applicable federal and state laws.
National Security: We may disclose health information to military authorities, federal officials, or other law enforcement officials authorized to receive such information for national security and other necessary activities.
Food and Drug Administration: We may disclose protected health information as required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance.
Legal Proceedings and Law Enforcement: We may disclose protected health information in response to a court order or administrative tribunal if such disclosure is expressly authorized. We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe the use or disclosure is necessary to prevent or lessen a serious and imminent threat to a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.
Access: You have the right to review your protected health information, with limited exceptions. Your request to obtain access to your information must be in writing, and upon your request, we will provide your information. We may need to charge you a reasonable cost-based fee for expenses including copies and staff time.
Restrictions: You may request that we apply additional restrictions to any disclosure of your healthcare information. We are not required to respond to the application of these additional restrictions. If we agree to follow your request regarding additional restrictions, we will follow the agreed restrictions unless an emergency situation dictates otherwise.
Alternative Communications: We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other methods of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to your healthcare provider.
Amending your protected health information: You can initiate a written request to amend your protected health information. Included in the amendment must be an explanation as to why information should be amended. Certain conditions may exist where we may reject your request.
Disclosures Accounting: Your rights include the choice to receive a review of our disclosures of your protected health information for reasons other than treatment, payment, healthcare information and certain other activities. Additional reasonable cost based fees may be extended if your requests for such information are more than one time per year.
Questions and Complaints
If you want more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may submit a complaint or request to us using the contact information listed above. You also may submit a written complaint to the Secretary of Health and Human Services. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
You will be asked to sign a form acknowledging that you have been provided an opportunity to view these privacy practices of East West Natural Health, LLC and Terrain Medicine, LLC.