Your Information. Your Rights. Our Responsibilities and Commitment.

We are committed to the privacy and protection of your health information.

This Notice of Privacy Practices outlines how we may utilize and disclose your protected health information (PHI) for the purpose of conducting treatment, processing payments, engaging in healthcare operations, and for other activities permitted or mandated by law. It also delineates your entitlements to access and manage your PHI. ‘Protected health information’ refers to data about you, including demographic details, which may identify you, and pertains to your current, past, or future physical or mental health, as well as associated healthcare services.

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. You may request a revised version by accessing our website, or by contacting the office and requesting that a revised copy be sent to you in the mail, or by simply asking for one at the time of your next appointment.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION

The following examples describe ways that we may use your protected health information for your treatment, payments, healthcare operations etc. but please be advised that not every use or disclosure in a particular category will be listed.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services.  This includes disclosing your protected health information to other medical providers, trainees, therapists, medical staff, pharmacies, laborites, and office staff that are involved in your health care. For example, your protected health information may be provided to a physician in whom you have been referred to ensure that the physician has necessary information to diagnose and/or treat you.

Payment: Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services provided by us or by another provider. We may utilize your protected health information to secure payment from an insurance company or another third-party entity. This could involve furnishing the necessary details to an insurance company for pre-authorization of a prescribed medication.

Health Care Operations: We may use or disclose your protected health information in order to operate this medical practice. These activities include training students, reviewing cases with employees, utilizing your information to improve quality of care, and contacting you via telephone, email, or text to remind you of your appointments. If we have to share your protected health information with third party “business associates” such as a billing service, we will have a written contract that contains terms that will protect the privacy of your protected health information. We may also use and disclose your protected health information for marketing activities. For example, we might send you a thank you card in the mail with a coupon for specialized services or products. We may also send you information about products or services that might be of interest to you. You can contact us at any point to stop receiving this information. We will not use or disclose your protected health information for any purpose other than those identified in this policy without your specific, written Authorization. You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. You can revoke this authorization at any time however it will not affect the protected health information that was shared while the authorization was in effect.

Appointment reminders: You may receive notifications via text, phone, or email to serve as a friendly reminder of your upcoming appointments, be it for your initial consultation, follow-up visit, or scheduled lab work.

Others Involved in Your Health Care: With your verbal consent, or if we provide you an opportunity to object and you do not raise any concerns, we may share protected health information about you with your family members or friends. For instance, if your spouse or friend is present during your evaluation, we may assume it is appropriate to share relevant professional information with them. In cases where you are unable to express agreement or objection, we may exercise our professional judgment to disclose such information if we believe it to be in your best interest, particularly in urgent or emergent situations.

Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.

Public Health Risks: We may disclose your protected health information, if necessary, in order to prevent or control disease, report adverse events from medications or products, prevent injury, disability or death. This information may be disclosed to healthcare systems, government agencies, or public health authorities. We may have to disclose your protected health information to the Food and Drug Administration to report adverse events, defects, problems, enable recalls etc. if required by FDA regulation.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities including, to report adverse events, product defects or problems, biologic product deviations, to track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Health Oversight Activities: We may disclose protected health information to health oversight agencies for audits, investigations, inspections or licensing purposes. These disclosures might be necessary for state and federal agencies to monitor healthcare systems and compliance with civil law.

Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal, state, and local laws.

Workers’ Compensation: We may disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally-established programs.

Required by Law: We may use or disclose your protected health information when required to do so by federal, state and/or local law.

Lawsuits: We may disclose your protected health information in response to a court action, administrative action or a subpoena.

Law Enforcement: We may release protected health information to a law enforcement official in response to a court order, subpoena, warrant, subject to all applicable legal requirements.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of 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.

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

Access to Medical Records: You possess the entitlement to access and obtain copies of your protected health information, which we utilize in making decisions about your care, so long as we maintain the protected health information. To initiate this process, kindly contact Peak Medical Wellness at info@peakwellnesspa.com. Please be aware that a nominal fee may be applicable to cover the time and resources required for obtaining, copying, and providing you with this information. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and laboratory results that are subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed.

Amendment: Should you believe that the protected health information we hold about you is inaccurate or incomplete, you have the right to request its amendment. To proceed, kindly submit a written request outlining the reasons for the proposed amendment. Please note that if a written request and a valid reason for amendment are not provided, we may regrettably have to decline your request. In the event of a denial, you will receive a detailed written explanation. We reserve the right to refuse a request if we determine that the protected health information is accurate and comprehensive.

Accounting of Disclosures: You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, for a facility directory, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement (as provided in the privacy rule) or correctional facilities, as part of a limited data set disclosure. You have the right to receive specific information regarding these disclosures that occur after April 14, 2003. The right to receive this information is subject to certain exceptions, restrictions and limitations. You must submit a written request to obtain this “accounting of disclosures” to the individual listed at the bottom of this policy. After your request has been approved, we will provide you the dates of the disclosure, the name of the individual or entity we disclosed the information to, a description of the information that was disclosed, the reason why it was disclosed, and any additional pertinent information. We reserve the right to charge a reasonable fee for this process.

Restriction Requests: You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment, or healthcare operations. We shall accommodate your request except where the disclosure is required by law. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Your provider is not required to agree to a restriction that you may request. If your provider does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with your physician.

Confidential Communication: You have the right to request that we communicate with you about healthcare matters via alternative means or alternative locations. We are committed to accommodating reasonable requests that also enable us to maintain necessary billing and payment processes.

Paper copy of this notice: You may request a hard copy of this privacy policy even if you reviewed and signed it via electronic means. See instructions at the end of this privacy policy.

Complaints: If you believe your privacy rights have been violated, you may file a complaint with our office. You also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.

Who can I contact with any questions concerning this Privacy Policy? info@peakwellnesspa.com

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.**