Notice of HIPAA Privacy Practices​

Notice of Privacy Practices

Effective Date: November 1, 2020
Privacy Official: Kara Dobelis
Email: info@integrativemediowa.com

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and our responsibilities.

You have the right to:

• Get a copy of your paper or electronic medical record

• Correct your paper or electronic medical record

• Request confidential communication

• Ask us to limit the information we share

• Get a list of those with whom we’ve shared your information

• Get a copy of this privacy notice

• Choose someone to act for you

• File a complaint if you believe your privacy rights have been violated

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
We’ll provide a copy or summary within 30 days of your request and may charge a reasonable, cost-based fee.

Ask us to correct your medical record

You can ask us to correct health information you think is incorrect or incomplete.
We may deny your request, but we’ll explain why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or send mail to a different address.
We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or operations.
We may say “no” if it would affect your care.
If you pay for a service out-of-pocket in full, you can ask us not to share that information with your insurer.

Get a list of those with whom we’ve shared information

You can ask for an accounting of disclosures for the past six years.
We’ll include all disclosures except those related to treatment, payment, and healthcare operations.

Get a copy of this notice

You can request a paper copy of this notice at any time, even if you’ve agreed to receive it electronically.

Choose someone to act for you

If you’ve given someone medical power of attorney or they’re your legal guardian, they can exercise your rights and make choices about your information.

File a complaint

If you feel we’ve violated your rights, you can:

• Contact us using the information above

• File a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights:

  • 200 Independence Avenue, S.W., Washington, D.C. 20201

  • 1-877-696-6775

  • www.hhs.gov/ocr/privacy/hipaa/complaints/
    We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share.

You have the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care

• Share information in a disaster relief situation

• Include your information in a hospital directory

If you’re unable to tell us your preference (e.g., if unconscious), we may share your information if we believe it’s in your best interest or to reduce a serious health or safety threat.

We never share your information unless you give us written permission for:

• Marketing purposes

• Sale of your information

• Most sharing of psychotherapy notes

Fundraising

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

We typically use or share your health information to:

Treat you

We can use and share your information with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We use and share your health information to run our practice, improve care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.

Bill for your services

We use and share your information to bill and get payment from health plans or other entities.
Example: We give information to your health insurance plan so it can pay for your services.

Other Permitted Uses and Disclosures

We are allowed or required to share your information in other ways — usually for public good, such as health and safety, research, or law enforcement.

Public health and safety issues

We may share information for:

• Preventing disease

• Product recalls

• Reporting adverse reactions

• Reporting abuse, neglect, or domestic violence

• Preventing or reducing a serious health or safety threat

Research

We can use or share your information for health research.

Comply with the law

We will share information if required by state or federal law, including with the Department of Health and Human Services.

Organ and tissue donation

We can share information with organ procurement organizations.

Medical examiners or funeral directors

We can share information to assist after death.

Workers’ compensation, law enforcement, and other government requests

We may share information for:

• Workers’ compensation claims

• Law enforcement purposes

• Health oversight activities

• Special government functions (military, national security, presidential protection)

Lawsuits and legal actions

We may share information in response to a court or administrative order, or subpoena.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.

• We will notify you promptly if a breach occurs that may compromise your information.

• We must follow the duties and privacy practices described here.

• We will not use or share your information other than as described unless you give written permission. You may revoke permission at any time in writing.

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

Changes to This Notice

We may change the terms of this notice at any time. The new notice will apply to all information we have about you.
The updated notice will be available upon request, in our office, and on our website.