Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Your Rights
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
Your Choices
You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Include you in a hospital directory
- Provide mental health care
- Market our services and sell your information
- Raise funds
Our Uses and Disclosures
We may use and share your information as we:
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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 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. 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
- 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 communications
- 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 what we use or share
- 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 information
- 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
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
- 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 feel your rights are violated
- 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.
Your Choices
For certain health information, 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:
- 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 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:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising:
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
We can use your health information and share it 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 can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services .
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 have to 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:
- 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
Do research
We can use or share your information for health research.
Comply with the law
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 federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- 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
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
- 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.
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.
Other Instructions for Notice
- Effective February 27, 2014
- For further information, please contact our Privacy Officer at Meridian Acupuncture & Wellness
- Phone: 503-692-9680
- Fax: 503-670-4954
- We never market or sell personal information
Notice of Privacy Practices
Esta notificación describe cómo puede utilizarse y divulgarse su información médica, y cómo puede acceder usted a esta información. Revísela con cuidado.
Sus derechos
Usted cuenta con los siguientes derechos:
Obtener una copia de su historial médico en papel o en formato electrónico. Corregir en papel o en formato electrónico su historial médico. Solicitar comunicación confidencial. Pedirnos que limitemos la información que compartimos. Recibir una lista de aquellos con quienes hemos compartido su información. Obtener una copia de esta notificación de privacidad. Elegir a alguien que actúe en su nombre. Presentar una queja si considera que se violaron sus derechos de privacidad.
Para mayor información, visite: http://www.hhs.gov/civil-rights/filing-a-complaint/complaint-process/spanish/, disponible en español.
Cambios a los términos de esta notificación
Podemos modificar los términos de esta notificación, y los cambios se aplicarán a toda la información que tenemos sobre usted. La nueva notificación estará disponible según se solicite, en nuestro oficina, y en nuestro sitio web.
Other Instructions for Notice
Nuestras responsabilidades
Responder a demandas y acciones legales
Tratar la compensación de trabajadores, el cumplimiento de la ley y otras solicitudes gubernamentales
Trabajar con un médico forense o director funerario
Responder a las solicitudes de donación de órganos y tejidos
Cumplir con la ley
Realizar investigaciones médicas
Ejemplo: Entregamos información acerca de usted a su plan de seguro médico para que éste pague por sus servicios.
¿De qué otra manera podemos utilizar o compartir su información médica? Se nos
permite o exige compartir su información de otras maneras (por lo general, de maneras
que contribuyan al bien público, como la salud pública e investigaciones médicas).
Tenemos que reunir muchas condiciones legales antes de poder compartir su información con dichos propósitos. Para más información, visite: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/factsheets_spanish.html, disponible en español.
Ayudar con asuntos de salud pública y seguridad
Ejemplo: Utilizamos información médica sobre usted para administrar su tratamiento y servicios.
Facturar por sus servicios
Ejemplo: Un médico que lo está tratando por una lesión le consulta a otro doctor sobre su estado de salud general.
Dirigir nuestra organización
Tratamiento
Nuestros usos y divulgaciones
Por lo general, ¿cómo utilizamos o compartimos su información médica? Por lo general, utilizamos o compartimos su información médica de las siguientes maneras.
En el caso de recaudación de fondos:
Si no puede decirnos su preferencia, por ejemplo, si se encuentra inconsciente, podemos seguir adelante y compartir su información si creemos que es para beneficio propio. También podemos compartir su información cuando sea necesario para reducir una amenaza grave e inminente a la salud o seguridad.
En estos casos, nunca compartiremos su información a menos que nos entregue un permiso por escrito:
Sus opciones
Para determinada información médica, puede decirnos sus decisiones sobre qué compartimos.
Si tiene una preferencia clara de cómo compartimos su información en las situaciones descritas debajo, comuníquese con nosotros. Díganos qué quiere que hagamos, y seguiremos sus instrucciones.
En estos casos, tiene tanto el derecho como la opción de pedirnos que:
Presentar una queja si considera que se violaron sus derechos
Elegir a alguien para que actúe en su nombre
Obtener una copia de esta notificación de privacidad
Recibir una lista de aquellos con quienes hemos compartido información
Solicitarnos que limitemos lo que utilizamos o compartimos
Solicitar comunicaciones confidenciales
Solicitarnos que corrijamos su historial médico
Sus derechos
Cuando se trata de su información médica, usted tiene ciertos derechos. Esta sección explica sus derechos y algunas de nuestras responsabilidades para ayudarlo.
Obtener una copia en formato electrónico o en papel de su
historial médico
Nuestros usos y divulgaciones
Podemos utilizar y compartir su información cuando:
Sus opciones
Tiene algunas opciones con respecto a la manera en que utilizamos y compartimos información cuando:
- Effective February 27, 2014
- For further information, please contact our Privacy Officer at Meridian Acupuncture & Wellness
- Phone: 503-692-9680
- Fax: 503-670-4954
- We never market or sell personal information.