SPINAL CARE CHIROPRACTIC & JOINT REHABILITATION, P.C.
NOTICE OF PRIVACY RIGHTS
Your Information. Your Rights. Our Responsibility.
PLEASE READ IT CAREFULLY
- Get an electronic or paper copy of your medical records
- You can ask to see or obtain a copy of your medical record & health information we have about you. Ask us how.
- Ask us to correct your medical record
- You can ask us to correct health information 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 communication
- You can ask us to contact you in a specific way (for example, cell or office phone) or to send mail to a different address.
- We’ll say yes to all reasonable requests.
- Get a list of those with whom we’ve shared information
- You can ask for a list of the times we’ve shared your health information for 6 yrs prior to the date you ask, who we shared it with, and why.
- We’ll include all disclosures except those about treatment, payment, and healthcare operations, and certain other disclosures (such as any you asked us to make). We’ll provide 1 accounting per year for free but will charge a reasonable, cost-based fee if you ask for another within 12 months.
- Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time.
- Choose someone to act for you
- If you’ve 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’ll make sure the person has this authority before taking any action.
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 the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your case
- Share information in a disaster relief situation
- Include your information in an office directory
If you are unable 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 we may have on file
- In the case of fundraising, a right Spinal Care has never and likely will never exercise:
- We may contact you for fundraising efforts, but you can tell us not to contact you again
OTHER USES AND DISCLOSURES
- Treat you
- We can use your health information and share it with other professionals who are treating you
- Run our organization
- We can use and share your health information to run our practice, improve your care, and contact you when necessary.
- Bill for your services
- We can use and share your health information to bill and get payment from health plans or other entities.
- Help with public health/safety issues
- We can share health information about you for certain situations such as: preventing disease, helping with product recalls, reporting suspected abuse, neglect, or domestic violence, preventing or reducing a serious threat to anyone’s health/safety
- Do research: we can use/share your information for health research
- Comply with the law, address government or workers’ comp requests
- We will share information about you if state or federal laws require it or for workers’ comp claims, law enforcement purposes, or special government functions
- Work with a medical examiner/funeral director or in response to organ and tissue donation requests
You have the right to file a complaint if you feel your rights are violated.
To first file a complaint with our practice’s Compliance Officer, contact Sharon Motson at 610-489-8800.
We will not retaliate against you for filing a complaint.
To file a complaint with the US Dept. of Health and Human Services Office for Civil Rights: call 877-696-6775, visit www.hhs.gov/ocr/privacy/hipaa/complaints/ or send a letter to 200 Independence Ave, S.W., Washington, DC 20201
NOTICE OF PRIVACY RIGHTS:
Keeping It Simple
Our Commitment to Protecting Your Privacy and Earning Your Trust
Earning and maintaining your trust and safeguarding your privacy is the cornerstone of our
patient relationship with you. The protection of your privacy is a key part of maintaining your
trust. This has been a fundamental operating principle of Spinal Care Chiropractic
since opening our doors, and remains so today. The Patient Privacy Notice lets you
know the information we collect about you, and how we safeguard and use this information to
Information We Collect About You
We collect non-public information about you from the following sources:
-Information you provide directly to us upon registration, including financial contracts.
-Information we obtain from others to verify information provided by you, such as your
insurance policy information and health history.
We only collect and use patient information that is necessary to render our procedures, provide
superior service and make you aware of services that we believe will be a benefit and value to
Information We Disclose to Others
We do not disclose any non-public, personal information about our patients (active or inactive),
to non-affiliated third parties, without written consent from the patient. We are concerned
about you and your privacy, and carefully limit and control the patient information we share
with others. We do not disclose information about our patients (active or inactive) to anyone,
except as outlined in this notice, or as permitted by law.
Our Security Procedures & Our Pledge To You
We are committed to protecting the security of our patient information. We maintain strict
internal policies regarding confidentiality of patient information. We limit access to this
information to only those employees who require it in order to perform their jobs. We
maintain physical, electronic and procedural safeguards that comply with federal guidelines to
safeguard patient information. Our employees are bound by our policies to access patient
information only for legitimate clinical and/or business purposes and to keep such information
confidential at all times. We pledge to do all we can to protect your privacy. If you have any
or used, please contact our Compliance/Privacy Officer, Sharon Motson, at 610-489-8800.
This notice is for you – please let us know if you would like an additional copy.