Notice of Privacy Practices (HIPAA)

Your rights

When it comes to your health information, you have the right to:

• Get an electronic or paper copy of your medical record. We will usually provide it within 30 days of your request and may charge a reasonable, cost-based fee.
• Ask us to correct information you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.
• Ask us to contact you in a specific way (for example, a different phone or address). We will say yes to all reasonable requests.
• Ask us not to use or share certain information for treatment, payment or operations. We are not required to agree, unless you paid for a service in full out of pocket and ask us not to share it with your health insurer.
• Get a list of the times we shared your information in the six years before your request, who we shared it with and why (except disclosures for treatment, payment, operations and other exceptions under the law). One list a year is free.
• Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you, such as a medical power of attorney or legal guardian.
• File a complaint if you feel your rights were violated, by contacting us support@iplugcrm.com, or with the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, phone 1-877-696-6775, or at www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Your choices

You can tell us your preferences about sharing information with family or close friends involved in your care, or in a disaster relief situation. If you cannot tell us (for example, if you are unconscious), we may share it if we believe it is in your best interest.

We will never use or share your information for marketing or sell it without your written permission.

How we use and share your information

• To treat you: we share your information with other professionals treating you (for example, the lab or the specialist we refer you to).
• To run our practice: to improve care, schedule appointments and communicate with you.
• To bill for your services: to collect membership fees and charges for services not included in your plan.

Other uses and disclosures allowed by law

• Public health and safety: preventing disease, reporting adverse reactions to medications, suspected abuse or domestic violence, or preventing a serious threat to health or safety.
• Research, when the requirements of the law are met.
• When state or federal law requires it, including the Department of Health and Human Services to check that we comply with federal privacy law.
• Organ and tissue donation, and medical examiners or funeral directors.
• Workers’ compensation, law enforcement, special government functions and court or administrative orders.

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, and you may change your mind at any time.

Changes to 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 on this page, at our locations and upon request.

Privacy officer contact

To exercise your rights or ask questions about this notice, contact the Ultrahealth privacy officer support@iplugcrm.com.