Duininck Chiropractic, P.A. HIPAA Privacy Notice
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Each time you come in for care, we create a record of treatment and services provided to you in this office. We are required by law to keep all of your medical information private and make available to you, the patient, information regarding your rights, your medical information and our legal duties and privacy practices. The information below describes how medical information about you may be used and disclosed, and how you can get access to this information.
Use and Disclosure of Your Medical Information
We may use and disclose your medical records only for treatment, payment and health care operations.
- Treatment : We may use your medical information to provide you with medical treatment or services. This means we may disclose medical information about you to doctors, technicians, or other health care providers who are treating you. (Example: Areas adjusted and possible therapies used.)
- Payment : We may disclose your medical information to obtain reimbursement for services, to confirm coverage and for billing and collection activities. (Example: Sending a bill to your insurance company for reimbursement.)
- Health care operations : We may use and disclose your medical information for our health care operations. This may include conducting programs for training, employee evaluations, auditing functions, measuring and improving quality and getting licenses, certificates and credentials we need to serve you. (Example: Internal quality assessment review.)
As Required by Law
We may also disclose health information to the following types of entities, including but not limited to:
- Public Health or legal authorities charged with preventing or controlling disease, injury, disability, or other threat to health or safety.
- Correctional institutions (if you are in custody of a correctional institution or a law enforcement officer).
- Worker’s compensation agents.
- Military command authorities.
- Health oversight agencies.
- National security and intelligence agencies.
- Law Enforcement/Legal Proceedings
We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena or court order.
Other Office Practices
T his office may contact you to provide information on treatment alternatives or other health related information or to inform you of requested information or products. The following communications are used by the practice:
- Telephoning your home, work, or contact person and leaving a message on your answering machine or with the individual answering the phone.
- Newsletters or health related articles, with health information we believe to be valuable to you, may be sent as requested.
- Ordinary practice related information may be communicated to you by any physical or electronic method that may be available and deemed reasonable and appropriate by the compliance officer.
Other Uses of Your Protected Health Information that Require Your Authorization
Uses and disclosures of your protected health information that involve the release of psychotherapy notes (if any), marketing, sales of your protected health information, or other uses or disclosures not described in this notice or required by law will be made only with your separate written permission. If you give us permission to use or disclose protected health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose protected health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission and that we are required to retain our records of the care that we provided to you.
Your Health Information Rights
Although your health record is the physical property of our facility, you have the right to:
- Inspect and copy protected health information. You may request access to your records by contacting us. You may also ask that we send your health information directly to another person based on your signed, written instructions. We may deny your request to inspect and copy in certain, very limited circumstances. If you are denied access to protected health information, you may request that the denial be reviewed by management in some situations. We will comply with the outcome of the review. We reserve the right to charge you a reasonable fee to cover the cost of providing you with a copy of your records.
- Request an amendment. If you feel that protected health information we have about you is incorrect or incomplete, you may ask us to amend the information by making a request in writing that explains the reason for the requested amendment. You have the right to request an amendment for as long as the information is kept for or by us. We may deny your request for an amendment; if this occurs, you will be notified of the reason for the denial.
- Request an accounting of disclosures. This is a list of certain disclosures we make of your protected health information for purposes other than treatment, payment, healthcare operations, or certain other permitted purposes.
- Request restrictions or limitations on the protected health information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the protected health information we disclose about you to someone who is involved in your care or the payment of your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We are not required to agree to your request, except as described below. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. If you ask us not to disclose your health information to your health plan, we will agree as long as (i) the disclosure would be for the purpose of payment or health care operations and is not otherwise required by law and (ii) the information only relates to items or services that someone other than your health plan has paid for in full.
- Request confidential communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you at work or by US mail. We will grant requests for confidential communications at alternate locations and/or via alternative means only if the request is submitted in writing and the written request includes a mailing address where you will receive bills for services rendered by the facility and related correspondence regarding payment for services. Please realize that we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response.
- A paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website at www.duininckchiro.com .
Changes to This Notice
We reserve the right to change this notice; the revised notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted in the facility and will include the new effective date. Copies of any revised notice will be available on our website and at our facility after the effective date.
Questions & Complaints
You have recourse if you feel that your privacy protections have been violated. If you have a complaint you can contact our privacy officer, Heather Preble, at 320-235-6320 or by mail at Duininck Chiropractic, P.A., 1550 Willmar Ave. SE, Suite B, Willmar, MN 56201. You may also contact the Secretary of the US Department of Health and Human Services.