HIPAA Notice of Privacy Practices
Powell Chiropractic Center — Tifton, GA
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.
Our Commitment to Your Privacy
Powell Chiropractic Center is committed to maintaining the privacy and security of your protected health information (PHI) as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the HITECH Act. This Notice of Privacy Practices describes how we may use and disclose your PHI and your rights regarding that information.
How We May Use and Disclose Your Health Information
Treatment. We may use your PHI to provide, coordinate, or manage your chiropractic care and related services. For example, we may share your information with other healthcare providers involved in your treatment.
Payment. We may use and disclose your PHI to bill and collect payment for the services we provide to you. For example, we may submit claims to your insurance company.
Health Care Operations. We may use and disclose your PHI for our internal business operations including quality assessment, staff training, auditing, and other activities necessary to run our practice.
Appointment Reminders. We may contact you to remind you of upcoming appointments or to provide information about treatment alternatives or other health-related services.
Uses and Disclosures Requiring Your Authorization
Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. You may revoke such authorization in writing at any time, except where we have already acted in reliance on it.
Your Rights Regarding Your Health Information
Right to Access. You have the right to inspect and obtain a copy of your PHI that we maintain in a designated record set.
Right to Amend. You may request that we amend your PHI if you believe it is incorrect or incomplete.
Right to Accounting of Disclosures. You have the right to request a list of disclosures of your PHI that we have made for purposes other than treatment, payment, and health care operations.
Right to Request Restrictions. You may request restrictions on how we use or disclose your PHI, though we are not always required to agree.
Right to Confidential Communications. You may request that we communicate your PHI in a certain way or at a certain location (e.g., only by mail to a specific address).
Right to a Paper Copy of This Notice. You have the right to receive a paper copy of this Notice upon request, even if you have agreed to receive it electronically.
Our Duties
We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, and notify you following a breach of your unsecured PHI. We reserve the right to change this Notice and the revised Notice will apply to all PHI we maintain.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with Powell Chiropractic Center or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be retaliated against for filing a complaint.
Contact Our Privacy Officer
Powell Chiropractic Center
1444 Tift Avenue North B, Tifton, GA 31794
Phone: (229) 382-3210