HIPAA NOTICE OF PRIVACY PRACTICES
Your right to privacy in this medical practice is paramount and we will never disclose any of your personal information without your express consent, unless required to do so by law.
This notice describes our office’s policy for how medical information about you may be used and disclosed, how you can get access to this information, and how your privacy is being protected. Please read it carefully.
The Physician/Non-Physician Providers/Nurse Practitioners collectively known as “HEALTH CARE PROVIDERS” will acquire private information about their patients. This is confidential and will not be discussed outside the office, except that the HEALTH CARE PROVIDERS may discuss patients with other healthcare professionals in terms that do not allow identification of the individual.
Your protected health information, including your clinical records, may be disclosed to another health care provider or hospital if it is necessary to refer you for further diagnosis, assessment, or treatment.
Your health care records, as well as your billing records, may be disclosed to another party, such as an insurance carrier, an HMO, a PPO, or your employer, if they are or may be responsible for payment of services provided to you.
Your name, address, phone number, and your health care records may be used to contact you regarding appointment reminders, information about alternatives to your present care, or other health related information that may be of interest to you. If you are not home to receive an appointment reminder or other related information, a message may be left on your answering machine or with a person in your household. You have a right to confidential communications and to request restrictions relative to such contacts, or contact by alternative means.
Additionally, we may be required to disclose your health information in the following circumstances: In the event of an emergency; if required by law; if there are substantial barriers to communicating with you, but in our professional judgement we believe that you intend for us to provide care; if ordered by the courts, government authorities, public health, law enforcement, coroners, or funeral directors; in the event of organ donations, research, military activity, or for national security.
Patients have the right to receive an accounting of any such disclosures made by our office.
Any use or disclosure of your protected health information, other than as outlined above, will only be made upon your written authorization.
Our office shall maintain a patient’s record a minimum of seven (7) years following the last patient encounter with the following exceptions:
Elevate Health and Wellness, LLC Duties: We at Elevate Health and Wellness, LLC, acknowledge and adhere to our legal obligations to protect the privacy of your Protected Health Information (PHI) as mandated by the Health Insurance Portability and Accountability Act (HIPAA) and other relevant federal and state laws. This duty extends to ensuring the confidentiality, integrity, and security of your PHI.
Required by Law: We are legally required to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices concerning your PHI, and abide by the terms of the privacy notice currently in effect.
Use and Disclosure of PHI: Any use or disclosure of PHI will be in accordance with our established policies, HIPAA regulations, and applicable federal and state laws. This includes, but is not limited to, using your PHI for treatment, billing, healthcare operations, and other purposes as permitted or required by law.
Acknowledgment and Queries: By availing of our services, you acknowledge your understanding of our legal duties to protect your PHI. Should you have any queries or require further clarification about our privacy practices or your rights, please do not hesitate to contact us at the details provided below.
By signing this form, you acknowledge your rights as an individual concerning the information collected and maintained by our organization under the Health Insurance Portability and Accountability Act (HIPAA). You have the right to access, inspect, and obtain a copy of your protected health information (PHI) held by the covered entity. Additionally, you have the right to request corrections or amendments to any inaccurate or incomplete PHI. If you have any concerns or complaints regarding the handling of your PHI, you have the right to lodge a complaint with the covered entity. We are committed to protecting your privacy and ensuring compliance with HIPAA regulations.
Elevate Health and Wellness, LLC
442 5th Ave
Suite 2430, New York, NY 10018
Tel: 1+ (833) 669-2112
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