Notice of Privacy Practices

Your rights

When it comes to your health information, you have certain rights. You can:

• Get a copy of your health and billing records. Ask us to see or get a paper or electronic copy. We will usually provide it within 30 days of your request and may charge a reasonable, cost-based fee.
• Ask us to correct your records if you think they are incorrect or incomplete. We may say “no,” but we will tell you why in writing within 60 days.
• Request confidential communications, such as contacting you at a different phone number or address. We will say “yes” to all reasonable requests.
• Ask us to limit what we use or share. We are not required to agree, except that if you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer, and we will agree unless a law requires us to share it.
• Get a list of those with whom we’ve shared your information for up to six years prior to your request, with certain exceptions. One list per year is free.
• Get a copy of this notice at any time, on paper, even if you agreed to receive it electronically.
• Choose someone to act for you, such as a legal guardian or someone with medical power of attorney.
• File a complaint if you feel your rights have been violated (see “Questions and complaints” below). We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share. You have both the right and choice to tell us to:

• Share information with your family, close friends or others involved in your care.
• Share information in a disaster relief situation.

If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We never share your information in these cases unless you give us written permission: marketing purposes, sale of your information, and most sharing of psychotherapy notes. This includes the use of photos, videos or reviews of you in our marketing or promotional materials, which requires your separate written authorization. You may revoke an authorization in writing at any time.

Our uses and disclosures

We typically use or share your health information in the following ways:

• To treat you. We use your information and share it with other professionals who are treating you.
• To run our organization. We use your information to operate our practice, improve your care, and contact you when necessary, including appointment reminders by text or email.
• To bill for your services. We use and share your information to bill and get payment from health plans, auto insurers, MedPay carriers, or other entities, including attorneys under a signed lien when you have authorized it.

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, and only when we have met conditions in the law. These include: helping with public health and safety issues; research; complying with the law; responding to organ and tissue donation requests; working with a medical examiner or funeral director; addressing workers’ compensation, law enforcement and other government requests; and responding to lawsuits and legal actions.

California law may provide additional protections for certain information, such as mental health, substance use and HIV-related information. Where state law is more protective than federal law, we follow state law.

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.

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 upon request, in our office, and on our website.

Questions and complaints

For questions, to make a request, or to file a complaint with us, contact:

Privacy Officer, ChiroCare Therapy
30486 Avenida De Las Banderas, Suite D, Rancho Santa Margarita, CA 92688
(949) 888-0404

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints.