HIPAA NOTICE

Our Legal Duty

We are required by law to maintain the privacy of protected health information and to provide you with notice of our legal duties and privacy practices with respect to your protected health information. We must abide by the terms of this Notice while it is in effect. However, we reserve the right to change the terms of this Notice and to make the new notice provisions effective for all of the protected health information that we maintain. If we make a change in the terms of this Notice, we will notify you in writing and provide you with a paper copy of the new Notice, upon request.

Uses and Disclosures

There are a number of situations in which we may use or disclose to other persons or entities your confidential health information.

Certain uses and disclosures require you to sign an acknowledgement that you received this Notice of Privacy Practices. They include:

• Treatment

• Payment

• Health care operations

Any use or disclosure other than treatment, payment, or health care operations requires your signed Authorization.

Certain disclosures required by law or under emergency circumstances may be made without your Acknowledgement or Authorization. We will use or disclose only the minimum necessary information.

Examples:

Treatment Example:
We may use your health information within our office to provide health care services or disclose it to another provider if referring you.

Payment Example:
We may use and share your health information to bill and obtain payment from health plans.

Health Care Operations Example:
We may use your information for internal quality assessment, business management, and administrative activities.

Running Our Organization:
We may use/share your information to run our practice, improve care, and contact you. This may include chiropractic interns.

Your name may be called when the provider is ready to see you.

We utilize open treatment and therapy areas. Private rooms are available upon request.

We may share your health information with a third-party “business associate” (such as billing or transcription services) under agreements that protect your information.

We may use and disclose your information for internal marketing (e.g., newsletters about services or products).

Appointment Reminders:
We may contact you via voicemail, postcard, or letter regarding appointments or other health-related information.

Your Choices

We never share your information for:

• Marketing purposes (without written permission)

• Sale of your information

• Most sharing of psychotherapy notes

Fundraising: We may contact you for fundraising, but you can opt out.

Disclosures Without Authorization

We may disclose your information for:

• Public health and oversight activities

• Law enforcement

• Judicial/administrative proceedings

• Reporting communicable diseases (including HIV/AIDS)

• Reporting suspected abuse, neglect, or domestic violence

• Immediate threats to health or safety

• Court orders

• Disaster relief coordination

Open adjusting room disclosures may not allow complete privacy, though we attempt to speak quietly. Private rooms are available upon request.

Others Involved in Your Healthcare

Unless you object, we may share relevant information with:

• Family members

• Relatives

• Close friends

• Individuals you identify as involved in your care

We may also notify responsible persons of your location, condition, or death.

Communication Barriers & Emergencies

If we cannot obtain consent due to communication barriers or emergencies, we may use professional judgment to disclose necessary information. We will attempt to obtain consent as soon as possible afterward.

Authorization Required

Except as described above, your health information will not be used or disclosed without your specific written authorization.

We will not disclose information related to:

• Mental health treatment

• Drug and alcohol abuse

• HIV/AIDS

• Sexually transmitted diseases

• Employer decisions

• Liability insurers or attorneys (auto accidents)

• Educational authorities

Without written authorization.

Patient Rights

1. Right to Request Restrictions

You may request restrictions on use/disclosure. We are not required to agree but will comply if we do (except emergencies or legal requirements).

If you pay out-of-pocket in full, you may request we not share information with your insurer.

Enhanced protections apply to reproductive health information, including:

• Contraception

• Fertility treatments

• Miscarriage care

• Termination services
  These cannot be used/disclosed for legal investigations without explicit written consent.

2. Right to Receive Confidential Communications

You may request alternative communication methods or locations (written request required).

3. Right to Inspect and Copy

You may inspect, copy, and request amendments to records (excluding psychotherapy notes and certain legal documents).

• Copies typically provided within 15 days

• May charge reasonable cost-based fee

• Extension of up to 15 additional days possible

4. Right to Amend

You may request amendments in writing. We may deny but will explain within 60 days.

5. Right to Receive an Accounting

You may request an accounting of disclosures (excluding psychotherapy notes and certain legal restrictions).

6. Right to Receive Notice

You may request a paper copy of this Notice.

We must notify you of a breach of PHI unless there is a low probability of compromise.

Substance Use Disorder Records

Federal law (42 CFR Part 2) provides additional privacy protections for SUD treatment records.

This clinic does not provide substance use disorder treatment services or maintain such records.

If SUD records are received from another provider, they will be maintained in accordance with federal/state law.

Complaints

You may file a complaint:

• With the clinic’s Privacy Officer

• Or with the U.S. Department of Health and Human Services Office for Civil Rights:

U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not be retaliated against.

Changes to This Notice

We may change this Notice. The updated version will apply to all your information and will be available upon request and on our website.

For more information:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Contact Information

Privacy Officer
TPC
8289 SW Cirrus Drive
Beaverton, OR 97008