Your rights regarding Protected Health Information
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.
Star Medical Wellness is required by federal law to:
The following categories describe different ways we may use and disclose your PHI. Not every use or disclosure will be listed, but all permitted uses and disclosures will fall into one of these categories.
We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes:
Example: We may share your lab results with a consulting physician or specialist to coordinate your treatment plan.
We may use and disclose your PHI to obtain payment for services we provide. This includes:
Example: We may provide your insurance company with information about your treatment to obtain payment for services.
We may use and disclose your PHI for our healthcare operations, including:
We may disclose your PHI to our business associates who perform services on our behalf. These include:
All business associates are required by contract to protect your PHI and follow HIPAA regulations.
We may use or disclose your PHI without your written authorization in the following circumstances:
We may use or disclose your PHI when necessary to prevent or lessen a serious and imminent threat to your health and safety or the health and safety of the public or another person.
We may disclose PHI to coroners or medical examiners for identification purposes, determining cause of death, or other duties as authorized by law. We may disclose PHI to funeral directors as necessary to carry out their duties.
You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request but will consider all requests carefully.
You have the right to request that we communicate with you about your health information in a certain way or at a certain location. For example, you can ask that we contact you only at work or by mail.
You have the right to inspect and obtain a copy of your medical records and other health information. We may charge a reasonable, cost-based fee for copies.
We may deny your request in certain limited circumstances. If we deny your request, you may request a review of that decision.
You have the right to request that we amend your health information if you believe it is incorrect or incomplete. We may deny your request in certain circumstances, but we will provide you with a written explanation.
You have the right to receive an accounting of certain disclosures of your PHI made by us. This does not include disclosures for treatment, payment, or healthcare operations, and certain other disclosures.
You have the right to receive a paper copy of this Notice of Privacy Practices at any time, even if you have previously received an electronic copy.
You have the right to be notified in the event of a breach of your unsecured PHI.
Other uses and disclosures of your PHI not covered by this notice or required by law will be made only with your written authorization. You may revoke your authorization in writing at any time. Revocation will not affect disclosures we have already made based on your authorization.
Specific uses that require authorization include:
To exercise any of your rights described in this notice, please submit your request in writing to:
Privacy Officer: Jill, APRN
Address: 111 West Magnolia Ave. Suite #2042, Longwood, FL 32750
Phone: (407) 986-1600
Email: [email protected]
If you believe your privacy rights have been violated, you may file a complaint with:
Star Medical Wellness:
Privacy Officer: Jill, APRN
Phone: (407) 986-1600
Email:
info@starmedicalwellness.com
U.S. Department of Health and Human Services:
Office for Civil Rights
Website: www.hhs.gov/ocr/privacy
Phone: 1-877-696-6775
You will not be retaliated against for filing a complaint.
We reserve the right to change this notice and to make the revised or new notice effective for all PHI we already have as well as any PHI we create or receive in the future. We will post a copy of the current notice on our website and in our office. The notice will contain the effective date on the first page.
Privacy Officer: Jill, APRN
Phone: (407) 986-1600
Email: info@starmedicalwellness.com
Address: 111 West Magnolia Ave. Suite #2042, Longwood, FL 32750