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
Elevate Health and Hormones LLC (“Elevate,” “we,” “us,” or “our”) is a healthcare provider and a HIPAA-covered entity. We are required by law to maintain the privacy and security of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. PHI is information that identifies you and relates to your past, present, or future physical or mental health, the care you receive, or the payment for that care.
How We May Use and Disclose Your Health Information
We may use and disclose your PHI without your written authorization for the following purposes:
- Treatment. We use your PHI to provide, coordinate, and manage your care. This includes sharing information with the providers, pharmacies, and laboratories involved in your treatment, for example sending a prescription to a compounding pharmacy or ordering and reviewing your lab work.
- Payment. We use and disclose your PHI to bill and collect payment for the services and treatments you receive, including processing your subscription and any additional charges.
- Healthcare operations. We use your PHI to run our practice, for example quality review, training, scheduling, and general administration.
- Business associates. We may share your PHI with third parties that perform services for us (such as our electronic health record system, billing, and technology partners). Each is required by a written Business Associate Agreement to protect your PHI to the same standard we do.
- As required by law. We will disclose your PHI when required by federal, state, or local law, and for public health, safety, law enforcement, or similar purposes permitted by HIPAA.
- Appointment reminders and communications. We may contact you with appointment reminders, refill notices, and information about your care or services.
Uses and Disclosures That Require Your Authorization
Some uses and disclosures require your written authorization. These include most uses of PHI for marketing, any sale of PHI, and most disclosures of psychotherapy notes. We do not sell your PHI. If you give us authorization, you may revoke it in writing at any time, and we will stop the future use or disclosure, except to the extent we have already acted on it.
Your Rights Regarding Your Health Information
You have the following rights with respect to your PHI:
- Access and copies. You may inspect and request a copy of your health and billing records. We will provide these in a form you request when readily producible, and may charge a reasonable, cost-based fee.
- Amendment. You may request that we correct PHI you believe is inaccurate or incomplete. We may deny the request in certain cases and will explain why in writing.
- Accounting of disclosures. You may request a list of certain disclosures we have made of your PHI.
- Restrictions. You may request a restriction on how we use or disclose your PHI. If you pay for a service in full and out of pocket, you may request that we not disclose that information to your health plan, and we will honor that request except where required by law.
- Confidential communications. You may request that we communicate with you in a specific way or at a specific location.
- Paper copy. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Breach notification. You have the right to be notified if a breach of your unsecured PHI occurs.
Our Duties
We are required by law to maintain the privacy of your PHI, to provide you this notice, and to abide by its terms. We reserve the right to change this notice, and to make the revised notice effective for PHI we already have as well as information we receive in the future. If we make a material change, we will post the updated notice and make it available on request.
How to Exercise Your Rights or File a Complaint
To exercise any of the rights above, or if you have questions about this notice, contact our Privacy Officer at info@elevatehealthandhormones.com.
If you believe your privacy rights have been violated, you may file a complaint with us using the contact information above, or with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or at www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.