Notice of Privacy Practices

Our duties

We are required by law to keep your health information private, to give you this notice of our legal duties and privacy practices, and to follow the notice that is currently in effect. We will tell you promptly if a breach occurs that may have compromised the privacy or security of your information.

“Health information” means information that identifies you and relates to your health, your care, or payment for your care. It includes your intake forms, case history, examination findings, X-rays and scans, visit notes, and billing records.

California law (the Confidentiality of Medical Information Act) sometimes protects your information more strictly than federal law. When it does, we follow the stricter rule.

How we use and share your health information

For treatment. We use your information to examine you, plan your care and treat you. We may share it with other providers involved in your care. For example, we may send imaging to a radiologist for a reading, or send records to your physician if you ask us to.

For payment. We may use and share your information to bill and get paid by you, your health plan, or another payer. For example, we may give your insurer the dates of your visits and the services you received.

For our health care operations. We may use and share your information to run the practice, improve care, train staff, and contact you when necessary. For example, we may review records to check the quality of our care.

Appointment reminders and follow-up. We may phone, text or email you about appointments, your care, or a request you sent us. Texts are sent individually by our staff. You can reply STOP to stop texts at any time, or tell us how you prefer to be contacted.

Recorded and transcribed visits. With your agreement, we may record a visit so that it can be transcribed and used to prepare your visit notes and a written summary for you. We never record a visit without telling you first, and you may say no. Saying no does not affect your care.

Our service providers (“business associates”). We use outside companies to provide services for us, such as practice software, secure data storage, email, our phone system, and transcription and note-drafting tools. When they handle your information, they must sign an agreement to protect it and to use it only for the services they perform for us.

Phone calls. Calls to our office may be recorded for quality and training. You will hear a message saying so at the start of the call.

Other ways we may share your information without your written permission

We may share your information without your written permission only where the law allows or requires it. These include:

• When required by law, including when the U.S. Department of Health and Human Services wants to see that we are complying with federal privacy law.
• Public health and safety: reporting disease, injury, or suspected abuse, neglect or domestic violence; reporting problems with products; and preventing a serious and imminent threat to someone's health or safety.
• Health oversight: audits, investigations, inspections and licensing, for example by the California Board of Chiropractic Examiners.
• Lawsuits and legal actions: in response to a court or administrative order, or to a subpoena that meets legal requirements.
• Law enforcement: for limited purposes, such as responding to a valid legal process or identifying a suspect or missing person.
• Workers' compensation: for workers' compensation claims and similar programs, as the law allows.
• Coroners, medical examiners and funeral directors, as the law allows.
• Organ and tissue donation organizations.
• Research, only when approved under rules that protect your privacy.
• Specialized government functions, such as military, national security and protective services.

Family and friends. If you agree, or if you are present and do not object, we may share information with a family member, friend or other person involved in your care or in paying for it. If you cannot agree, for example in an emergency, we may share information if we believe it is in your best interest.

Uses that need your written permission

We will not do the following without your written permission (an “authorization”):

• Use or share your information for marketing.
• Sell your information.
• Share your information for any purpose not described in this notice.

You can take back (revoke) an authorization at any time in writing. Revoking it stops future sharing, but cannot undo sharing that already happened while it was in place.

We do not keep psychotherapy notes.

Your rights

To use any of these rights, contact our Privacy Officer at the details at the end of this notice.

See and get a copy of your records. You can ask to see or get a copy of your health information, on paper or electronically if we keep it electronically. Under California law, we will let you inspect your records within 5 working days of your written request and provide copies within 15 days. We may charge a reasonable, cost-based fee for copies. In rare cases allowed by law we may deny a request; if we do, we will tell you why in writing and how to ask for a review.

Ask us to correct your records. If you think information in your record is wrong or incomplete, you can ask us in writing to correct it. We may say no, but we will tell you why in writing within 60 days. You may then add a written statement of up to 250 words that we will include in your record.

Ask for confidential communications. You can ask us to contact you in a particular way (for example, only on your cell phone) or at a different address. We will agree to all reasonable requests.

Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment or operations. We are not required to agree, except in one case: if you pay for a service in full out of pocket, you can ask us not to share information about that service with your health plan, and we will agree unless the law requires us to share it.

Get a list of those we've shared information with. You can ask for a list (an “accounting”) of the times we shared your information in the six years before your request, who we shared it with, and why. It will not include sharing for treatment, payment or operations, or sharing you authorized. We provide one list a year free and may charge a reasonable, cost-based fee for more.

Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically. It is also posted in our office and at www.hbucc.com/notice-of-privacy-practices.

Choose someone to act for you. If you have given someone medical power of attorney, or someone is your legal guardian, that person can use your rights and make choices about your health information. We will check that they have this authority before we act.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all the information we have about you. The new notice will be available on request, in our office, and on our website.

Complaints

If you believe your privacy rights have been violated, you can complain to us using the contact details below. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights: 200 Independence Avenue S.W., Washington, D.C. 20201; 1-877-696-6775; or www.hhs.gov/ocr/privacy/hipaa/complaints/.

We will not retaliate against you for filing a complaint.

Privacy Officer

Dr. Roger Smith DC
Huntington Beach Upper Cervical Chiropractic
16052 Beach Blvd. Ste. 130, Huntington Beach, CA 92647
Phone: (714) 716-4373 · Email: info@hbucc.com