ELEVATED HEALTH & WELLNESS

HIPAA NOTICE OF PRIVACY PRACTICES (“NOTICE”)

HIPAA NOTICE OF PRIVACY PRACTICES

Effective Date: January 01, 2025

This Notice of Privacy Practices ("Notice") describes how Elevated Health and Wellness ("Practice") and its health care professionals, employees, volunteers, and staff may use and disclose your Protected Health Information ("PHI") to carry out treatment, payment, health care operations, and for other purposes permitted or required by law. It also describes your rights to access and control your PHI. Please review this Notice carefully.

We understand that your health information is personal and we are committed to protecting it. We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices, and to abide by the terms of this Notice.

I. How We May Use and Disclose Your Health Information

  1. Treatment: We may use or disclose your PHI to provide, coordinate, or manage your health care and related services. Examples include sharing information with other physicians, labs, pharmacies, hospitals, or rehabilitation centers involved in your care.

  2. Payment: We may use or disclose your PHI to obtain reimbursement for the services we provide to you, including billing and collection activities. For example, we may contact your insurer to verify coverage or submit claims on your behalf.

  3. Health Care Operations: We may use and disclose PHI to support business activities such as quality assessment, employee review, compliance, training, business planning, and customer service. We may use sign-in sheets, call you by name in the waiting room, and contact you to remind you of appointments or to share information about health-related services.

  4. Health Information Exchanges (HIEs): We may participate in HIEs, allowing electronic sharing of PHI for purposes of treatment, payment, and health care operations.

  5. Business Associates: We may share PHI with third-party "business associates" who perform services on our behalf. We require them by contract to protect your information.

  6. Fundraising and Marketing: We may contact you for fundraising activities but you have the right to opt out. We may also send marketing communications about our own health-related services.

II. Other Uses and Disclosures

  1. Individuals Involved in Your Care or Payment: We may share your PHI with family members, close friends, or any person you identify, if they are involved in your care or payment, unless you object.

  2. Emergencies: In emergency situations, we may use or disclose your PHI without your consent if needed to treat you.

  3. Communication Barriers: If we are unable to obtain your consent due to substantial communication barriers and we determine you would consent if able, we may use your PHI.

III. Uses and Disclosures Required or Permitted by Law

Without your authorization, we may use or disclose your PHI in the following situations:

  • Required by Law: To comply with federal, state, or local law.

  • Public Health Activities: Reporting disease, injury, or vital events such as births and deaths.

  • Communicable Diseases: To prevent the spread of communicable diseases.

  • Health Oversight: Audits, investigations, and inspections by government agencies.

  • Abuse, Neglect, or Domestic Violence: Reporting to authorized governmental agencies.

  • Food and Drug Administration: Reporting adverse events or product defects.

  • Legal Proceedings: In response to a court or administrative order, subpoena, or lawful request.

  • Law Enforcement: For law enforcement purposes as required by law.

  • Coroners, Medical Examiners, and Funeral Directors: For identification, cause of death determinations, or performance of other authorized duties.

  • Organ Donation: To facilitate organ, eye, or tissue donation and transplantation.

  • Research: Under certain conditions, PHI may be used or disclosed for research purposes.

  • Threats to Health or Safety: To prevent a serious threat to the health or safety of a person or the public.

  • Specialized Government Functions: For military, national security, or correctional institution purposes.

  • Workers' Compensation: To comply with workers' compensation laws.

IV. Your Rights

You have the following rights regarding your PHI:

  • Right to Inspect and Copy: You may request access to your medical record.

  • Right to Request Amendment: You may request corrections to your record if you believe it is inaccurate.

  • Right to an Accounting of Disclosures: You may request a list of disclosures made about you, excluding those made for treatment, payment, or health care operations.

  • Right to Request Restrictions: You may request restrictions on certain uses and disclosures.

  • Right to Request Confidential Communications: You may request that communications from us be made in a certain way or at a certain location.

  • Right to a Paper Copy of This Notice: You can request a paper copy of this Notice at any time.

To exercise any of these rights, please contact:

Privacy Officer:

Keyona Gayles, APN

2315 East 93rd Street, Suite 339, Chicago, Illinois 60617

312-927-1897

Elevated@myelevatedcare.com

V. Changes to This Notice

We reserve the right to change the terms of this Notice at any time. Any new Notice will be effective for all PHI we maintain. A copy of the current Notice will be available at our office and on our website.

VI. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

To file a complaint with us, contact:

Privacy Officer:

Keyona Gayles, APN

2315 East 93rd Street, Suite 339, Chicago, Illinois 60617

312-927-1897

Elevated@myelevatedcare.com

Acknowledgment of Receipt of Notice: We will ask you to sign an acknowledgment that you received this Notice.

Thank you for trusting Elevated Health and Wellness with your care.