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.
Effective Date: January 1, 2025
Last Updated: January 1, 2025
Spine Design Chiropractic is committed to protecting the privacy of your health information in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable state laws.
Our Responsibilities
We are required by law to:
- Maintain the privacy of your protected health information (PHI)
- Provide you with this Notice of our legal duties and privacy practices regarding your health information
- Follow the terms of this Notice currently in effect
- Notify you in the event of a breach of your unsecured protected health information
How We May Use and Disclose Your Health Information
We may use and disclose your protected health information for the following purposes:
For Your Care
We may use your health information to provide, coordinate, or manage your chiropractic care. We may share your information with other healthcare providers involved in your care.
For Payment
We may use and disclose your health information to obtain payment for services provided to you. This may include providing information to your insurance company or other third-party payer.
For Healthcare Operations
We may use and disclose your health information for our practice operations, including quality assessment, staff training, business management, and compliance activities.
As Required by Law
We may use or disclose your health information when required to do so by federal, state, or local law.
Public Health Activities
We may disclose your health information for public health purposes, such as reporting communicable diseases, work-related injuries, or to prevent a serious threat to health or safety.
Health Oversight Activities
We may disclose your health information to a health oversight agency for activities authorized by law, including audits, investigations, and inspections.
Legal Proceedings
We may disclose your health information in response to a court order, subpoena, or other lawful process.
Your Rights Regarding Your Health Information
You have the following rights with respect to your protected health information:
Right to Access
You have the right to inspect and obtain a copy of your health information. We may charge a reasonable fee for copying costs. Requests must be submitted in writing.
Right to Request Corrections
If you believe your health information is inaccurate or incomplete, you may request that we amend it. We may deny the request in certain circumstances, and we will provide a written explanation if we do.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your health information. This does not include disclosures made for your care, payment, healthcare operations, or disclosures you authorized in writing.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your health information. While we will consider all requests, we are not required to agree to a restriction except in certain circumstances required by law.
Right to Request Confidential Communications
You have the right to request that we communicate with you about your health matters in a certain way or at a certain location. For example, you may request that we contact you only at your work phone number.
Right to a Paper Copy of This Notice
You are entitled to receive a paper copy of this Notice at any time, even if you have previously agreed to receive it electronically. Please contact our office to request a copy.
Reproductive Health Information
We are committed to protecting the privacy of your reproductive health information. We will not disclose reproductive health information when requested for the purpose of investigating or penalizing individuals seeking, obtaining, or providing lawful reproductive healthcare. If disclosure is requested for such purposes, we will require a signed attestation confirming the request is not for prohibited purposes.
Changes to This Notice
We reserve the right to change this Notice and make the new provisions effective for all health information we maintain. A revised Notice will be posted on our website and available at our office.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. You will not be penalized or retaliated against for filing a complaint.
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: hhs.gov/ocr/privacy/hipaa/complaints
Privacy Officer Contact
For questions about this Notice or to exercise any of your rights, please contact:
Privacy Officer
Spine Design Chiropractic
1102 W Indiantown Rd STE 11, Jupiter, FL 33458
Phone: (561) 741-1316
Email: spinedesign1@gmail.com
