HIPAA- NOTICE OF PRIVACY PRACTICES.
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.
ProBalance, Inc. is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide our patients
with notice of our legal duties and privacy practices with respect to your protected health information.
Disclosure of Your Health Care Information
Treatment
We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations. We are a teaching facility so there may be students observing treatments for their respective professional programs. On
occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with ProBalance, Inc.
“It is our policy to provide a substitute health care provider, authorized by ProBalance, Inc. to provide assessment and/or treatment
to our patients, without advanced notice, in the event of your primary health care provider’s absence due to vacation, sickness, or
other emergency situation.”
Payment
We may disclose your health information to your insurance provider for the purpose of payment or health care operations.
Electronic Communication
Much of our communication is via electronic means, including online scheduling software and encrypted electronic charting and storage. Your information is not shared with third parties as is used to facilitate communication between practitioners & clients/patients. Please be assured that every step is taken to ensure the confidentiality of your health information, included password protected computers and accounts in accordance with HIPAA requirements.
Emergencies
We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your
medical condition or in the event of an emergency or of your death.
Public Health
As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
Judicial and Administrative Proceedings.
We may disclose your health information in the course of any administrative or judicial proceeding.
Law Enforcement.
We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material
witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.
Deceased Persons.
We may disclose your health information to coroners or medical examiners.
Organ Donation.
We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.
Research.
We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.
Teaching Facility
We are a teaching facility so there periodically may be students observing your session or class. Please be assured that they are required to adhere to this published privacy policy.
Public Safety.
It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the
health or safety of a particular person or to the general public.
Specialized Government Agencies.
We may disclose your health information for military, national security, prisoner and government benefits purposes.
Change of Ownership.
In the event that ProBalance, Inc. is sold or merged with another organization, your health information/record will become the property of the new owner.
* You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that ProBalance, Inc. is not required to agree to the restriction that you requested.
* You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request. Note that there may be administrative/records fees associated with acquisition/copying of records.
* You have the right to inspect and copy your health information.
* You have a right to request that ProBalance, Inc. amend your protected health information. Please be advised, however, that
ProBalance, Inc. is not required to agree to amend your protected health information. If your request to amend your health information
has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with
the denial.
* You have a right to receive an accounting of disclosures of your protected health information made by ProBalance, Inc.
* You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
Changes to this Notice of Privacy Practices
ProBalance, Inc. reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, ProBalance, Inc. is required by law to comply with this Notice.
ProBalance, Inc. is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this notice or if you want more information about your privacy rights, please contact: Ada Wells by calling this office at (510) 523-1900. If Ada Wells is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
Complaints
Complaints about your Privacy rights, or how ProBalance, Inc. has handled your health information should be directed to Ada Wells by calling this office at (510) 523-1900. If Ada Wells is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to:
DHHS, Office of Civil Rights
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
This notice is effective as of July 1st, 2008.
