HIPAA Notice of Privacy Practices

Effective date: January 1, 2023
PLEASE REVIEW THIS NOTICE CAREFULLY. IT DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU MAYGAIN ACCESS TO THAT INFORMATION.

POLICY STATEMENT
Great Falls Chiropractic Clinic, PLLC (the Practice) is committed to maintaining the privacy of your protected health information ("PHI"), which includes information about your medical condition and the care and treatment you receive from the Practice and other health care providers. This Notice details how your PHI may be used and disclosed to third parties for purposes of your care, payment for your care, health care operations of the Practice, and for other purposes permitted or required by law. This notice also details your rights regarding your PHI.

USE OR DISCLOSURE OF PHI
The Practice may use and/or disclose your PHI for purposes related to your care, payment for your care, and health care operations of the Practice. The following are examples of the types of uses and/or disclosures of your PHI that may occur. These examples are not meant to include all possible types of use and/or disclosure. Care — In order to provide care to you, the Practice will provide your PHI to those health care professionals directly involved in your care so they may understand your medical condition and needs and provide advice or treatment. For example, your
physician may need to know how your condition is responding to the treatment provided by the Practice.

Payment — In order to get paid for some or all of the health care provided by the  Practice, the Practice may provide your PHI, directly or through a billing service, to appropriate third party payers, pursuant to their billing and payment requirements. For example, the practice may need to provide your health insurance carrier with information about health care services you received from the Practice so the Practice may be properly reimbursed.

Health Care Operations — In order for the Practice to operate in accordance with applicable law and insurance requirements and in order for the Practice to provide quality and efficient care, it may be necessary for the Practice to compile, use and/or disclose your PHI. For example, the Practice may use your PHI in order to evaluate the performance of the Practice's personnel in providing care to you.

Note: Genetic information is protected by law and is not considered part of Health Care
Operations.

AUTHORIZATION NOT REQUIRED
The Practice may use and/or disclose your PHI, without a written Authorization from you, in the following instances:

  1. De-identified Information — Your PHI is altered so that it does not identify you and, even without your name, cannot be used to identify you.
  2. Business Associate — To a business associate, who is someone the Practice contracts with to provide a service necessary for your treatment, payment for your treatment and/or health care operations (e.g., billing service or transcription service). The Practice will obtain satisfactory written assurance, in accordance with applicable law, that the business associate and their
    subcontractors will appropriately safeguard your PHI.
  3. Personal Representative — To a person who, under applicable law, has the authority to represent you in making decisions related to your health care.
  4. Public Health Activities — Such activities include, for example, information collected by a public health authority, as authorized by law, to prevent or control disease, injury or disability. This includes reports of child abuse or neglect.
  5. Federal Drug Administration — If required the Food and Drug Administration to report adverse events, product defects, problems, biological deviations, or to track products, enable product recalls, repairs or replacements, or to conduct post marketing surveillance.
  6. Abuse, Neglect or Domestic Violence — To a government authority, if the Practice is required by law to make such disclosure. If the Practice is authorized by law to make such a disclosure, it will do so if it believes the disclosure is necessary to prevent serious harm or if the Practice believes you have been the victim of abuse, neglect or domestic violence. Any such
    disclosure will be made in accordance with the requirements of law, which may also involve notice to you of the disclosure.
  7. Health Oversight Activities — Such activities, which must be required by law, involve government agencies involved in oversight activities that relate to the health care system, government benefit programs, government regulatory programs and civil rights law. Those activities include, for example, criminal investigations, audits, disciplinary actions, or general oversight
    activities relating to the community's health care system.
  8. Family and Friends –  Unless you object, the Practice may disclose medical information about you to a member of your family, a relative, close friend or any other person that you identify who is involved in your care. The Practice may also tell your family or friends, personal representative, or any other person who is responsible for your care, of your location, general condition or death, unless you object.
  9. Judicial and Administrative Proceeding — For example, the Practice may be required to disclose your PHI in response to a court order or a lawfully issued subpoena.
  10. Law Enforcement Purposes — In certain instances, your PHI may have to be disclosed to a law enforcement official for law enforcement purposes. Law enforcement purposes include: (1) complying with a legal process (i.e., subpoena) or as required by law; (2) information for identification and location purposes (e.g., suspect or missing person); (3) information regarding a
    person who is or is suspected to be a crime victim; (4) in situations where the death of an individual may have resulted from criminal conduct; (5) in the event of a crime occurring on the premises of the Practice; and (6) a medical emergency (not on the Practice's premises) has occurred, and it appears that a crime has occurred.
  11. Coroner or Medical Examiner — The Practice may disclose your PHI to a coroner or medical examiner for the purpose of identifying you or determining your cause of death, or to a funeral director as permitted by law and as necessary to carry out its duties.
  12. Organ Eye or Tissue Donation – If you are an organ donor, the Practice may disclose your PHI to the entity to whom you have agreed to donate your
    organs.
  13. Research — If the Practice is involved in research activities, your PHI may be used, but such use is subject to numerous governmental requirements intended to protect the privacy of your PHI such as approval of the research by an institutional review board, the de-identification of your PHI before is used, and the requirement that protocols must be followed. Individuals have the option to 'opt out' of certain types of research activities.
  14. Avert a Threat to Health or Safety — The Practice may disclose your PHI if it believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and the disclosure is to an individual who is reasonably able to prevent or lessen the threat.
  15. Specialized Government Functions — When the appropriate conditions apply, the Practice may use PHI of individuals who are Armed Forces personnel: (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veteran Affairs of eligibility for benefits; or (3) to a foreign military authority if you are a member Of that foreign military service. The practice may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities including the provision of protective services to the President or others legally authorized.
  16. Inmates — The Practice may disclose your PHI to a correctional institution or a law enforcement official if you are an inmate of that correctional facility and your PHI is necessary to provide care and treatment to you or is necessary for the health and safety of other individuals or inmates.
  17. Workers' Compensation — If you are involved in a Workers' Compensation claim, the Practice may be required to disclose your PHI to an individual or entity that is part of the Workers' Compensation system.
  18. Disaster Relief Efforts — The Practice may use or disclose your PHI to a public or private entity authorized to assist in disaster relief efforts.
  19. Marketing – Face to face communication directly with the patient, treatment and coordination of care activities, refill reminders or communications about drugs that have already been prescribed, or promotional gifts of nominal value do not require authorization as long as the practice receives no financial remuneration for making the communication. All other situations require separate authorization.
  20. Required by Law — if otherwise required by law, but such use or disclosure will be made in compliance with the law and limited to the requirements of the law.

AUTHORIZATION
Uses and/or disclosures, other than those described above, will be made only with your written Authorization. These authorizations may be revoked at any time; however, we
cannot take back disclosures already made with your permission. We also will NOT use or disclose your PHI for the following purposes, where applicable, without your express written Authorization:

  • Marketing – This does not including marketing communications described in item #19. The Practice will obtain prior authorization before disclosing PHI in
    connection with marketing activities in which financial remuneration is received.
  • Sales – The Practice may receive payment for sharing your information in specific situations (i.e. public health purposes or specific research projects – see #12 above).
  • Specially protected information – Certain types of information such as psychotherapy notes, HIV status, substance abuse, mental health, and genetic testing information require their separate written authorization for the purposes of treatment, payment or healthcare operations.

APPOINTMENT REMINDER
The Practice may, from time to time, contact you to provide appointment reminders. The reminder may be in the form of a letter or postcard. The Practice will try to minimize the amount of information contained in the reminder. The Practice may also contact you by phone and, if you are not available, the Practice will leave a message for you.

TREATMENT ALTERNATIVES/BENEFITS
The Practice may, from time to time, contact you about treatment alternatives it offers, or other health benefits or services that may be of interest to you.

YOUR RIGHTS
You have the following rights regarding your medical information. In order to exercise these rights, you must contact The HIPAA Privacy Officer at the Company. You may be asked to submit a written request. The HIPAA Privacy Officer may be contacted using the following information:

Great Falls Chiropractic Clinic
Attn: HIPAA Privacy Officer
400 13 th Avenue South, Suite 104
Great Falls, MT 59405
Phone: (406) 727-1660
Fax: (406) 452-9094
Email: reception@gfccmt.com

Right to Inspect and Copy. With certain exceptions, you have the right to inspect and receive copies of your medical information.

Amendment. If you feel that medical information about you is incorrect or incomplete, you may ask the Company to amend the information.

Right to an Accounting of Disclosures. You have the right to receive a list of certain disclosures that we may have made of your medical information.

Right to Request Restrictions. You have the right to request a restriction or limitation on medical information that the Company uses or discloses about you for treatment, payment or health care operations, and to request a limit on the medical information that the Company may disclose to family members or friends involved in your care.

Request Confidential Communications. You have the right to request that the Company communicate with you about your appointments or other matters related to your treatment in a specific way or at a specific location.

Receive a Copy. You have the right to obtain a copy of this notice.

CHANGES TO THIS NOTICE
The Company reserves the right to change the terms of this Notice at any time. The Company reserves the right to make the revised or changed notice effective for medical information the Company already has about you as well as any information the Company receives in the future. The Company will post a copy of the current Notice. The Notice will contain an effective date.