Thomsen Chiropractic – Notice of Privacy Practices

Thomsen Chiropractic, LLC is committed to safeguarding your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state law.

We may use or disclose your PHI for the following purposes without additional authorization:

• Treatment: We may use and share your PHI to coordinate or manage your care with other healthcare providers. For example, if your primary care provider needs to know what services you have received with Thomsen Chiropractic in order to determine whether additional therapies are required, we may share your PHI with your primary care provider.
• Payment: We may use and share your PHI to bill and receive payment from insurance companies or third-party payers. For example, we may share your PHI with your insurance company to prove we provided a service and get paid for that service.
• Healthcare Operations: We may use and share your PHI to run the clinic and make sure all patients receive good care, improve your care, and run the clinic better. For example, we may use your PHI for administrative purposes such as quality assessment, training, and business management.

• Business Associates: We have individuals and entities that perform functions and activities on behalf of the clinic, which may have access to your PHI. Examples include billing companies, accountants, and lawyers.
• Legal Requirements: In response to law enforcement requests, subpoenas, court orders, or public health requirements.
• Emergencies or Communication Barriers: When necessary to act in your best interest if you are unable to communicate.
• Family or Friend: We may disclose to a family member, other relative, or a close personal friend of yours, or any other person identified by you, the PHI directly relevant to that person’s involvement with your care or payment.
• Notice: To give notice to your family member, your personal representative, or another person responsible for your care your location, general condition, or death.
• Fundraising: We may contact you to raise funds for the clinic, but you have the option to opt out of these communications.
• Breach Notification: We will notify you if a breach involving your unsecured PHI occurs.
• Other Special Cases: For research, military or national security purposes, organ donation, and workers’ compensation as permitted by law.

We will not use or disclose your PHI without your written authorization with regard to your psychotherapy notes, marketing, or the sale of your PHI.

Any other uses and disclosures not described in this notice will be made unless you provide written authorization.

If you provide a written authorization, you may revoke the written authorization at any time by providing the clinic with a written revocation. However, revocation may not be effective if we have already taken action in reliance of the written authorization or the written authorization was obtained as a condition of obtaining insurance coverage.

We will not use or disclose your PHI as provided in 45 C.F.R. 164.502(a)(5)(iii), which regards reproductive health care. For example, we will not use or disclose your PHI to impose criminal, civil, or administrative liability on any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care.

Once your PHI is used or disclosed pursuant to the reasons set forth above, your PHI is subject to redisclosure by the recipient and no longer protected under 45 C.F.R. 164, Subpart E.

You have the right to:

• Access, Inspect, and Copy Your Records: Access your records, inspect your records, and request a paper or digital copy of your health records, unless restricted or prohibited by law.
• Request Restrictions: Request limitations on how we use or share your information. We may not agree to the requested restriction, but we will in cases where disclosure restrictions are required.
• Confidential Communications: Request that we contact you at a specific address, phone number, or method.
• Amend Your Records: Request corrections to your health information if you believe it is inaccurate or incomplete.
• Accounting of Disclosures: Request a list of disclosures made in the past six (6) years.
• Revoke Authorizations: Cancel previously granted authorizations at any time in writing.
• Receive a Paper Copy: Request a paper copy of this notice at any time.
• File a Complaint: 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. To file a complaint with us, please call or email the Privacy Officer (listed below).