Notice of Privacy Practices

Muscle and Joint Chiropractic – 250 North Main Street Suite A, Tooele UT 84074

Marty Rueckert D.C. – (435) 243-5542

Effective Date: 8-8-13

NOTICE OF PRIVACY PRACTICES

Your Medical Information Privacy Matters

Effective Date: August 8, 2013

This notice describes how we handle your medical information, outlining its use and disclosure, your rights, and our commitment to safeguarding your privacy. Please take a moment to review it carefully.

1. OUR COMMITMENT TO PRIVACY

We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. This notice outlines how we may use and disclose your medical information, your rights concerning this information, and how to contact our Privacy Officer with any questions.

2. TABLE OF CONTENTS

A. How We May Use or Disclose Your Health Information B. When We May Not Use or Disclose Your Health Information C. Your Health Information Rights D. Changes to this Notice of Privacy Practices E. Complaints

A. How We May Use or Disclose Your Health Information

1. Treatment: We use your medical information to provide the care you need, sharing it with healthcare providers involved in your treatment.
2. Payment: We may disclose your medical information to obtain payment for services provided to you, including sharing it with health plans or other providers involved in your care.
3. Health Care Operations: Your information may be used for the operation of this medical practice, including quality improvement, legal obligations, and reviews.
4. Appointment Reminders: We may contact you to remind you about appointments, leaving messages on your answering machine or with the person answering the phone if you’re not available.
5. Sign-In Sheet: We use your information when you sign in at our office or call your name when we are ready to see you.
6. Notification and Communication with Family: We may disclose your health information to notify family members, personal representatives, or others involved in your care unless instructed otherwise.
7. Marketing: We may contact you with information about related products, services, or health plans. We won’t use or disclose your information for marketing without your written authorization.
8. Sale of Health Information: We won’t sell your health information without your written authorization.
9. Required by Law: We may use or disclose your information as required by law, including reporting abuse, neglect, domestic violence, or responding to legal proceedings.
10. Public Health: We may disclose your information for public health purposes like disease prevention or reporting abuse.
11. Health Oversight Activities: Your information may be disclosed to health oversight agencies for audits, investigations, and inspections as required by law.
12. Judicial and Administrative Proceedings: We may disclose your information in legal proceedings or in response to subpoenas or other lawful requests.
13. Law Enforcement: Your information may be disclosed to law enforcement officials as required by law.
14. Coroners: We may disclose your information to coroners during investigations of deaths.
15. Organ or Tissue Donation: Your information may be shared with organizations involved in organ and tissue donation.
16. Public Safety: We may disclose your information to prevent harm to individuals or the general public.
17. Proof of Immunization: We will disclose proof of immunization to schools as required.
18. Specialized Government Functions: Your information may be disclosed for military, national security, or correctional purposes.
19. Workers’ Compensation: We may disclose your information to comply with workers’ compensation laws.
20. Change of Ownership: If this practice is sold or merged, your health information becomes the property of the new owner, but you have the right to request copies of your information.
21. Breach Notification: We will notify you of breaches of unsecured protected health information as required by law.

B. When We May Not Use or Disclose Your Health Information

We will not use or disclose your health information without your written authorization, except as described in this Notice of Privacy Practices.

C. Your Health Information Rights

1. Right to Request Special Privacy Protections: You have the right to request restrictions on certain uses and disclosures of your health information.
2. Right to Request Confidential Communications: You can request that your health information be sent to a specific location or in a specific way.
3. Right to Inspect and Copy: You have the right to inspect and copy your health information, with limited exceptions.
4. Right to Amend or Supplement: You may request amendments to your health information that you believe are incorrect or incomplete.
5. Right to an Accounting of Disclosures: You can receive an accounting of disclosures of your health information made by this medical practice, with some exceptions.
6. Right to a Paper or Electronic Copy of this Notice: You have the right to receive a paper copy of this Notice of Privacy Practices.

For more detailed information about these rights or to exercise them, contact our Privacy Officer.

D. Changes to this Notice of Privacy Practices

We may amend this notice at any time. The revised notice will apply to all protected health information maintained by us. We will keep a current copy posted in our reception area and on our website.

E. Complaints

If you have concerns about how we handle your health information, please contact our Privacy Officer. You may also file a formal complaint with the Department of Health and Human Services (HHS).

Email: OCRMail@hhs.gov Complaint Form: www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf

Filing a complaint will not result in any penalty. Your privacy and satisfaction are important to us.