Notice of Privacy Practices
HIPAA Compliance - Effective Date: January 1, 2025
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.
Our Commitment to Your Privacy
NutriLife Wellness is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of Protected Health Information (PHI), provide you with notice of our legal duties and privacy practices, and follow the terms of our Notice of Privacy Practices currently in effect.
What is Protected Health Information (PHI)?
PHI is information that identifies you and relates to your past, present, or future physical or mental health condition, the provision of healthcare services to you, or payment for those services. This includes information such as your name, address, date of birth, Social Security number, health history, dietary records, and billing information.
How We May Use and Disclose Your PHI
Uses and Disclosures Without Your Authorization
We may use and disclose your PHI without your written authorization for the following purposes:
Treatment
We may use your PHI to provide, coordinate, or manage your nutrition care. This includes sharing information with other healthcare providers involved in your care.
Payment
We may use and disclose your PHI to bill and collect payment for services, including disclosures to insurance companies and other payers.
Healthcare Operations
We may use your PHI for quality assessment, staff training, business management, and other administrative activities.
As Required by Law
We may disclose PHI when required by federal, state, or local law, including reporting abuse, neglect, or domestic violence.
Public Health Activities
We may disclose PHI to public health authorities for purposes such as preventing or controlling disease.
Uses and Disclosures Requiring Your Authorization
For uses and disclosures not described above, we will obtain your written authorization. This includes:
- Marketing purposes
- Sale of your PHI
- Most uses of psychotherapy notes (if applicable)
- Other uses and disclosures not covered by this notice
You may revoke your authorization in writing at any time, except to the extent we have already acted on it.
Your Rights Regarding Your PHI
Right to Access
You have the right to inspect and obtain a copy of your PHI. Requests must be in writing. We may charge a reasonable fee for copies.
Right to Amend
You have the right to request amendments to your PHI if you believe it is incorrect or incomplete. We may deny requests in certain circumstances.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your PHI, excluding disclosures for treatment, payment, and healthcare operations.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to all requests.
Right to Confidential Communications
You have the right to request that we communicate with you in a specific way or at a specific location.
Right to a Paper Copy
You have the right to receive a paper copy of this notice upon request, even if you agreed to receive it electronically.
Our Responsibilities
- Maintain the privacy of your PHI as required by law
- Provide you with this notice of our privacy practices
- Follow the terms of the notice currently in effect
- Notify you if we cannot agree to a requested restriction or amendment
- Notify you in the event of a breach of your unsecured PHI
Changes to This Notice
We reserve the right to change this notice and make the new provisions effective for all PHI we maintain. If we make material changes, we will post the revised notice on our website and make copies available upon request.
Filing 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. You will not be retaliated against for filing a complaint.
To file a complaint with us:
Privacy Officer
NutriLife Wellness
123 Wellness Way, Suite 100
Health City, HC 12345
Email: privacy@nutrilifewellness.com
Phone: (555) 123-4567
To file a complaint with HHS:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Website: www.hhs.gov/ocr
Phone: 1-877-696-6775
Contact Information
For more information about our privacy practices or to exercise your rights, please contact:
Privacy Officer
NutriLife Wellness
123 Wellness Way, Suite 100
Health City, HC 12345
Email: privacy@nutrilifewellness.com
Phone: (555) 123-4567