Notice of Privacy Practices & Your PHI Patient Rights

HOW YOUR MEDICAL INFORMATION MAY BE USED OR DISCLOSED & HOW YOU CAN GET ACCESS TO THIS INFORMATION
Purpose

This Notice of Privacy Practices describes established privacy guidelines followed by our staff in relation to your protected health information (PHI). This notice will explain most situations of how and when we may use and disclose your PHI. Please note that despite our best efforts, this notice may not include every possible situation. Please address any questions to the Compliance Officer as noted at the end of this notice.

Protected health information (PHI)

This notice addresses information we maintain regarding your health, health status, and the healthcare services provided at our office. This information may include information collected and recorded in this office, as well as information received from other healthcare providers. The information may be in written, electronic, or spoken form. It may include information about your health history, health status, symptoms, examinations, test results, diagnoses, treatments, procedures, prescriptions, related billing activity; and similar types of health-related information. We are required by law to give you this notice. It will explain how we may use and disclose PHI about you and explain your rights regarding the use of that information.

How your PHI may be disclosed without your written consent

For Treatment - We may use or disclose information with healthcare providers who are involved in your care. Personnel in our office may share information to coordinate your care. Family members and other healthcare providers involved in your care outside of this office may require information about you.

For Payment - We may use or disclose PHI to bill for services provided and receive payment from an insurance company or other third party. Insurance companies may need information regarding a specific visit or procedure or require information to pre-approve future services.  

For Healthcare Operations - We may use or disclose PHI to operate and/or improve the office, its programs, and services.

Health Information Exchange (HIE) - HIE is a computer based, secure method of exchanging or disclosing patient health information with other organizations, for the purposes of healthcare treatment, payment, and operations.

Business Associates – We may contract with business associates who may perform certain functions and activities on our behalf. Our business associates are required to safeguard your PHI.

Appointment Reminders - We may contact you directly or leave messages as a reminder of your appointment for services.

Insurance Verification - We may contact your insurance company via telephone or their website to verify your insurance enrollment status.  

Treatment Alternatives - We may contact you regarding possible treatment alternatives.

Health-Related Products and Services – We may contact you regarding health-related products or services that may be of interest.

Other situations in which pine springs health may release PHI without consent

As Required by Law - We will use and disclose PHI when required by federal, state, or local law or by a court order. We may disclose PHI in response to a subpoena, warrant, summons, or similar process subject to all applicable legal requirements.

For Abuse Reports - We may use or disclose PHI to meet legally mandatory reporting requirements. The use is intended to prevent a serious threat to your health and safety or the health and safety of the public.

Research - We may use and disclose PHI for research projects if you have consented to participate in the study. If you have voluntarily consented to participation in a research study, researchers will be subject to the same PHI restrictions.  

De-Identified Information - We may use or disclose PHI in a way that does not identify who you are.

Organ and Tissue Donation - If you are an organ donor, we may use or disclose PHI to organizations that manage organ procurement to facilitate organ donation, transport, and transplantation.

Military, Veterans, National Security, and Intelligence - If you are or were a member of the armed forces, or part of the national security or intelligence communities, we may use or disclose PHI to military command or other government authorities as required.

Workers Compensation - We may use or disclose PHI for workers compensation or similar programs.  

Public Health Risks - We may use or disclose PHI for public health reasons to prevent or control disease, injury, or disability, or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products.

Health Oversight Activities - We may use or disclose PHI to a health oversight agency for audits, investigations, inspections, or licensing purposes.

Lawsuits and Disputes – We may use or disclose PHI in response to a court administrative order due to your involvement in a lawsuit or dispute. We may release PHI in response to a subpoena subject to all applicable legal requirements.

Coroners, Medical Examiners, and Funeral Directors - We may use or disclose PHI to a coroner or medical examiner when requested.

Your PHI Privacy Rights

Right to Inspect and Copy - With certain exceptions, you have the right to make a written request to receive a copy of your health records.

Right to Amend - You have the right to request that an amendment to your record be made if you think the information is incorrect or there is information missing. Your request must be in writing and must include a reason for the request. Pine Springs Health may deny your request for an amendment if the amended information was not originally created by Pine Springs Health, is not part of PHI that we maintain, was not permitted to be inspected and/or copied, or is already accurate and complete. A copy of your amendment request will be put in your record even if we do not agree to amend the record itself.

Right to Request Confidential Communications - You have the right to request that we communicate with you about your PHI in a way that complies with your Communication Preferences.  

Right to a List of Disclosures - You have the right to an “accounting of disclosures” of your PHI. This is a list of disclosures of PHI about you for purposes other than treatment, payment, healthcare operations, and a limited number of special circumstances involving national security, correctional institutions, and law enforcement. The list will exclude any disclosures we have made based on your written authorization.

Right to Request Restrictions - You have the right to request a restriction or limitation on the use of your PHI. The request must be in writing and describe what information you wish to be restricted and to whom. If the request is approved, the restrictions may be terminated in writing at any time in the future.

Right to Request Restrictions to Health Plan - You have the right to request a restriction of disclosure to your health plan for treatments you pay cash for. The request must be in writing and describe what information you wish to be restricted and the name of your health plan. This restriction does not extend to follow-up care or disclosures authorized to another provider unless the restriction request specifies. Pine Springs Health does have the right to bill your health plan if we are unable to obtain payment from you.

Right to Receive Notification of a Breach - If there is a breach involving your PHI, we will contact you in writing with a description of the breach, the type of information involved, the steps you should take to protect yourself, a summary of what is being done, and the person you can contact for further information.  

Right to File a Complaint - You have the right to file a complaint if you feel your privacy rights have been violated. You will not be penalized for filing a complaint. You may contact the Clinic Manager, or the Office for Civil Rights at:

Medical Privacy, Complaint Division  

U.S. Department of Health and Human Services  

200 Independence Avenue, SW  

HHH Building, Room 509H  

Washington, D.C. 20201  

Toll free phone: 877-696-6775  

866-627-7748 (phone)  

www.hhs.gov/ocr

Right to a Paper Copy of this Notice - You have a right to a paper copy of this notice at any time.

Website Privacy Policy & Terms of Service

Last Updated: July 25th, 2024

At Pine Springs Health, we respect your privacy and are committed to protecting it. This Privacy Policy outlines how we collect, use, communicate, disclose, and safeguard your information when you visit our website, or any website of ours that links to this privacy notice.

These terms and conditions outline the rules and regulations for the use of this website. By accessing this website, we assume you accept these terms and conditions in full. Do not continue to use Pine Springs Health's website if you do not accept all of the terms and conditions stated on this page.

The following terminology applies to these Terms and Conditions, Privacy Statement, and Disclaimer Notice and any or all Agreements: "Client," "You," and "Your" refers to you, the person accessing this website and accepting the Company's terms and conditions. "The Company," "Ourselves," "We," "Our," and "Us," refers to our Company. "Party," "Parties," or "Us," refers to both the Client and ourselves, or either the Client or ourselves. All terms refer to the offer, acceptance, and consideration of payment necessary to undertake the process of our assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or any other means, for the express purpose of meeting the Client's needs in respect of provision of the Company's stated services/products, in accordance with and subject to, prevailing law of United States. Any use of the above terminology or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable and therefore as referring to the same.

Information We Collect

We collect personal information that you provide to us voluntarily when you interact with our website. This may include your name, email address, postal address, phone number, and any other information you choose to provide.

We may also automatically collect certain information about your device, including your IP address, browser type, referring website, pages viewed, and the dates and times of your visits to our website.

Use of Information

We may use the information we collect from you to:

Disclosure of Information

We may disclose your personal information to third-party service providers who assist us in operating our website and providing services to you. These third parties are contractually obligated to use your personal information only as necessary to provide the services to us.

We may also disclose your personal information if required by law or in response to valid requests by public authorities (e.g., a court or government agency).

Security

We take reasonable measures to protect the security of your personal information and to prevent unauthorized access, disclosure, alteration, or destruction.

Links to Other Websites

Our website may contain links to third-party websites that are not operated by us. We have no control over, and assume no responsibility for, the content, privacy policies, or practices of any third-party websites or services.

Changes to This Privacy Policy

We may update our Privacy Policy from time to time. We will notify you of any changes by posting the new Privacy Policy on this page. You are advised to review this Privacy Policy periodically for any changes.

Cookies

We employ the use of cookies. By using Pine Springs Health's website you consent to the use of cookies in accordance with our privacy policy.

Most of the modern-day interactive web sites use cookies to enable us to retrieve user details for each visit. Cookies are used in some areas of our site to enable the functionality of this area and ease of use for those people visiting. Some of our affiliate/advertising partners may also use cookies.

License

Unless otherwise stated, Pine Springs Health and/or its licensors own the intellectual property rights for all material on pinespringshealth.com. All intellectual property rights are reserved. You may view and/or print pages from https://www.pinespringshealth.com for your own personal use subject to restrictions set in these terms and conditions.

You must not:

Reservation of Rights

We reserve the right at any time and in its sole discretion to request that you remove all links or any particular link to our Web site. You agree to immediately remove all links to our Web site upon such request. We also reserve the right to amend these terms and conditions and its linking policy at any time. By continuing to link to our Web site, you agree to be bound to and abide by these linking terms and conditions.

Removal of links from our website

If you find any link on our Web site or any linked web site objectionable for any reason, you may contact us about this. We will consider requests to remove links but will have no obligation to do so or to respond directly to you.

Disclaimer

To the maximum extent permitted by applicable law, we exclude all representations, warranties, and conditions relating to our website and the use of this website (including, without limitation, any warranties implied by law in respect of satisfactory quality, fitness for purpose and/or the use of reasonable care and skill). Nothing in this disclaimer will:

The limitations and exclusions of liability set out in this Section and elsewhere in this disclaimer: (a) are subject to the preceding paragraph; and (b) govern all liabilities arising under the disclaimer, including liabilities arising in contract, in tort, and for breach of statutory duty.

To the extent that the website and the information and services on the website are provided free of charge, we will not be liable for any loss or damage of any nature.

Contact Us

If you do not agree with our policies and practices, please do not use our Services. If you still have any questions or concerns, please contact us at info@pinespringshealth.com.