Notice of Privacy Practices
This Notice of Privacy Practices describes how Whole Body Health may use and disclose your protected health information (PHI) to provide treatment, obtain payment, and conduct healthcare operations. It also outlines your rights regarding your PHI and how you can get access to this information. Please review this notice carefully.
Right to a Copy of This Notice: You have a right to have a paper copy of our Notice of Privacy Practices at any time.
Right of Access to Review and Request: You have the right to review and obtain copies of your medical records, available in electronic or paper formats (fees may apply for paper copies). To request your records, please sign a release form at the front desk. You can also request to send records to a third party. We may deny requests in certain situations, and if we do, we will provide a written explanation and inform you of your right to have our decision reviewed.
Right to Have Medical Information Amended: You have the right to have us correct medical information about you that you think is incorrect or incomplete. We will notify others who have copies of incorrect or incomplete information. If you would like us to correct information, you must provide us with a request in writing that explains your reasoning. We may deny your request, but we will inform you of our reasoning in writing.
Right to Request Confidential Communication: You have the right to request to be contacted at a different location or by a different method as long as the request is made in writing.
Right to Choose Someone to Act For You: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and acts for you before we take any action.
Right to an Accounting of Disclosures: You have the right to receive a detailed listing of the times that we have shared your health information in the last six years. If you would like to receive an accounting, you may send us a letter requesting one. We will include all disclosures except for those about treatment, payment, and healthcare operations. If you request an accounting more than once every year, we may charge you a fee to cover the costs of preparing the accounting.
Right to Request Restrictions on Uses and Disclosures: You have the right to request that we limit the use and disclosure of your PHI for treatment, payment and health care operations. We are not required to agree with your request for a restriction and we may say no if it affects your care. Under federal law, we must agree to your request and comply with your requested restriction(s) if:
The medical information pertains solely to a health care item or service that has been paid out-of-pocket in full unless required by law to share that information.
Once we agree to your request, we must follow your restrictions (except if the information is necessary for emergency treatment). You may cancel the restrictions at any time. In addition, we may cancel a restriction at any time as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation.
Patient Rights
You have several rights with respect to your PHI. This section of the Notice will briefly mention each of these rights. If you would like to know more about your rights, please contact our front desk.
Patient Choices
For certain health information you can choose what we share. If you have preferences about the scenarios described below, please let us know.
You have the choice to tell us to share information with your family, friends, or others involved in your care.
We never share your information without written permission for marketing purposes such as social media.
Our Uses and Disclosures
This section of our Notice explains how we may use and disclose your PHI in order to provide health care, obtain payment for that health care, and operate our business efficiently. This section then briefly mentions several other circumstances in which we may use or disclose medical information about you. For more information about any of these uses or disclosures, or about any of our privacy policies, procedures or practices, contact the front desk.
Treatment:
We may use and disclose medical information about you to provide, coordinate or manage your health care. We may share information with Northwestern Health Sciences University for imaging reports, Activate Metabolics, your insurance company, and other associate providers including but not limited to Dr. David Neubauer, DC. We may also use your information to contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Payment
We may use and disclose your PHI to obtain payment for health care services that you received. We may disclose medical information about you to others (such as insurers, collection agencies, and consumer reporting agencies).
Healthcare Operations
We may use and disclose medical information about you in performing a variety of business activities that we call “health care operations.” These “health care operations” activities allow us to, for example, improve the quality of care we provide and reduce health care costs. For example, we may use or disclose medical information about you in performing the following activities:
Reviewing and evaluating the skills, qualifications, and performance of health care providers taking care of you.
Providing training programs for students, trainees, health care providers or non-health care professionals to help them practice or improve their skills.
Cooperating with outside organizations that evaluate, certify or license health care providers, staff or facilities in a particular field or specialty.
Cooperating with ChiroHealthUSA, the program used for cash patients in this office.
Cooperating with outside organizations that assess the quality of the care others and we provide, including government agencies and private organizations.
Working with our electronic health record, HealthCORE.
Reviewing our activities and using or disclosing medical information in the event that control of our organization significantly changes.
Working with others (such as lawyers, accountants and other providers) who assist us to comply with this Notice and other applicable laws.
Persons Involved in Your Care
Family and Friends: We may disclose your medical information to a relative, close friend, or person you identify if they are involved in your care and you provide written consent. Disclosure will be limited to relevant information. You can request that we not share your information, and we will honor your request, except in emergencies or if the patient is a minor.
Minors: We may disclose medical information about a minor to a parent, guardian or other person responsible for the minor except in limited circumstances. If the patient is a minor, we may or may not be able to agree to a request to not disclose information.
National Priority Uses and Disclosures
When allowed by law, we may disclose your medical information without your permission for activities deemed "national priorities." The government recognizes certain circumstances as critical for disclosure without individual consent. We will only disclose your information under these specific legal conditions:
Required by law: We will share information if it is necessary to comply with state and federal laws.
Threat to health or safety: We may use or disclose medical information about you if we believe it is necessary to prevent or lessen a serious threat to a patient’s health or safety. This includes suspected abuse, neglect, or domestic violence.
Public health activities: We may use or disclose medical information for public health issues such as: investigating and preventing disease, helping with product recalls, and reporting adverse reactions to medications.
Health research: We can use or share information for health research.
Medical examiner or funeral director: We may share health information with a coroner, medical examiner, or funeral director or to organizations that help with organ, eye and tissue transplants when an individual dies.
Workers’ compensation, law enforcement, and other government requests: We may use or disclose information for workers’ compensation claims, law enforcement purposes, health oversight agencies for activities authorized by law, or for special government functions including military, national security, and correctional institutions.
Court proceedings: We may disclose information about you in response to a court or administrative order.
Authorizations
Other than the uses and disclosures described above, we will not use or disclose medical information about you without your or your personal representative’s written consent. In a circumstance that we wish to use or disclose your PHI we will contact you to ask for your written consent. In other instances, you may contact us to ask us to disclose medical information and we will ask you to sign a records release form. If you sign a written consent allowing us to disclose medical information about you, you may later revoke your authorization in writing.
Our Responsibilities
We are required by law to maintain the privacy and security of your PHI including information about care we provide to you, payment for health care provided to you, or patient identification information . It may also be information about your past, present, or future medical condition(s).
We are also required by law to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices with respect to your medical information.
We are required by law to notify you if there is a breach of PHI that has compromised the privacy or security of your information.
We will not use or share your PHI other than as described in this Notice unless we are given your consent in writing. If you give consent, you can change your mind at any time so long as we are informed in writing.
We are legally required to follow the terms of this Notice.
Changes to the Terms of this Notice
We may change the terms of this Notice in the future. We reserve the right to make changes and to make the new Notice effective for all medical information that we maintain. If we make changes to the Notice, we will notify you.
This Notice is effective January 1st of 2025.
Filing a Complaint
If you believe that your privacy rights have been violated or if you are dissatisfied with our Notice of Privacy Practices, you may file a written complaint either with us or with the federal government. We will not take any action against you or change our treatment of you in any way if you file a complaint.
To file a written complaint with us, you may bring your complaint directly to Dr. Alan Bergquist at drb@compliantchiro.com.
To file a written complaint with the federal government, please use the following contact information:
U.S. Department of Health and Human Services Office for Civil Rights:
200 Independence Avenue, S.W.
Room 509F,
HHH Building
Washington, D.C. 20201
Toll-Free Phone: (800) 368-1019
TDD Toll-Free: (800) 537-7697
Website: http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
Email: OCRMail@hhs.gov