For Wheelock Chiropractic
67 Millbrook St., Suite 204 Worcester, MA 01606
This notice is effective as of May 1, 2005, and describes how medical information about you can be used and disclosed in our office and how you can get access to this information. Please read carefully.
The Health Insurance and Accountability Act of 1996 (HIPPA) is a federal program that requires that all medical records and other identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This act gives you, the patient, important new rights to understand and control how your health information is used. HIPPA provides penalties for covered entities that misuse personal health information.
As required by HIPPA, Wheelock Chiropractic has prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information. We may use and disclose your medical records only for each of the following purposes: treatment, payment, and health care operations.
- Treatment means providing, coordinating, or managing health care and related services by one or more health care providers.
- Payment means obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review.
- Health care operations include the business aspect of running our practice, such as conducting quality assessment and improvement activities, auditing, functions, cost management analysis, and customer service.
Wheelock Chiropractic may also credit and distribute reidentified health information by removing all references to individually identifiable information.
This office may contact you to provide appointment reminders or information about treatment alternatives or other health-related services and benefits that may be of interest to you.
Any other uses and disclosures will be made only by your written authorization. You may revoke such authorization in writing, and we are required to honor and abide by that written request, except to the extent that we have already taken action relying on your prior authorization.
You have the following rights regarding your protected health information, which you can exercise by presenting a written request to the Privacy Officer:
- The right to reasonable requests to receive confidential communications of protected health information from Wheelock Chiropractic by alternative means or at alternative locations.
- The right to inspect or copy your protected health information.
- The right to amend your protected health information.
- The right to receive a detailed accounting of disclosures or your protected health information.
- The right to obtain a paper copy of this notice from us at your request.
We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.
This notice is effective as of May 1, 2005, and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of such provisions from this office. You have recourse if you feel your privacy protection has been violated. You have the right to file a formal complaint written with our office or with the Department of Health and Human Services, Office of Civil rights, about violations of the terms of this notice or the polices and procedures of our office.
For more information about HIPPA or to file a complaint:
The US Department of Health and Human Services
Office of Civil Rights , 200 Independence Ave. SW, Washington, DC 20201
1-877-696-6775