Health Star Clinic, INC. DBA Health Star Clinic
Silver Group Chiropractic, Inc DBA Health Star Clinic
NOTICE OF PRIVACY PRACTICES
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.
This notice talks about the privacy of your Protected Health Information. That’s nothing new – we’ve always taken great care to guard our patients’ privacy. What is new is a government regulation requiring us to spell out your rights. That’s what you’ll find on the following pages, and that’s why we asked for your signature indicating that you received this notice.
Health Star Clinic. is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information.
This Notice of Privacy Practices describes how we may use and disclose Protected Health Information to carry out treatment, payment, or other healthcare operations and for other specified purposes that are permitted or required by law. This notice also describes your rights with respect to your Protected Health Information. We are required to provide this notice to you by the Health Insurance Portability and Accountability Act (HIPPA).
Health Star Clinic is required to follow the terms of this notice. We will not use or disclose your Protected Health Information. We will not use or disclose your Protected Health Information without your written authorization, except as described or otherwise permitted by this notice. We reserve the right to change our practices and this notice, and to make the new notice effective for all Protected Health Information we maintain. Upon request, we will provide any revised notice to you.
Normally, the privacy of a patient’s personal health information is protected. However, under certain circumstances government rules and regulations supercede the patient’s right of privacy. For instance, doctors are required by law to report certain communicable diseases to the appropriate government agencies. Child abuse is another area where government regulations supercede the patient’s right to privacy.
Effective April 14, 2003, all physicians are required, by law, to provide their patients with a written notice listing the situations in which the patient’s right of privacy may be superceded by, or secondary to, other government regulations and/or Health Star Clinic’s privacy practices. The following is your notice, which we are required to give to every patient, and also to have each patient acknowledge the fact that they received the notice.
Types of Information We Collect
Non-personal information is data about usage and service operation that is not directly associated with a specific personal identity. The Operators may collect and analyze non-personal information to evaluate how visitors use the Operators’s web sites.
The Operators may gather aggregate information, which refers to information your computer automatically provides to us and that cannot be tied back to you as a specific individual. Examples include referral data (the web sites you visited just before and just after our site), the pages viewed, time spent at our Web site, and Internet Protocol (IP) addresses. An IP address is a number that is automatically assigned to your computer whenever you access the Internet. For example, when you request a page from one of our sites, our servers log your IP address to create aggregate reports on user demographics and traffic patterns and for purposes of system administration.
Every time you request or download a file from the web site, the Operators may store data about these events and your IP address in a log file. The Operators may use this information to analyze trends, administer the web site, track users’ movements, and gather broad demographic information for aggregate use or for other business purposes.
Most browser software can be set up to deal with cookies. You may modify your browser preference to provide you with choices relating to cookies. You have the choice to accept all cookies, to be notified when a cookie is set or to reject all cookies. If you choose to reject cookies, certain of the functions and conveniences of our web site may not work properly, and you may be unable to use those of the Operators’s services that require registration in order to participate, or you will have to re-register each time you visit our site. Most browsers offer instructions on how to reset the browser to reject cookies in the “Help” section of the toolbar. We do not link non-personal information from cookies to personally identifiable information without your permission.
The Operators’s web site also may use web beacons to collect non-personal information about your use of our web site and the web sites of selected sponsors or members, your use of special promotions or newsletters, and other activities. The information collected by web beacons allows us to statistically monitor how many people are using our web site and selected sponsors’ sites; how many people open our emails; and for what purposes these actions are being taken. Our web beacons are not used to track your activity outside of our web site or those of our sponsors. The Operators do not link non-personal information from web beacons to personally identifiable information without your permission.
Personal information is information that is associated with your name or personal identity. The Operators use personal information to better understand your needs and interests and to provide you with better service. On some of the Operators web pages, you may be able to request information, subscribe to mailing lists, participate in online discussions, collaborate on documents, provide feedback, submit information into registries, register for events, apply for membership, or join technical committees or working groups. The types of personal information you provide to us on these pages may include name, address, phone number, e-mail address, user IDs, passwords, billing information, or credit card information.
Members-Only Web Sites
Information you provide on Operators’s membership applications is used to create a member profile, and some information may be shared with other of the Operators’s individual member representatives and organizations. Member contact information may be provided to other members on a secure web site to encourage and facilitate collaboration, research, and the free exchange of information among the Operators’s members, but we expressly prohibit members from using member contact information to send unsolicited commercial correspondence. The Operators’s members may be automatically added to the Operators’s mailing lists. From time to time, member information may be shared with event organizers and/or other organizations that provide additional benefits to the Operators’s members. By providing us with your personal information on the membership application, you expressly consent to our storing, processing, and distributing your information for these purposes.
How We Use Your Information
The Operators may use non-personal data that is aggregated for reporting about the Operators’s web site usability, performance, and effectiveness. It may be used to improve the experience, usability, and content of the site.
The Operators may use personal information to provide services that support the activities of the Operators’s members and their collaboration on the Operators’s standards and projects. When accessing the Operators’s members-only web pages, your personal user information may be tracked by the Operators in order to support collaboration, ensure authorized access, and enable communication between members.
Credit card information may be collected to facilitate membership applications; or if you purchase a product or service from our website, such information will not be kept longer than necessary for providing the services requested. Credit card numbers are used only for processing payment and are not used for other purposes. Payment processing services may be provided by a third-party payment service, and a management company external to the Operators may provide support for the financial activities of the Operators. the Operators may share your personal information with its partners to facilitate these transactions.
In keeping with our open process, the Operators may maintain publicly accessible archives for the majority of our activities. For example, posting an email to any of the Operators’s-hosted public mail lists or discussion forums, subscribing to one of our newsletters or registering for one of our public meetings may result in your email address becoming part of the publicly accessible archives.
On some sites, anonymous users are allowed to post content and/or participate in forum discussions. In such a case, since no user name can be associated with such a user, the IP address number of a user is used as an identifier. When posting content or messages to a Operators site anonymously, your IP address may be revealed to the public.
If you are a registered member of an Operators’s website or email list, you should be aware that some items of your personal information may be visible to other members and to the public. The Operators’s member databases may retain information about your name, e-mail address, company affiliation (if an organizational member), and such other personal address and identifying data as you choose to supply. That data may be visible to other of the Operators’s members and to the public. Your name, e-mail address, and other information you may supply also may be associated in the Operators’s publicly accessible records with the Operators’s various committees, working groups, and similar activities that you join, in various places, including: (i) the permanently-posted attendance and membership records of those activities; (ii) documents generated by the activity, which may be permanently archived; and, (iii) along with message content, in the permanent archives of the Operators’s e-mail lists, which also may be public.
Please remember that any information (including personal information) that you disclose in public areas of our web site, such as forums, message boards, and news groups, becomes public information that others may collect, circulate, and use. Because we cannot and do not control the acts of others, you should exercise caution when deciding to disclose information about yourself or others in public forums such as these.
If you do not want your personal information collected and used by the Operators, please do not visit the Operators’s web site or apply for membership of any of the Operators’ websites or email lists.
Access to and Accuracy of Member Information
The Operators are committed to keeping the personal information of our members accurate. All the information you have submitted to us can be verified and changed. In order to do this, please email us a request. We may provide members with online access to their own personal profiles, enabling them to update or delete information at any time. To protect our members’ privacy and security, we also may take reasonable steps to verify identity, such as a user ID and password, before granting access to modify personal profile data. Certain areas of the Operators’s web sites may limit access to specific individuals through the use of passwords or other personal identifiers; a password prompt is your indication that a members-only resource is being accessed.
The Operators make every effort to protect personal information by users of the web site, including using firewalls and other security measures on its servers. No server, however, is 100% secure, and you should take this into account when submitting personal or confidential information about yourself on any web site, including this one. Much of the personal information is used in conjunction with member services such as collaboration and discussion, so some types of personal information such as your name, company affiliation, and email address will be visible to other the Operators’s members and to the public. The Operators assume no liability for the interception, alteration, or misuse of the information you provide. You alone are responsible for maintaining the secrecy of your personal information. Please use care when use access this web site and provide personal information.
From time to time the Operators may email you electronic newsletters, announcements, surveys or other information. If you prefer not to receive any or all of these communications, you may opt out by following the directions provided within the electronic newsletters and announcements.
Disclosure of Your Health Care Information
The following categories describe different ways that we use and disclose your Protected Health Information. We have also provided examples in certain categories; however, not ever use or disclosure in a category will be listed. Under certain circumstances, your protected Health Information may be disclosed as outlined below:
1. Disclosure for Treatment Purposes
We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations. Examples:
On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with Health Star Clinic.
It is our policy to provide a substitute health care provider, authorized by Health Star, Inc. DBA Health Star Clinic to provide assessment and/or treatment to our patients, without advanced notice, in the event of your primary health care provider’s absence due to vacation, sickness, or other emergency situation”
2. Inadvertent Disclosures
In our clinic, some of the treatment areas are used to provide treatment to more than one patient at the same time. For this reason, we try to talk to the patient quietly but, it is possible that other patients might, from time to time, overhear parts of our conversations with you, or be able to see portions of your x-rays or medical records. Therefore, if you feel a need for additional privacy at any time, you may make this request and we will make every attempt to honor your request.
3. Disclosure for Payment Purposes
We may disclose your health information to your insurance provider for the purpose of payment or health care operations. Example:
“As a courtesy to our patients, we will submit an itemized billing statement to your insurance carrier for the purpose of payment to Health Star Clinic for health care services rendered. If you pay for your health care services personally, we will, as a courtesy, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you. The billing statement contains medical information, including diagnosis, date of injury or condition, and codes which describe the health care services received.”
Under certain circumstances we are also permitted to use or disclose your Protected Health Information for the following purposes. However, Health Star Clinic. may never have reason to make some of these disclosures
4. Disclosure for Workers’ Compensation Purposes
We may disclose your health information as necessary to comply with State Workers’ Compensation Laws.
5. Disclosure for Emergency Purposes
We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or of your death.
6. Disclosure for Public Health Purposes
As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
7. Disclosure for Judicial and Administrative Proceedings.
We may disclose your health information in the course of any administrative or judicial proceeding.
8. Disclosure for Law Enforcement Purposes
We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.
9. Disclosure for Deceased Persons.
We may disclose your health information to coroners or medical examiners.
10. Disclosure for Public Safety Purposes.
It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.
11. Disclosure for Specialized Government Agencies Purposes.
We may disclose your health information for military, national security, prisoner and government benefits purposes.
12. Disclosure for Appointment Reminders, Marketing & Fundraising Purposes
We may contact you for appointment reminders, marketing purposes or fundraising purposes, as described below: Examples:
A) Appointment Reminders – Our policy is to remind you of scheduled or missed appointments. Typically, we may call your home concerning a scheduled appointment or missed appointment. If you are not at home, we may leave a reminder message on your answering machine or with the person answering the phone. We may also call you at your work number. If you are not available, we may leave a reminder on your voice mail or with the person who takes your messages. No personal health information will be disclosed during this recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment.
B) Marketing & Fundraising – It is our practice to participate in charitable events ( such as Patient Appreciation Days) to raise awareness, food donations, gifts, money, etc. In doing so, we may send you a letter, post card, invitation or call your home to invite you to participate in the charitable activity. We will provide you with information about the type of activity, the dates and times, and invite you to participate. It is not our policy to disclose any personal health information about your condition for the purpose of Health Star Clinic. sponsored or co-sponsored fundraising events.
13. Lab or Test Results
We may notify you of the availability of lab or test results by calling your home or office. If you are not available, we will leave a message stating that your results are available and asking you to return the call.
We may, from time to time, communicate with you by electronic mail. We will assume your electronic mail is private. If your electronic mail is not private, or if you do not want to receive communications by electronic mail, please let us know.
15. Disclosure In the Event of Change of Ownership.
In the event that Health Star Clinic. is sold or merged with another organization, your health information/record will become the property of the new owner.
16. Video Survelliance.
The waiting area, therapy area and common adjusting area of our office are equipped with video cameras. These allow the doctors and staff to see how many patients are in each area. This information helps us to manage the health care operations of our office. We store the last 7-10 days of video in electronic format, but we do not make or keep videotapes of these areas. The only cameras in this office are in the waiting area, hallway, therapy area and common adjusting area.
YOUR HEALTH INFORMATION RIGHTS
You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that Health Star Clinic. is not required to agree to the restriction that you requested.
You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.
You have the right to inspect and request a copy of your health information. In most cases, you have the right to access and copy the Protected Health Information that we maintain about you. To inspect or copy your Protected Health Information, you must send a written request to our Privacy Officer at Health Star Clinic. Po Box 241467, Montgomery, Al 36124. We may charge you a fee for the costs of copying, mailing and supplies necessary to fulfill your request. By law, Health Star Clinic has 60-90 days to respond to your written request. In certain limited circumstances we may deny your request.
You have a right to request that Health Star Clinic. amend your Protected Health Information. Please be advised, however, that Health Star Clinic. is not required to agree to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s)and information about how you can disagree with the denial.
You have a right to receive an accounting of disclosures of your protected health information made by Health Star Clinic.
You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
Changes to this Notice of Privacy Practices
Health Star Clinic. reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, Health Star Clinic. is required by law to comply with this Notice.
Health Star Clinic. is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this notice or if you want more information about your privacy rights, please contact: The Privacy Officer by calling this office at (334) 491-1111. If our Privacy Officer is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
Complaints about your Privacy rights, or how Health Star Clinic has handled your health information should be directed to our Privacy Officer by calling Montgomery at (334) 356-1111 or Prattville at (334) 491-1111. If our Privacy Officer is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to:DHHS, Office of Civil Rights 200 Independence Avenue, S.W. Room 509F HHH Building Washington, DC 20201