Privacy Policy

Your Information. Your Rights. Our Responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully.

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Your Rights

When it comes to your health information, you have certain rights.
This section explains your rights and some of our responsibilities to help you.

• Get an electronic or paper copy of your medical record:
  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within thirty (30) days of your request. We may charge a reasonable, cost-based fee.
• Ask us to correct your medical record
  • You can ask us to correct health information about you that you think is incorrect or incomplete.
    Ask us how to do this.
  • We may say “no” to your request, but we will tell you why in writing within sixty (60) days.
• Request confidential communications
  • You can ask us to contact you in a specific way (for example, home or office phone or to send mail to a different address).
  • We will say “yes” to all reasonable requests.
• Ask us to limit what we use or share
  • You can ask us not to use or share certain health information for treatment, payment, or our operations.
  • Note: We are not required to agree to your request, and we say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
  • Note: We will say “yes” unless a law requires us to share that information.
• Get a list of those with whom we’ve shared information
  • You can ask for a list (accounting) of the times we have shared your health information for six (6) years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another within twelve (12) months.
• Get a copy of this privacy notice
  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive this notice electronically. We will provide you with a paper copy promptly.
• Choose someone to act for you
  • If you have given someone medical power of attorney or is 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 can act for you before we take any action.
• File a compliant if you feel you rights are violated
  • You can complain if you feel we have violated your rights by contacting us using the information found in this document. on the back page.
  • You can file a complaint with the U.S. Department Health and Human Services Office for Civil Rights by sending a letter to:
  • 200 Independence Avenue, S.W.
    Washington, D.C. 20201
    Phone: 1-877-696-6775
    Website: www.hhs.gov/ocr/privacy/hippa/complaints/
  • We will no retaliate against you for a filing a complaint.

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Your Choices

For certain health information, you can tell us your choices about what we share.
If you have a clear preference for how we share information in the situations described below, talk to us. Tell us what you want to do, and we will follow your instructions.

• In these cases, you have both the right and choice to tell us to:
  • Share information with your family, close friends, or others involved in your care.
  • Share information in a disaster relief situation
  • Note: If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to your health or safety.
• In these cases, we never share your information unless you give us written permission
  • Marketing purposes
  • Sale of your information

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Other Uses and Disclosures

How do we typically use or share your health information?
We typically use or share your health information in the following ways.

• Treat you
  • We can use your health information and share it with other professionals who are treating you.
  • Example: A doctor treating you for an injury asks another doctor about your overall health condition.
• Run our organization
  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  • Example: We use health information about you to manage your treatment and services.
• Bill for your Services
  • We can use and share your health information to bill and get payment from health plans or other entities.
  • Example: We give you information about you to your health insurance plan so it will pay for your services.

How do we typically use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes.

For more information visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

• Comply with the law
  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
• Address workers’ compensation, law enforcement, and other government requests
  • We can use or share information about you:
    • For workers’ compensation claims
    • For law enforcement purposes or with a law enforcement official
    • With health oversight agencies for activities authorized by law
    • For special government functions such a military, national security, and presidential protective services
• Respond to lawsuits and legal actions
  • We can share health information in response to a court or administrative order, or in response to a subpoena.
• Research
  • We may use and disclose information for certain research purposes, but only when we have approval from an Institutional Review Board (IRB) or other specific conditions are met.

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Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Changes to the Terms of This Notice:
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

This Notice of Privacy Practices applies to the following organization:
Spiras Health, Inc.
111 Westwood Place Suite 100
Brentwood, Tennessee 37027

Privacy & Compliance Officer: Jonathan Weaver
Phone: (615) 398-6299
Email: privacy@spirashealth.com
Website: www.spirashealth.com