PRIVACY POLICY

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

Atlas Rising 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.

Disclosure of Your Health Care Information

Treatment

We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations (example)

“On occasion, it may be necessary to seek consultation regarding your treatment from other health care providers associated with Atlas Rising”

“It is our policy to provide a substitute health care provider, authorized by Atlas Rising 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.”

Due to the nature of Atlas Rising’s adjusting areas, others may overhear conversations between the doctor and patient although every effort will be made to avoid loss of confidentiality. At any time, you may request a private consultation with the doctor.

Payment

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 statement to your insurance center for the purpose of payment to Atlas Rising for health care services rendered. If you pay for your health care services personally, we will, as a courtesy to you, provide and 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 may describe the health care services received.”

Worker’s Compensation

We may disclose your health information as necessary to comply with State Workers Compensation Laws.

Emergencies

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 your death.

Public Health

As required by law, we may disclose your health information to public health authorities for the 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 reaction to medications, and reporting disease or infectious exposure.

Judicial and Administrative Proceedings

We may disclose your health information in the course of any administrative or judicial proceedings.

Law Enforcement

We may disclose your health information to law enforcement officials for purposes such as identifying or location a suspect, fugitive, material witness or missing person, complying with a court order of subpoena, and other law enforcement purposes.

Deceased Persons

We may disclose your health information to coroners or medical examiners.

Organ Donation

We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.

Research

We may disclose your health information to researchers conducting research that has been approved by the Institutional Review Board.

Public Safety

It may be necessary to disclose your health information to appropriate persons in order to prevent or lesson a serious and imminent threat to the health or safety of a particular person or to the general public.

Specialized Government Agencies

We may disclose your health information for military, nation security, prisoner and government benefits purposes.

Marketing

We may contact you for marketing purposes or fundraising purposes, as described below: (example)

As a courtesy to our patients, it can be our policy to call your home on the evening prior to your scheduled appointment to remind you of your appointment time. If you are not home, we will leave a reminder message on your answering machine or with the person answering the phone. 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.

“It is our practice to participate in charitable events to raise awareness, food donations, etc. During these times, we may need to send you a letter, post card, email 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 request your participation in such an event. It is not our policy to disclose any personal health information about your condition for the purpose of Atlas Rising sponsored fund-raising events.”

I grant permission to Atlas Rising and its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/ or video images taken of me, or members of my family, for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Atlas Rising and its legal representatives for all claims and liability relating to said images or video. I waive my right to any compensation.

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 Atlas Rising is not required to agree to the restriction 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 receive a copy of your health information.
You have the right to request that Atlas Rising amend your protected health information. Please be advised, however, that Atlas Rising 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.
You have the right to receive an accounting of disclosures of your protected health information made by Atlas Rising.
You have the right to a paper copy of this Notice of Privacy Practices at any time upon request.

Changes to this Notice of Privacy Practices

Atlas Rising 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 the information that it maintains. Until such an amendment is made, Atlas Rising is required by law to comply with this Notice.

Atlas Rising 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 Chandra Endel by calling this office at 614-898-9195. If she is not available you may make an appointment for a personal conference in person or by telephone within 2 working days.

Complaints

Complaints about your privacy rights or how Atlas Rising has handled your health information should be directed to Chandra Endel by calling this office at 614-898-9195. If she is not available you may make an appointment for a personal conference in person or by telephone within 2 working days.

I have read the Privacy Notice and understand my rights contained in the notice by way of my signature, I provide Atlas Rising with my authorization and consent to use and disclose my protected health care information for the purposes of the treatment, payment and health care operations as described in the Privacy Notice.