Notice of Privacy Practices

Effective Date: October 1, 2023

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.

The privacy of your medical information is important to us.

Summary

This notice contains a detailed description of how Summit Hyperbarics + Wellness protects your health information, your rights as a participant, and the legal duties that apply to our privacy practices.

Uses and Disclosures of Health Information

We may use and disclose protected health information to treat you, support care coordination, and obtain payment for healthcare services. We may also disclose information for limited operational activities such as quality assessment, licensing, accreditation, and training.

Uses and Disclosures Based on Your Authorization

Except as otherwise described in this notice or permitted by law, we will not use or disclose your protected health information without your written authorization. You may revoke your authorization in writing at any time, except to the extent we have already acted on it.

Uses and Disclosures Not Requiring Your Authorization

In specific circumstances, we may disclose protected health information without written authorization, including for:

  • Others involved in your care (for example, family members or close friends involved in care decisions)
  • Certain limited research purposes
  • Public health and safety activities
  • Health oversight activities such as audits and investigations
  • Abuse, neglect, or domestic violence reporting when authorized by law
  • Food and Drug Administration reporting activities
  • Law enforcement and required-by-law disclosures
  • Court, subpoena, warrant, and other legal process requirements

Participant Rights

As a participant, you have rights regarding your protected health information, including the right to access records, request restrictions in certain situations, request confidential communications, and request amendments where appropriate.

Our Legal Duty

We are required by applicable federal and state laws to maintain the privacy of your protected health information, provide this notice of our legal duties and privacy practices, and follow the terms of this notice while it is in effect.

We reserve the right to change our privacy practices and this notice. Revised terms may apply to all protected health information we maintain, including information created or received before the change.

Detailed Uses and Disclosures of Protected Health Information

Treatment

We may use and disclose protected health information to provide, coordinate, or manage your healthcare and related services. This can include sharing information with physicians, specialists, laboratories, and other providers involved in your care.

Payment

We may use protected health information as needed to obtain payment for healthcare services. This may include activities such as prior authorization, utilization review, medical necessity review, and related communications with health plans.

Health Care Operations

We may use or disclose protected health information for business and operational activities, including quality assessment, employee review, training, licensing, and similar practice-management functions.

We may also share protected health information with contracted business associates who perform services for our practice. These arrangements are governed by written agreements that require protection of your information.

Sale of Health Information

We will not sell or exchange your protected health information for financial remuneration without your written authorization.

Fundraising Communications

We may use or disclose your health information for fundraising purposes, but you have the right to opt out of receiving fundraising communications.

Others Involved in Your Health Care

Unless you object, we may disclose protected health information to a family member, relative, close friend, or other person you identify as involved in your healthcare or payment for care. If you are unable to agree or object, we may disclose information when we determine it is in your best interest.

Marketing

We may contact you with information about treatment alternatives that may be of interest to you. We may also use or disclose information to a business associate to assist with these activities, where permitted by law.

Research; Death; Organ Donation

We may disclose protected health information for certain research activities where legally permitted. We may also disclose information related to decedents to coroners, medical examiners, funeral directors, or organ procurement organizations as allowed by law.

Public Health and Safety

We may disclose protected health information to public health authorities or other authorized government agencies to prevent or control disease, injury, or disability, and to avert serious threats to health or safety.

Health Oversight

We may disclose protected health information to health oversight agencies for legally authorized activities such as audits, investigations, inspections, and licensing.

Abuse or Neglect

We may disclose protected health information to appropriate authorities as required or permitted by law in connection with abuse, neglect, or domestic violence reporting.

Food and Drug Administration

We may disclose protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products, enable recalls, or perform post-marketing surveillance as required.

Criminal Activity

Consistent with federal and state law, we may disclose protected health information when we believe the use or disclosure is necessary to prevent or lessen a serious and imminent threat to health or safety, or when necessary for law enforcement to identify or apprehend an individual.

Required by Law

We may use or disclose protected health information when required to do so by law, including disclosures to federal or state authorities and other legally authorized recipients.

Process and Proceedings

We may disclose protected health information in response to a court or administrative order, subpoena, discovery request, warrant, or other lawful process, under limited circumstances and as permitted by law.

Law Enforcement

We may disclose limited protected health information to law enforcement officials in circumstances permitted by law, including disclosures related to victims, suspects, witnesses, or persons in lawful custody.

Participant Rights Details

Access

You have the right to inspect and obtain a copy of protected health information about you, with limited exceptions. You may request access to records that are maintained in electronic form. Reasonable, cost-based fees may apply for certain copies or mailing.

Accounting of Disclosures

You have the right to receive a list of certain disclosures of your protected health information made by us or our business associates for purposes other than treatment, payment, and healthcare operations, subject to legal limitations and time periods.

Restriction Requests

You have the right to request restrictions on uses or disclosures of your protected health information. We are not required to agree to every request, except where required by law, including certain out-of-pocket payment situations.

Confidential Communication

You have the right to request that we communicate with you about medical matters in confidence by alternative means or at alternative locations. We will accommodate reasonable requests submitted in writing.

Amendment

You have the right to request an amendment of protected health information if you believe it is incorrect or incomplete. Requests must be in writing and explain why the amendment is needed. In some cases, we may deny the request and will provide a written explanation.

Electronic Notice

If you receive this notice electronically, you are entitled to request a paper copy at any time.

Notice of Unauthorized Disclosures

If an unauthorized disclosure of your protected health information occurs, we will notify you as required by law and help you understand available mitigation steps.

Questions and Complaints

If you want more information about our privacy practices or have concerns, please contact us using the information below.

If you believe your privacy rights have been violated, you may file a complaint with Summit Hyperbarics + Wellness and/or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Contact Person

Name: Bonnie Carns, MSN, RN, CPC

Email: [email protected]

Telephone: (208) 813-9552

Address: 3231 E. Barber Valley Dr. Boise, ID 83716