HIPAA Notice
of Privacy Practices

HIPAA stands for "Health Insurance Portability and Accountability Act." This notice describes how health information may be used and disclosed and how you can get access to this information.

1. My Pledge Regarding Personal Health Information (PHI)

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this somatic therapy practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

Make sure that protected health information (“PHI”) that identifies you is kept private.
Give you this notice of my legal duties and privacy practices with respect to health information.
I reserve the right to change the terms of this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect.
I will never sell your PHI and I will never disclose your PHI for marketing purposes.

your rights and responsibilities in advance concerning care and treatment you will receive, including any changes, the frequency of care/service, the nature and purpose of any technique that will be performed, including information about the potential benefits and contraindications
Your right to grant explicit consent prior to the start of any treatment or program and be advised of any change in the treatment plan, before the change is made;
specific charges for these services, billing policies, payment procedures, and any changes in the information provided at the initial time of purchase;
what to do in the event of an emergency; or be referred to another organization if The Body Intuitive is unable to meet your needs or if you are not satisfied with the services you are receiving

2. How I May Use & Disclose PHI

I may use and disclose your PHI for treatment, payment, and health care operations purposes with the consent you are providing here. I also make use of Contractor Labor, Vendor Partners, and Business Associates to facilitate these functions. To help clarify these terms, here are some definitions:

“Treatment” is when I provide, coordinate, or manage your health care and other services related to your health care. An example of treatment would be when I consults with another health care provider, such as your family physician or an outside mental health care provider.
“Payment” is when I obtain or facilitate reimbursement for your healthcare. An example of payment is when identifying the service you have received from me when you use credit card as a method of payment.
“Health Care Operations” are activities that relate to the performance and operation of my practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, case management and care coordination, and my consultation with another professionals to better assist you.
“Contract Labor," "Vendor Partners," or "Business Associates” - There are some tasks I may hire other business to do for me. Examples include, but are not limited to, my practice’s AI-integrated notes software, email provider, and phone provider. These business associates may have access to some of your health information, to the appropriate level for their job function and professional training and responsibilities. To protect your privacy, they must sign a a contractor agreement and NDA with me to safeguard your PHI. All associates specifically working with client information processing have received training to comply with HIPAA in handling of your PHI.
“Use” applies only to activities within my practice, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
“Disclosure” applies to activities outside of my practice, such as releasing, transferring, or providing access to information about you to other parties.

Appropriate and professional continuity of care in accordance with my scope of practice;
Respectful, dignifying teatment without regard to race, creed, gender, age, handicap, sexual orientation, veteran status or lifestyle
a timely response from the agency to his or her request for service, scheduling, or customer support;
A fair opportunity to resolve and voice grievances and suggest changes in service without fear of retaliation or discrimination;
A safe environment free from any abusive behavior, neglect or exploitation of any kind by Body Intuitive

3. Certain Uses & Disclosures Require Your Authorization

I may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your authorization is obtained. An “authorization” is written permission that permits only specific disclosures and is above and beyond the general consent provided here. In those instances when I am asked for information for purposes outside of treatment, payment, and health care operations, I will obtain an authorization from you before releasing this information. When I use your PHI or disclose it to others, I share only the minimum amount of information necessary for those other people to do their jobs. I will also need to obtain an authorization before releasing your general notes. “Provider notes” are notes I have made about our conversation during a private, group, joint, or online session which I have kept separate from the rest of your medical record. In certain cases, these notes are given a greater degree of protection than PHI.

4. Certain Uses & Disclosures Do NOT Require Your Consent or Authorization

Subject to certain limitations in the law, I can use and disclose your PHI and Notes without your Consent or Authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
2. Reporting suspected child, elder, or dependent adult abuse, preventing or reducing a serious threat to anyone’s health or safety, and other public health activities.
3. For health oversight activities, including audits and investigations.
4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.
5. For my use in defending myself in legal proceedings instituted by you.
6. For law enforcement purposes, including reporting crimes occurring on my premises.
7. To coroners or medical examiners, when such individuals are performing duties authorized by law.
8. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
9. For my use in training or supervising health practitioners to help them improve their skills in group, individual, couples, or online coaching.
10. For workers' compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers' compensation laws.
11. Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.

5. Certain Uses & Disclosures Require You to Have the Opportunity to Object

Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

6. You Have the Following Rights with Respect to Your PHI:

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.
2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI for health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.
4. The Right to See and Get Copies of Your PHI. Other than “Provider notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost based fee for doing so.
5. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.
6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.

7. HIPAA Complaints

Please inform me of any questions, concerns, or complaints related to the handling of your privacy at <[email protected]>. If you are concerned that I have violated your privacy rights, or you disagree with a decision I made about access to your records, you may send a written complaint to the Secretary of the U.S. Department of Health and Human Services.

ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By checking the box on your waiver to consent to services, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on 04/01/2025

HIPAA Notice of Privacy Practices

1. My Pledge Regarding Personal Health Information (PHI)