NOTICE OF PRIVACY PRACTICES FOR
PROTECTED HEALTH INFORMATION
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.
We may use or disclose your protected health information without your written consent, written authorization, or oral agreement for the following purposes:
Treatment
We may use your health information within our office to provide health care services to you or we may disclose your health information to another provider if it is necessary to refer you to them for services.
We may use your health information during communication with you via address, phone/text, e-mail, social media, and messages regarding appointment reminders, missed appointment, rescheduling notifications, office closures, newsletters/events, birthday/ holiday notices, and information about your treatment, treatment alternatives or other health related information.
We may use your photograph/likelihood, and/or written or verbal testimony on marketing material such as brochures, websites, print, digital, and social media.
We may provide treatment in an open room where other patients are also being treated. You are aware that other persons in the office may overhear some of the/your protected health information during care. Should you need to speak with the doctor at any time in private, the doctor will provide a room for these conversations.
Payment
We may disclose your health information to a third party such as an insurance carrier, government agency, employer, or any review agency which conducts practice utilization under an agreement with the patient’s employer or payment source to obtain payment for services provided to you.
Health Care Operations
We may use your health information to conduct internal quality assessment and improvement activities and for business management and general administrative activities.
We may use or disclose your protected health information without your written consent, written authorization, or oral agreement under the following circumstances:
If we provide services, in an emergent situation or not, to you while you are a patient.
If we are required by law to provide services to you and we were unable to obtain your consent after attempting to do so.
If there are substantial barriers to communication and we determine, in the exercise of our professional judgment, that you intend for us to treat you.
If we need to notify, or assist in the notification of, a family member, personal representative or another person responsible for your care of your location, general condition or death.
If we are required by law to disclose your health information to a public health authority that is authorized to receive information for the purposes of preventing or controlling disease, injury, or disability.
If we are required by law to disclose your health information to a public health or other government authority that is authorized to receive reports of child abuse or neglect.
If we are required to disclose your health information to any governmental body including the Food and Drug Administration.
If we are required to disclose your health information to your employer to evaluate whether you have a work-related injury or illness.
If we are required by law to disclose your health information to a government authority authorized to receive reports of abuse, neglect, or domestic violence.
If we are required to disclose your health information to a health oversight agency for oversight activities required by law.
If we are required to disclose your health information in response to a law enforcement official or by court order or a subpoena.
If we are required to disclose your health information to a coroner, medical examiner or funeral director.
For research purposes.
If we, in good faith, believe that the use or disclosure of your health information is necessary to prevent a serious threat to the health of you or safety of others.
If we are authorized by law to disclose your health information to comply with laws established to provide benefits for work-related injuries or illnesses.
Except for the above circumstances, any use or disclosure of your health information will be made only with your written authorization. Your written authorization may be revoked, in writing, at any time except to the extent that we have provided services or acted in reliance on your authorization.
All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties, excluding aggregators and providers of the Text Message services.
SMS Communications and Opt-In Consent
Ability Chiropractic may collect your name, email address, phone number, and message details when you submit a form, request an appointment, contact our team, or opt in to receive text messages from us.
By providing your phone number and checking the applicable consent box on our website forms, you agree to receive text messages from Ability Chiropractic. These messages may include appointment confirmations, appointment reminders, follow-up messages, patient communication, service-based messages, wellness updates, special offers, and promotional messages, depending on the consent you provide.
Consent to receive text messages is not a condition of any purchase or service. Message frequency may vary. Msg & data rates may apply. You may opt out at any time by replying STOP. You may request assistance by replying HELP.
No Sharing of SMS Opt-In Information
Ability Chiropractic does not sell, rent, or share SMS opt-in consent, phone numbers, or text messaging data with third parties or affiliates for marketing or promotional purposes.
This includes mobile opt-in data, consent records, and SMS messaging information. SMS opt-in information is used only to provide the communications you requested or consented to receive.
Cookies and Tracking Technologies
Ability Chiropractic may use cookies, tracking pixels, analytics tools, and similar technologies to understand website activity, improve user experience, measure marketing performance, and provide relevant content.
These technologies may collect information such as your browser type, device information, IP address, pages visited, time spent on the website, referring pages, and interactions with forms or website content.
You may control or disable cookies through your browser settings. Disabling cookies may affect how certain parts of the website function.
Data Security
Ability Chiropractic takes reasonable administrative, technical, and physical safeguards to help protect the personal information we collect. These safeguards are designed to protect information against unauthorized access, loss, misuse, disclosure, alteration, or destruction.
While we take reasonable steps to protect your information, no website, system, or method of electronic transmission is completely secure. We cannot guarantee absolute security, but we work to protect your information using appropriate security practices.
II. Your Rights
You have the right to receive a paper copy of this notice upon request. You have the right to request restrictions on certain uses and disclosures of your health information. However, we are not required to agree to the requested restrictions. Your request to limit the use and/or disclosure of your health information must be made in writing to our Privacy Official. You have the right to receive confidential communications concerning your health information. We will accommodate all reasonable requests by you to receive your health information at a place other than your home address or by means other than regular mail. You have the right to inspect or copy, within boundaries, the protected health information to be used/disclosed.
III. Our Duties
We are required by law to maintain the privacy of protected health information and to provide you with notice of our legal duties and privacy practices with respect to your protected health information. We must abide by the terms of this notice while it is in effect. However, we reserve the right to change the terms of this notice as applicable by local, state, or federal authorizations and to make the new notice provisions effective for all of the protected health information that we maintain.
IV. Complaints
You may complain to us and to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by writing to our Privacy Official at the address that follows. We will not take any action against you for filing a complaint.
V. How to Contact Us
If you would like further information about our privacy practices, please contact:
Ability Chiropractic LLC
Billing Address: 6329 Pullman Dr, Lewis Center, OH 43035
Email: info@abilitychiro.com
Phone:(614) 888-WELL
EFFECTIVE DATE OF NOTICE:
Jan 1, 2022