HIPAA Notice of Privacy Practices

Our Pledge Regarding Your Medical Information

We understand that medical information about you and your health is personal. We are committed to protecting your medical information. We create a record of the care and services you receive at Wellness Revolution Texas. We 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 Wellness Revolution Texas, whether made by our staff or your personal provider. This notice will tell you about the ways in which we may use and disclose medical information about you.

How We May Use and Disclose Medical Information About You

For Treatment

We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to providers, nurses, technicians, or other personnel who are involved in taking care of you at our facilities.

For Payment

We may use and disclose medical information about you so that the treatment and services you receive at Wellness Revolution Texas may be billed to and payment may be collected from you, an insurance company, or a third party.

For Health Care Operations

We may use and disclose medical information about you for health care operations. These uses and disclosures are necessary to run our practice and make sure that all of our patients receive quality care.

Appointment Reminders

We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at Wellness Revolution Texas.

Treatment Alternatives

We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Benefits and Services

We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

Your Rights Regarding Medical Information About You

Right to Inspect and Copy

You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.

Right to Amend

If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our practice.

Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, and health care operations.

Right to Request Restrictions

You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

Special Situations

As Required By Law

We will disclose medical information about you when required to do so by federal, state, or local law.

Public Health Risks

We may disclose medical information about you for public health activities, including:

• To prevent or control disease, injury, or disability
• To report births and deaths
• To report reactions to medications or problems with products
• To notify people of recalls of products they may be using

Health Oversight Activities

We may disclose medical information to a health oversight agency for activities authorized by law, including audits, investigations, inspections, and licensure.

Lawsuits and Disputes

If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order or in response to a subpoena.

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facilities and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

Contact Information

For questions about this notice or to exercise your rights: