NOTICE OF PRIVACY POLICIES – July 2, 2020

Heil Health & Wellness, PLLC is dedicated to providing services with respect for human dignity. Protecting your privacy and healthcare information is fundamental to our relationship with you. This notice will remain in effect until it is replaced or amended by changes in the law.

We gather personal information and health information in several ways:

  • Information we receive from you
  • Information we receive from other healthcare providers
  • Information we receive from third party payers

Protected Health Information is any information that includes demographic information; information gathered by Heil Health & Wellness, PLLC as it relates to your past, present, and future physical or mental health or condition; or past, present, or future payments for healthcare services.

You should be aware that during the course of our relationship with you, we will likely use and disclose health information about you for the treatment, payment, and healthcare operations we perform.

Without your consent or authorization, this office may disclose information about you only to the following groups for the specified purposes:

  • To a public health agency, for a purpose such as controlling
  • In case of suspected child abuse, to the appropriate governmental
  • In other cases of suspected abuse, neglect or domestic violence, to the appropriate governmental authority, with your agreement or if required by law, or if you are incapacitated or it appears necessary to prevent serious harm to you or
  • To health oversight authorities, for regulatory, licensing, and other legal
  • In litigation, subject to certain requirements controlling the terms of the
  • To law enforcement agencies, subject to applicable legal requirements and
  • For medical research purposes, subject to your authorization or approval by an institutional review board.
  • If you are in the United States military, national security, or intelligence for Foreign Service, to your authorized superiors or other federal

We may not use or disclose information about you for any other purpose without your authorization, provided separately from your written consent. You may submit written authorization to disclose Protected Health Information to a person or group specified by you.

Marketing
This office will not use your health information for marketing communications without your written authorization. Marketing communications may include birthday cards, newsletters, and appointment reminders, by calls, postcards, or letters.

Disclosure
This office may use or disclose your Protected Health Information when required by law.

Patient Rights

  • Upon written request, you have the right to access, review, or receive copies of your healthcare
  • Upon written request, unless prohibited by law, you have the right to receive a list of items this office disclosed about your healthcare
  • You have the right to request that this office place additional restrictions on disclosure of your Protected Health
  • You have the right to request restrictions on the use of your Protected Health Information for the purposes of treatment or payment for healthcare operations, but Heil Health & Wellness, PLLC is not required to agree to these restrictions. However, if Heil Health & Wellness, PLLC agrees to a restriction that you request, the restriction is binding to Heil Health & Wellness, PLLC.
  • You have the right to request that we amend your Protected Health Information. This request must be in writing.
  • You have the right to receive all notices in

More Information
If you have any questions or complaints, or would like to receive more information, contact Thom Heil, L.Ac., at 872-216-9612.

Complaints
Complaints about your privacy rights or how your privacy is handled at this office can be directed to Thom Heil, L.Ac., at the phone number above or by directing a letter to his attention.

If you are not satisfied with how our office handles your complaint, you may submit a formal complaint to:

DHHS (Office of Civil Rights)
200 Independence Avenue, S.W.
Washington, D.C. 20201