Effective date – February 11, 2022

HIPPA COMPLIANCE DISCLOSURE

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

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.

Introduction:

In order to provide healthcare services, Solely Therapeutic Massage must obtain and maintain protected health information from you, the patient.  The Notice of Privacy Practices describes the types of information that is collected and your rights with regards to this information.

Protected Health Information “includes” the following:

  • Your health history
  • Your medical records
  • Your name, address, and date of birth
  • Your marital status
  • Information regarding your dependents
  • Other similar information that relates to your past, present or future medical care

YOUR RIGHTS

You have the right to:

  • Get a copy of your paper or electronic medical record
  • Correct your paper or electronic medical record
  • Request confidential communication
  • Ask Solely Therapeutic Massage to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated

OUR USES AND DISCLOSURES

Solely Therapeutic Massage may use and share your information as we:

  • Treat you
  • Run our organization
  • Bill for your services
  • Help with public health and safety issues
  • Do research
  • Comply with the law
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions

YOUR RIGHTS

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record 

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • Solely Therapeutic Massage will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete, or register a complaint with Solely Therapeutic Massage.

Request confidential communications

  • You can ask Solely Therapeutic Massage to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • Solely Therapeutic Massage will say “yes” to all reasonable requests.

Ask us to limit what we use or share

  • You can ask Solely Therapeutic Massage not to use or share certain health information for treatment, payment, or our operations. Solely Therapeutic Massage is not required to agree to your request, and Solely Therapeutic Massage may say “no” if it would affect your care.
  • You will have the opportunity to disclose who we are allowed to share private health information with in your intake form.
  • In the unlikely event that you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety

Get a list of those with whom Solely Therapeutic Massage has shared information

  • You can ask for a list (accounting) of the times Solely Therapeutic Massage has shared your health information for six years prior to the date you ask, who Solely Therapeutic Massage shared it with, and why.
  • Solely Therapeutic Massage will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). Solely Therapeutic Massage will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. Solely Therapeutic Massage will provide you with a paper copy promptly.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Solely Therapeutic Massage will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel Solely Therapeutic Massage have violated your rights by contacting us using the information on page 1.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

YOUR CHOICES

For certain health information, you can tell us your choices about what Solely Therapeutic Massage share.  If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

Our Uses and Disclosures

HOW DO WE TYPICALLY USE OR SHARE YOUR HEALTH INFORMATION?

We typically use or share your health information in the following ways.

Treat you

With your permission Solely Therapeutic Massage can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

Solely Therapeutic Massage can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

HOW ELSE CAN WE USE OR SHARE YOUR HEALTH INFORMATION?

Solely Therapeutic Massage is allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research.  Solely Therapeutic Massage is required to meet many conditions in the law before we can share your information for these purposes.  For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Solely Therapeutic Massage may also share this information with its business partners including for purposes of utilization reviews, appropriateness of care reviews, consultation with outside health care providers, consultants, and attorneys.  Solely Therapeutic Massage requires its business partners to sign a contract specifying their compliance with Solely Therapeutic Massage.

In order to ensure the privacy of your protected health information Solely Therapeutic Massage has developed privacy policies and procedures.  Procedures are based on appropriate administrative, technical and physical safeguards necessary to maintain confidentially of your protected health information.  Such information is limited to those individuals that have a legitimate business need for the information by Solely Therapeutic Massage business partners.

Help with public health and safety issues

Solely Therapeutic Massage can share health information about you for certain situations such as:

  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research

Solely Therapeutic Massage can use or share your information for health research.

Comply with the law

Solely Therapeutic Massage will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to lawsuits and legal actions

Solely Therapeutic Massage can share health information about you in response to a court or administrative order, or in response to a subpoena.

  • We never market or sell personal information.
  • We do not create or maintain psychotherapy notes at this practice.
  • We will never share any substance abuse treatment records without your written permission.

OUR RESPONSIBILITIES

Solely Therapeutic Massage is required by law to maintain the privacy and security of your protected health information.

  • Solely Therapeutic Massage will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • Solely Therapeutic Massage must follow the duties and privacy practices described in this notice and give you a copy of it.
  • Solely Therapeutic Massage will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

CHANGES TO THE TERMS OF THIS NOTICE

Solely Therapeutic Massage can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available in our place of business and on this website.