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Effective Date 9/19/2013
This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!
Notice of Privacy Practices September 19, 2014
As required by the Health Insurance Portability and Accountability Act (HIPPA) Omnibus Rule March 26, 2013 Chadron Chiropractic, PC through it Officers of the Board of Directors, physicians and staff employees, endeavor to protect the privacy and confidentiality of all patient’s and employee’s protected health information(PHI).
Uses and disclosures for marketing purposes; and uses and disclosures that constitute the sale of PHI will require a written authorization from the individual.
Marketing Chadron Chiropractic, PC must obtain written authorization to use and disclose PHI for marketing purposes, including most non-face-to-face communications when the provider receives payment to make the communication. If payment is involved, the marketing authorization must disclose the fact. However, Chadron Chiropractic, PC may inform a patient about a third party’s product or service without the patient’s written authorization when Chadron Chiropractic, PC does not receive any compensation for the communication. The communication is face-to-face; the communication involves a product the patient is being instructed to use the payment is limited to reasonable reimbursement of the costs of communication; and the communication involves general health promotion. Chadron Chiropractic, PC is still permitted to give patients promotional gifts of nominal value.
Fundraising Chadron Chiropractic, PC now may disclose more information to institutionally-related foundations for fundraising, but they must explain how the recipient may opt-out of receiving future fundraising communications. If an individual opts-out, Chadron Chiropractic, PC must not make any further communications to the individual.
Restrict disclosure to health plans
You have the right to request restrictions on certain uses and disclosures of your PHI. Requests must be made in writing with information you want to limit and to whom you wants the limits to apply. Chadron Chiropractic, PC will comply with a request for restrictions on disclosures made to health plans for payment or health care operations purposes if the PHI to an item or service for which the individual paid completely out-of-pocket.
Breach of notification statement
Chadron Chiropractic, PC has the highest ethical obligation in protecting our patient’s health information, has taken safeguards that are effective and perform a periodic in-house policy conduct review of identifying safeguards. However, in compliance with HIPPA Omnibus Rule 3-26-2013, Breach of Notification Rule, if a breach demonstrates that a person’s PHI has been compromised said person will be notified within 60 calendars days from when the breach was discovered, unless law enforcement requests a delay.
Chadron Chiropractic, PC Forms of acknowledgement may be by:
a. A copy of A Privacy Notice Written Acknowledgement will be filed with the patient’s PHI, and will be renewed each year.
b. Initialing and retaining a copy of the initialed Notice of Privacy Practices with the patient’s PHI.
|Monday||8:00 am||5:00 pm|
|Tuesday||8:00 am||5:00 pm|
|Wednesday||8:00 am||5:00 pm|
|Thursday||8:00 am||5:00 pm|
|Friday||8:00 am||12:00 pm|
|8:00 am||8:00 am||8:00 am||8:00 am||8:00 am||Closed||Closed|
|5:00 pm||5:00 pm||5:00 pm||5:00 pm||12:00 pm||Closed||Closed|