HIPPA Notice of Privacy
Train Like a Pro, LLC HIPAA Notice of Privacy Practices
Effective Date: 12/26/2017
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.
I. Preamble
Train Like a Pro, LLC is dedicated to maintaining the privacy of your protected health information (PHI) as part of providing professional performance coaching. In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your PHI. By federal and state law, we must follow the terms of the Notice of Privacy Practices that we have in effect at the time.
II. How We May Use and Disclose Your PHI
We use and disclose health information about you for treatment, payment, and healthcare operations. For example:
Treatment: We may use and disclose your PHI to provide, coordinate, or manage your health care and any related services.
Payment: Your PHI will be used, as needed, to obtain payment for your health care services.
Healthcare Operations: We may use or disclose, as needed, your PHI in order to support the business activities of [Your Performance Coaching Business Name].
Other Uses and Disclosures: As permitted by federal and state law, we may use or disclose your PHI without your consent or authorization for several other reasons. Subject to certain requirements, we may give out PHI without prior authorization for public health purposes, abuse or neglect reporting, health oversight, research studies, funeral arrangements and organ donation, workers’ compensation purposes, and emergencies. We also disclose PHI when required by law, such as in response to a request from law enforcement in specific circumstances.
III. Your Rights Regarding Your PHI
You have the following rights regarding PHI we maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy PHI that may be used to make decisions about your care.
Right to Amend: If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information.
Right to an Accounting of Disclosures: You have the right to request an accounting of certain disclosures of your PHI.
Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose.
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.
IV. Complaints
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact info@mattwilkins.me. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
V. Contact Information
For further information about Train Like a Pro’s privacy policies, please contact info@mattwilkins.me.