How Sleep Balance Academy PC may use and disclose your protected health information, the rights you have over it, and how to exercise them or complain.
Effective
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Contents
Effective date
1What this notice covers
When you receive care from us, we create and keep a record of that care. The law calls this protected health information. It includes what you tell a clinician, what a clinician records, the results of a sleep test, the devices ordered for you, the messages you send through your patient portal, and information about payment for your care.
This notice tells you how we may use that information, when we may share it, what rights you have over it, and what we are required to do. We are required by law to keep your health information private, to give you this notice, and to follow the version of it that is currently in effect.
Information you give us purely as a shopper, for example a delivery address for a product order placed without any clinical involvement, is covered by our Privacy Policy instead. Where the two overlap, this notice governs the health information.
2How we may use and share your health information without asking you first
2.1 For your treatment
We use your health information to provide, coordinate and manage your care, and we share it with others involved in that care. For example, a clinician reviews your sleep history before your visit, and we send the results of a home sleep test to the clinician who ordered it and to another clinician you have asked us to involve.
2.2 To get paid
We use and share your health information to bill and collect payment for your care. For example, we may share information about a service with a payment processor, or with an insurer if you ask us to submit a claim, so that the service can be paid for.
2.3 To run our practice
We use your health information to run and improve the practice. For example, we review records to check the quality of care, to train and supervise clinicians, to arrange for legal and audit services, and to plan how we staff appointments.
2.4 To remind you and to follow up
We may contact you about an appointment, about a device or a shipment related to your care, or with information about other treatment options and health services that may interest you. You can tell us to stop, and you can tell us which way to reach you.
2.5 To people involved in your care
Unless you object, we may share information relevant to a person's involvement with a family member, a friend, or anyone else you identify as helping with your care or with paying for it. If you are not able to tell us what you want, we use our professional judgment and share only what is directly relevant.
3Other uses and disclosures the law permits or requires
We may use or share your health information without your written permission in the situations below. In each case we share only what the law allows.
Required by law. When federal, state or local law requires it.
Public health. To prevent or control disease, injury or disability, to report a birth or a death, and to report a problem with a medical device or a medication to the Food and Drug Administration.
Abuse, neglect or domestic violence. To a government authority when we are required or authorized by law to report suspected abuse, neglect or domestic violence.
Health oversight. To an agency that oversees the health care system, for audits, investigations, inspections and licensure.
Lawsuits and disputes. In response to a court or administrative order, and in response to a subpoena or discovery request where the legal requirements for notice or a protective order have been met.
Law enforcement. To law enforcement in the limited circumstances the law allows, for example to respond to a valid court order or warrant, or to report a death we believe resulted from criminal conduct.
After a death. To a coroner, medical examiner or funeral director as necessary for them to carry out their duties.
Organ and tissue donation. To an organ procurement organization, where that applies.
Research. For research, but only where an ethics board has approved the research and the safeguards for your information, or where the information has been stripped of everything that identifies you.
Serious threat to health or safety. To prevent a serious and imminent threat to your health or safety or to someone else's.
Specialized government functions. For military and veterans activities, national security and intelligence, protective services, and for someone in lawful custody.
Workers compensation. As authorized by workers compensation law, to the extent necessary to comply with it.
4Uses and disclosures that need your written permission
Any use or disclosure not described in this notice is made only with your written authorization. Three categories always require it.
Psychotherapy notes. Notes a mental health professional records separately from the rest of the record, if we ever maintain any.
Marketing. Using or sharing your health information to encourage you to buy or use a product or a service, where a third party is paying us to send the message.
Sale of your information. Any disclosure that amounts to a sale of your health information. We do not sell your health information.
You can withdraw a written authorization at any time by telling us in writing. Withdrawing it stops any further use or sharing under that authorization. It cannot undo something we already did while the authorization was in effect.
5Advertising, analytics and your health information
We do not disclose your health information to an advertising platform, we do not use it to build or seed an advertising audience, and we do not place advertising or analytics technology inside your patient portal, the doctor portal, or a video visit.
A cookie banner is not a valid permission for anything in this notice. If a use of your health information would need your written authorization, we ask you for it properly, on its own, and not by burying it in a website consent prompt.
6Records of substance use disorder treatment
Some records about treatment for a substance use disorder receive extra protection under a separate federal rule. If we receive records of that kind about you from a treatment program, the following applies to them in addition to everything else in this notice.
They cannot be used against you in a proceeding. They may not be used or disclosed in a civil, criminal, administrative or legislative proceeding against you unless you give written consent or a court issues an order that meets the requirements of that rule. A subpoena on its own is not enough.
You can withdraw consent. Where you have given written consent for us to use or share them for treatment, payment or health care operations, you may withdraw that consent in writing at any time, except to the extent we have already acted on it.
You can ask for a list of disclosures. You may ask us for a list of the disclosures we made with your consent for treatment, payment or health care operations, covering the three years before your request.
You can ask us to restrict them. You may ask us to restrict how they are used or shared, including for treatment, payment and health care operations.
You can complain. If you believe your rights over these records have been violated, you may complain to us and you may also complain to the Secretary of the US Department of Health and Human Services.
Some state laws give records about substance use, mental health, HIV status, genetic testing and other sensitive categories more protection than federal law does. Where the law of your state is stricter, we follow the stricter rule.
7Your rights
7.1 See and get a copy of your record
You can ask to see and get a copy of the health information we hold about you, including an electronic copy where we hold it electronically. Ask us in writing and we will respond within 30 days, or tell you why we need more time. We may charge a reasonable, cost-based fee for a copy, and we will tell you the amount before we charge it. In limited situations we may deny a request, and if we do we will tell you in writing why and how you can have that decision reviewed.
7.2 Ask us to correct your record
If you believe something in your record is wrong or incomplete, you can ask us to amend it. Ask in writing and say why. If we agree, we will make the change and tell the people who need to know. If we do not agree, we will explain why in writing, and you may add a written statement of disagreement that we keep with the record and include when the record is disclosed.
7.3 Ask for a list of disclosures
You can ask for a list of the times we shared your health information in the six years before your request. The list does not include disclosures for treatment, payment or running the practice, disclosures you authorized, or disclosures to you or to someone involved in your care. The first list in any twelve month period is free.
7.4 Ask us to limit what we use or share
You can ask us to restrict how we use or share your information for treatment, payment or running the practice. We are not required to agree, and we will tell you if we do not. There is one restriction we must honor: if you pay for a service in full yourself and ask us not to tell your health plan about it, we will not, unless the law requires us to.
7.5 Ask us to contact you a particular way
You can ask us to reach you at a specific address, phone number or channel, or to avoid one. We will accommodate a reasonable request and we will not ask you to explain why.
7.6 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 these rights and make choices about your health information. We will check that the person has the authority before we act.
7.7 Get a paper copy of this notice
You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically, and we will give you one promptly at no charge.
7.8 Be told if there is a breach
If a breach happens that compromises the privacy or security of your health information, we will notify you.
7.9 Complain
You can complain to us using the contact details at the end of this notice. You can also complain directly to the US Department of Health and Human Services Office for Civil Rights, and you do not have to raise it with us first. We will not retaliate against you, refuse you care, or treat you differently in any way for making a complaint, and nothing you agree to with us takes that right away.
Write to our Privacy Contact using the details at the end of this notice.
Or file with the Office for Civil Rights online, by mail, or by telephone. Their complaint portal is at hhs.gov/ocr/complaints.
A complaint generally has to be filed within 180 days of when you knew about the problem.
8What we are required to do
Keep your health information private and secure, as the law requires.
Give you this notice and follow the version of it that is in effect.
Tell you promptly if a breach compromises the privacy or security of your information.
Require anyone who handles health information on our behalf to protect it and to use it only for the work we engaged them to do, under a written agreement.
Not use or share your information for any purpose other than those described here, unless you tell us in writing that we may.
9Changes to this notice
We may change this notice. A change applies to the health information we already hold as well as to information we receive afterwards. The current version is always available on our website and in your patient portal, and the date it took effect is shown at the top. If we make a material change we will make the new notice easy to find and, where the law requires, we will provide it to you directly.
10How to reach our Privacy Contact
For anything in this notice, including a request to see your record, a request to correct it, a restriction, a complaint, or a question about how we handled your information, contact our Privacy Contact.
You can reach the Privacy Contact by telephone at:
877-230-0324
Who to ask for
The Privacy Contact at Sleep Balance Academy PC. You do not need to know a name; ask for the Privacy Contact and your message will be routed.
If you would rather not put your request in an email, write to us at the address above and mark the envelope for the Privacy Contact. We will respond in writing.
