Notice of privacy practices
Effective TODO(client)
TODO(client counsel): this page is a template and must be reviewed and approved by the practice's attorney before launch.
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.
Our duties
L.A Health and Wellness Center, PLLC is required by law to keep your protected health information private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
How we may use and disclose your information
- Treatment: to provide and coordinate your care, including with other providers involved in it.
- Payment: to bill you, your insurer, or another payer for services.
- Health care operations: to run the practice, including quality review and training.
- Appointment reminders and treatment alternatives, by the methods you have agreed to.
- As required by law, for public health, to avert a serious threat to health or safety, and in other situations the law permits.
Psychotherapy notes, marketing uses, and any sale of information require your written authorization, which you may revoke at any time.
Your rights
- To see and get a copy of your record, and to request corrections.
- To ask for restrictions on how we use or share your information, and to restrict disclosures to your health plan for services you paid for in full.
- To request confidential communications by a particular means or location.
- To an accounting of certain disclosures.
- To a paper copy of this notice, and to be notified if a breach affects your information.
Complaints
If you believe your privacy rights have been violated, contact our privacy officer at info@lahealthwellness.com or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
Changes to this notice
We may change this notice and apply the new version to all information we hold. The current notice is always posted here and available on request.
Privacy officer: TODO(client) name, info@lahealthwellness.com.