HIPAA Notice of Privacy Practices

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.

Pacific Spine & Rehab is required by the Health Insurance Portability and Accountability Act (HIPAA) and the California Confidentiality of Medical Information Act (CMIA, Civ. Code §§56–56.37) to maintain the privacy of your Protected Health Information (PHI), provide this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.

How we may use and disclose your PHI

• Treatment: to provide chiropractic, rehab, shockwave, and related care, and to coordinate with other providers involved in your treatment.
• Payment: to bill and collect from you, your insurer, an attorney, or a third-party payer for services rendered, including PIP/MedPay and personal-injury liability claims.
• Health care operations: for quality review, staff training, credentialing, audits, and business management.
• Appointment reminders and care information: via phone, voicemail, text, or email using the contact information you provide.
• As required by law: including public-health reporting, suspected abuse or neglect, judicial or administrative proceedings, law enforcement, workers' compensation, and to coroners or medical examiners.

Uses and disclosures requiring your written authorization

We will obtain your written authorization before using or disclosing PHI for: (a) most uses of psychotherapy notes; (b) marketing communications; (c) any sale of PHI; and (d) any other purpose not described in this Notice. California law also requires written authorization for most disclosures of medical information to third parties. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your rights

• Inspect and copy your medical and billing records (subject to certain limits). California law generally requires us to permit inspection within 5 business days and provide copies within 15 days of a written request.
• Request an amendment if you believe information is incorrect or incomplete.
• Request an accounting of certain disclosures we have made.
• Request restrictions on certain uses and disclosures. We must agree to restrict disclosure to a health plan if the service was paid for in full out-of-pocket.
• Request confidential communications at an alternative address or by alternative means.
• Receive notice of any breach of your unsecured PHI.
• Receive a paper copy of this Notice on request, even if you agreed to receive it electronically.

Our responsibilities

• Maintain the privacy and security of your PHI.
• Notify you promptly if a breach occurs that may have compromised your information.
• Follow the terms of the Notice currently in effect.
• Not retaliate against you for exercising your privacy rights.

Changes to this Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. The current Notice is posted in our clinics and on this website with the effective date above.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or directly with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue, S.W., Washington, D.C. 20201, or at hhs.gov/ocr. California residents may also contact the California Attorney General or the California Department of Public Health. We will not retaliate against you for filing a complaint.

Contact our Privacy Officer

Pacific Spine & Rehab — Privacy Officer
2103 S El Camino Real, Oceanside, CA 92054
(760) 240-9010 · privacy@pacificspinerehab.com