Effective Date: 09/10/2024
At Custom Health Centers, we are committed to protecting your privacy and ensuring the confidentiality of your Protected Health Information (PHI). This Privacy Policy explains how we collect, use, and disclose your PHI, as required by the Health Insurance Portability and Accountability Act (HIPAA). It also outlines your rights regarding your health information and how you can exercise those rights.
1. Our Commitment to Protecting Your Health Information
We understand that your health information is personal, and we are committed to protecting it. We create records of your health and the services you receive for use in providing care and for legal or billing purposes. This policy applies to all the PHI we maintain, whether electronically, on paper, or otherwise.
2. How We Use and Disclose Your Protected Health Information (PHI)
We may use and disclose your PHI for the following purposes:
A. Treatment
We may use your PHI to provide medical treatment or services. We may disclose your PHI to doctors, nurses, technicians, or other healthcare personnel involved in your care.
B. Payment
We may use and disclose your PHI to bill and collect payment for services rendered. This includes disclosing information to financial parties, credit card entities, banks, and financing companies.
C. Healthcare Operations
We may use and disclose your PHI for healthcare operations, including quality assessment, staff training, compliance audits, and patient care evaluations.
D. Other Uses and Disclosures
We may also use and disclose your PHI in the following circumstances:
- As Required by Law: When mandated by federal, state, or local law.
- Public Health Activities: For disease control and prevention, reporting adverse events, and to prevent or control disease, injury, or disability.
- Law Enforcement: To comply with court orders, subpoenas, or legal investigations.
- To Avoid a Serious Threat to Health or Safety: If necessary, to prevent a serious and imminent threat to the health or safety of a person or the public.
- Business Associates: We may share PHI with third-party business associates who perform functions on our behalf, such as billing or legal services. Our business associates are required to safeguard your information as required by HIPAA.
3. Your Rights Regarding Your PHI
As a patient, you have the following rights regarding your Protected Health Information:
A. Right to Access and Inspect
You have the right to inspect and obtain a copy of your PHI. You may submit a written request to review your medical records, and we will provide access within a reasonable time frame, as required by law.
B. Right to Amend
If you believe that any information in your medical record is incorrect or incomplete, you may request an amendment. We will review your request and may amend the record as appropriate.
C. Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures of your PHI made by Custom Health Centers, including those for purposes other than treatment, payment, or healthcare operations.
D. Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of your PHI. While we are not required to agree to your request, we will accommodate it where possible.
E. Right to Confidential Communications
You may request that we communicate with you in a certain way or at a certain location (e.g., home vs. work). We will make every effort to accommodate reasonable requests.
F. Right to a Copy of This Privacy Policy
You have the right to request a paper copy of this Privacy Policy at any time.
4. Changes to This Privacy Policy
We reserve the right to change this Privacy Policy at any time. Any changes will apply to all PHI we maintain, including information created or received before the policy change. The revised Privacy Policy will be available on our website and at our office.
5. Contact Information
If you have any questions about this Privacy Policy or would like more information, please contact our Privacy Official:
Privacy Official: Rebecca H.
Email: hello@customhealthcenters.com
Address: 55130 Van Dyke Ave. #25, Shelby Twp., MI 48316
6. Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Official or with the U.S. Department of Health and Human Services (HHS). We will not retaliate against you for filing a complaint.
To file a complaint with the U.S. Department of Health and Human Services:
Visit HHS Website or call 1-800-368-1019.
7. Acknowledgment of Receipt
We ask that you acknowledge receipt of this Privacy Policy. Your acknowledgment indicates that you have been informed of how we use and disclose your PHI, as well as your rights concerning your health information.
This Privacy Policy reflects our commitment to complying with HIPAA requirements and safeguarding your Protected Health Information.
