HIPAA PRIVACY STATEMENT

HIPAA PRIVACY STATEMENT

IMPORTANT: PLEASE READ CAREFULLY – INFORMATION ABOUT YOUR PRIVACY
Who is covered by this notice: This notice applies to our medical facility and any programs associated with NorthLife Aesthetics & Wellness Management.

Our commitment to your privacy: We understand that your medical information is personal and we are dedicated to safeguarding it. We create and maintain records of the care and services you receive at our facility, which are necessary for quality care and legal compliance. This notice applies to all your records.

We are obligated by law to:

Description of privacy practices: This Notice of Privacy Practices outlines how we may use and disclose your protected health information for treatment, payment, healthcare operations, and other purposes permitted or required by law. It also explains your rights to access and control your health information. “Protected Health Information” refers to information that identifies you and relates to your physical or mental health, including past, present, or future care.

Changes to this notice

We reserve the right to modify this notice. Any changes will apply to existing and future medical information. We will make the current notice available at our facility and on our website: https://northlife.com/. You will also receive a copy of the current notice when you visit our facility for treatment.

Complaints

If you believe that your privacy rights have been violated, you can file a complaint with our facility or directly with the United States Department of Health and Human Services: Office for Civil Rights, located at 200 Independence Avenue, S.W., Washington D.C. 20201. Toll-Free: (877) 696-6775. You can also visit www.hhs.gov/ocr/privacy/hipaa/complaints/ for more information. To file a complaint with our facility, please submit a written complaint within 180 days of the suspected violation to info@northlifecda.com. Please include as much detail as possible about the incident.

Use and disclosure of your medical information:

Treatment: We may use and disclose your protected health information to provide, coordinate, or manage your healthcare. This includes sharing information with other healthcare providers involved in your care. We may also disclose your information to external parties involved in your medical care or related services. In certain cases, we will obtain your authorization before disclosing your information. Only the minimum necessary information will be shared.
Communication with family: Involving your family or personal friends in your care, we may disclose relevant health information to them. In emergency situations or when you are unable to object, we may disclose your information in your best interest. After an emergency, you will be informed of the disclosure and given the opportunity to object to further disclosures.
Healthcare operations: We may use your medical information to support quality assessment, improvement activities, and various operational purposes that do not involve treatment. This includes activities such as provider evaluation, educational purposes, accreditation, and business planning and development.
Payment: We may use and disclose your medical information to bill for services rendered and collect payment from you, insurance companies, or third parties. This may involve sharing information with your health plan to facilitate payment or prior approval.
Business associates: We may engage business associates to provide specific services. To ensure your privacy, we require them to safeguard your information in accordance with the law.
Appointment reminders: We may contact you to remind you of upcoming appointments or reschedule missed appointments.
Treatment aftercare: We may use and disclose your medical information to assess your satisfaction, recommend treatment aftercare options, and inform you about health-related benefits or services we offer.
Legal requirements: We will disclose your information when required by federal, state, or local law.
Public health risks: We may disclose your medical information for public health activities, including disease control, reporting child abuse, medication reactions, notifying exposed individuals, or reporting domestic violence.
Health oversight activities: We may disclose your medical information to health oversight agencies authorized by law for audits, investigations, inspections, and licensure purposes.
Lawsuits and disputes: In legal proceedings, we may disclose your medical information in response to a court order or lawful process.
Law enforcement: We may release your medical information to law enforcement officials under certain circumstances, such as court orders, subpoenas, reporting criminal conduct, or emergencies related to crime or safety.
Correctional institutions: If you are an inmate, we may disclose your protected health information to correctional institutions or law enforcement officials for healthcare purposes, safety, or security.
Medical examiners: We may release your medical information to medical examiners for identification purposes or determining the cause of death.
National security and intelligence activities: In compliance with the law, we may release your medical information to authorized federal officials for national security and intelligence activities.

Your rights regarding your medical information:

Right to inspect and copy: You have the right to review and receive a copy of your medical information maintained by our facility. To request access, please submit a written request to info@northlifecda.com or to our address provided. We may charge a reasonable fee for copying and associated supplies.
Right to amend: If you believe that your medical information is incorrect or incomplete, you may request an amendment. Your request must be made in writing, explaining the reason, and submitted to info@northlifecda.com or our address provided. We may deny your request under certain circumstances.
Right to accounting of disclosures: You have the right to request a list of disclosures we have made of your medical information. Your request should be in writing, specifying the desired time period, and sent to info@northlifecda.com or our address provided. Additional accountings may incur a fee.
Right to request confidential communications: You have the right to request confidential communication regarding your medical matters. To make this request, please submit it in writing to info@northlifecda.com or our address provided, specifying the desired communication method.
Breach notification: In the event of a breach of your unsecured Protected Health Information, we will notify you as required by law.
Right to request restrictions: You have the right to request restrictions on the use or disclosure of your medical information for treatment, payment, or healthcare operations. We are not obligated to agree to your request, except in certain circumstances. To request restrictions, please submit your written request to info@northlifecda.com or our address provided.
Right to a copy of this notice: You have the right to request a paper copy of this notice at any time. To obtain a copy, please submit your request in writing to info@northlifecda.com or our address provided.

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