Notice of Privacy Practices

 

Your Information. Your Rights. Our Responsibilities. 

This notice describes how medical information may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

When it comes to your health information, you have certain rights. This selection explains your rights and some of our responsibilities to help you. 

Get an electronic copy of your medical record

  • You can ask to see to receive or get an electronic or paper copy of your medical record and other information we have about you. Ask us how to do this.

  • We will provide a copy or summary of your health information, usually within 30 days of your request.

Ask us to correct your medical record

  • You can ask to see to get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

  • We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record 

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

  • We may refuse your request, but we will explain why in writing within 60 days.

​Request confidential communications

  • You can ask us to contact you in a specific way (for example by mobile, home or office phone) or to send mail to a different address.

  • We will agree to all reasonable requests.

Ask to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment or our operations.

    • We are not required to agree to your request, and we may refuse if it would affect your care.

  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.

    • We will agree unless a law requires us to share that information.

Get a list of those with whom we've shared information

  • You can ask for a list of the times we have shared your health information for six years prior to the date you ask, who we have shared it with, and why.

  • We will include all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We may chare a reasonable, cost-based fee for this request.

Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive this notice electronically. We will provide you with a paper copy promptly.

Chose someone to act for you

  • If you have given someone medical power of attorney, or if someone if your legal guardian, that person can exercise your rights and make choices about your health information.

  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us at:

    • Dayly Wellness, LLC
      Courtney Day, ND
      4145 SW Watson Ave. Suite 350
      Beaverton, OR 97005
      (503) 495-3373

  • You can file a complaint by contacting or sending a letter to:

    • U.S. Department of Health and Human Services Office for Civil Rights
      200 Independence Avenue, S.W.
      Washington D.C.. 20201
      1-877-696-6775

  • We will not retaliate against you for filing a complaint

 

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care

  • Share information in a disaster relief situation

  • Include your information in a clinic directory

  • Contact you for fundraising efforts, awareness campaigns or educational purposes
    If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious imminent threat to health or safety.

​In these cases, we never share your information unless you give us written permission:

  • Marketing purposes

  • Sale of your information

  • Most sharing of psychotherapy notes

In the case of fundraising efforts, awareness campaigns or educational purposes:

  • We may contact you for fundraising efforts, awareness campaigns or educational purposes, but you can request for us to not contact you again.

 

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways:

Treatment collaboration

  • We can use your health information and share it with other professionals who are treating you (eg. a doctor treating your for an injury asks another doctor about your overall health condition).

To provide effective care and run our organization

  • We can use and share your health information to help run our practice, improve your care and contact you when necessary. We use your health information to manage your treatments and services.

Billing for your services

  • We can use and share your health information for billing and payment purposes, such as to request reimbursement from health plans or other entities. We give information to your health insurance plan so it may pay for your treatments or services.

How else can we share your health information? We are allowed or required to share your information in other ways - usually in ways that contribute to public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Help with public health and safety issues

  • We can share health information about your for certain situations such as:

    • Preventing disease

    • Helping with product recalls

    • Reporting adverse reactions to medications

    • Reporting suspected abuse, neglect or domestic violence

    • Preventing or reducing a serious threat to anyone's health and safety

Research purposes

  • We can use or share your information for health research.

Comply with the law

  • We will share information about you if state or federal law require it, including with the Department of Health and Human Services if needed to investigate compliance with federal privacy law.

Respond to organ and tissue donation requests

  • We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

  • We can share health information with a coroner, medical examiner or funeral director when an individual dies.

Address workers' compensation law enforcement, and other government requests

  • We can use or share health information about you for:

    • Worker's compensation claims

    • Law enforcement purposes or with a law enforcement official

    • Health oversight agencies for activities authorized by law

    • Special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach occurs that may have compromised the privacy or security or your information.

  • We must follow the duties and privacy practices described in this notice and provide you a copy of it.

  • We will not use or share your information other than as described unless you request so by writing or documentation of authorization. If you authorize us to disclose your health information to any party, you may change your mind at any time. Let us know in writing if you change your mind.

 

For more information visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

 

Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request and on our website.

Effective 1/1/2020

This Notice of Privacy Practices applies to the following organizations:
Dayly Wellness, LLC