Privacy Policy
OUR LEGAL RESPONSIBILITIES
We are required by law to give you this notice. It provides you information on how we may use and disclose protected health information about you and describes your rights and our obligations regarding the use and disclosure of that information. We shall maintain the privacy of protected health information and provide you with notice of our legal duties and privacy practices with respect to your protected health information.
We have the right to change these policies at any time. If we change our privacy policies, we will notify you of these changes immediately. This current policy is in effect unless stated otherwise. If the policy is changed, it will apply to all your current and past health information.
You may request a copy of our notice at any time. You may contact Garden of Bloom Med Spa LLC at:
Garden of Bloom Med Spa LLC
207 Western Avenue, Suite #7
Davenport, Iowa 52801
HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION
The following examples describe ways that we may use your protected health information for your treatment, payment, and healthcare operations. Please note that not every use or disclosure in a particular category will be listed.
Treatment
We may use and disclose your protected health information to provide you treatment. This includes disclosing your protected health information to other medical providers, trainees, therapists, medical staff, and office staff involved in your health care.
For example, your medical provider might need to consult with another provider to coordinate your care. Office staff may need to use and disclose your protected health information to other individuals outside of our office, such as a pharmacy when a prescription is called in.
Payment
Your protected health information may be used to obtain payment from an insurance company or another third party. This may include providing an insurance company your protected health information for pre-authorization of a medication we prescribed.
Healthcare Operations
We may use or disclose your protected health information to operate this medical practice. These activities include training students, reviewing cases with employees, utilizing your information to improve the quality of care, and contacting you by telephone, email, or text to remind you of your appointments.
If we must share your protected health information with third-party “business associates,” such as a billing service, we will have a written contract containing terms that protect the privacy of your protected health information.
We may also use and disclose your protected health information for marketing activities. For example, we might send you a thank you card in the mail with a coupon for specialized services or products. We may also send you information about products or services that might be of interest to you. You may contact us at any time to stop receiving this information.
We will not use or disclose your protected health information for any purpose other than those identified in this policy without your specific written authorization. You may give us written authorization to use or disclose your protected health information for any purpose. You may revoke this authorization at any time; however, it will not affect information already shared while the authorization was in effect.
Appointment Reminders
We may contact you as a reminder that you have an appointment for your initial visit, follow-up visit, or lab work via text, phone, or email.
Others Involved in Your Health Care
We may disclose protected health information about you to your family members or friends if we obtain your verbal agreement or give you an opportunity to object and you do not raise an objection. For example, if your spouse or friend is present during your evaluation, we may assume we can disclose relevant information to that person.
If you are unable to agree or object, we may disclose such information as necessary if we determine it is in your best interest based on professional judgment in urgent or emergency situations.
Research
We will not use or disclose your health information for research purposes unless you give us authorization to do so.
Organ Donation
If you are an organ donor, we may release protected health information to organizations that handle organ procurement or organ, eye, or tissue transplantation as necessary to facilitate this process.
Public Health Risks
We may disclose your protected health information when necessary to prevent or control disease, report adverse events from medications or products, prevent injury, disability, or death. This information may be disclosed to healthcare systems, government agencies, or public health authorities. We may also disclose protected health information to the Food and Drug Administration (FDA) to report adverse events, defects, problems, or enable recalls as required by regulation.
Health Oversight Activities
We may disclose protected health information to health oversight agencies for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for state and federal agencies to monitor healthcare systems and compliance with civil law.
Required by Law
We will disclose protected health information about you when required to do so by federal, state, and/or local law.
Worker’s Compensation
We may disclose your protected health information to worker’s compensation programs or similar programs.
Lawsuits
We may disclose your protected health information in response to a court action, administrative action, or subpoena.
Law Enforcement
We may release protected health information to a law enforcement official in response to a court order, subpoena, or warrant, subject to all applicable legal requirements.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
Access to Medical Records
You have the right to access and receive copies of your protected health information that we use to make decisions about your care. You must submit a written request to obtain your protected health information. We reserve the right to charge a reasonable fee for the time it takes to obtain, copy, and provide this information.
Amendment
If you believe the protected health information we have about you is incorrect or incomplete, you may request that we amend the information. You must submit a written request explaining why the information should be amended. We may deny your request if you do not submit it in writing or provide a reason. If we deny your request, we will provide you with a written explanation. We may deny the request if we believe the protected health information is accurate and complete.
Accounting of Disclosures
You have the right to receive a list of instances in which we disclosed your protected health information, except for disclosures used for treatment, payment, healthcare operations, pursuant to valid authorization, or otherwise permitted by law. You must submit a written request to obtain this accounting.
If approved, we will provide the date of disclosure, the name of the individual or entity to whom the information was disclosed, a description of the information disclosed, the reason for disclosure, and any additional relevant information. This accounting may not include disclosures older than six (6) years prior to the date of your request. We reserve the right to charge a reasonable fee for this process.
Restriction Requests
You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment, or healthcare operations. We will accommodate your request except where disclosure is required by law. This request must be submitted in writing.
Confidential Communication
You have the right to request that we communicate with you about healthcare matters in a certain way or at a certain location. We will accommodate reasonable requests as long as it allows us to continue to collect payments and bill you.
Paper Copy of This Notice
You may request a hard copy of this privacy policy even if you have reviewed and signed it electronically.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our office. You may also file a complaint with the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.
Contact Information
Garden of Bloom Med Spa LLC
207 Western Avenue, Suite #7
Davenport, Iowa 52801
