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.

The Spine Works Chiropractic understands the importance of your privacy and is committed to maintaining the confidentiality of your medical information. We create medical records to provide quality care, comply with legal requirements, and support practice operations. We are required to maintain the privacy of your protected health information (PHI), provide this notice describing our legal duties and privacy practices, and notify you of any breach involving unsecured PHI.

A. How This Medical Practice May Use or Disclose Your Health Information

1. Treatment

We may use or disclose your health information to provide, coordinate, or manage your healthcare, including:

• Sharing information with other physicians, chiropractors, therapists, or healthcare providers participating in your care
• Providing records to imaging centers, laboratories, or pharmacies
• Communicating with family members or caregivers involved in your treatment (unless you object)

2. Payment

We may use or disclose your information to obtain payment for services, including:

• Submitting claims to health plans
• Confirming coverage or treatment authorization
• Sharing information with other providers for billing

3. Health Care Operations

We may use or disclose your information to support business and administrative operations, including:

• Quality assessment and improvement activities
• Licensing, accreditation, training, and credentialing
• Medical reviews, audits, legal services, and compliance programs
• Business associate functions such as billing, record storage, or IT services (under confidentiality agreements)
• Sharing PHI with other healthcare organizations involved in organized health care arrangements (OHCAs) for operational purposes

4. Appointment Reminders

We may use or disclose your information to remind you of appointments. If you are unreachable, messages may be left with limited details.

5. Sign-In Sheets and Calling Names

You may be asked to sign in at the front desk, and your name may be called when you are ready for your appointment.

6. Notification and Communication With Family

We may disclose information to family members, personal representatives, or others involved in your care when:

• You authorize it
• You do not object when given the opportunity
• You are unable to object due to emergency circumstances
• In disaster situations, disclosures may be made to authorized relief agencies

7. Marketing

We may contact you with information related to appointment reminders, care coordination, and products or services directly related to your treatment or health. We will not use your PHI for paid marketing or third-party marketing without your written authorization.

8. Sale of Health Information

We will not sell your PHI without your prior written authorization.

9. Required by Law

We may disclose PHI when required by federal, state, or local laws, including mandatory reporting of abuse or neglect, judicial or administrative orders, and certain law enforcement requests.

10. Public Health

We may disclose information for public health activities, including preventing or controlling disease, reporting reactions to medications, and reporting abuse or neglect.

11. Health Oversight

We may disclose PHI to health oversight agencies for audits, investigations, inspections, or licensure purposes.

12. Judicial and Administrative Proceedings

We may disclose PHI in response to court orders, subpoenas, or legal requests (with required patient notifications).

13. Law Enforcement

We may disclose PHI for law enforcement purposes as required or allowed by law.

14. Coroners, Medical Examiners, and Funeral Directors

We may disclose PHI to assist in identifying deceased persons or determining cause of death.

15. Organ and Tissue Donation

We may provide PHI to organizations involved in organ, eye, or tissue donation.

16. Public Safety

We may disclose PHI to prevent or lessen serious and imminent threats to patients, others, or the public.

17. Immunization Disclosures

We may provide proof of immunization to schools with patient agreement.

18. Specialized Government Functions

We may disclose PHI for military, national security, or correctional institution purposes.

19. Workers' Compensation

We may disclose PHI to comply with workers' compensation laws or for related claims.

20. Change of Ownership

If the practice is sold or merged, medical records will transfer to the new owner, but you retain the right to request copies of your records.

21. Breach Notification

If a breach involving unsecured PHI occurs, we will notify you as required by law.

B. When This Medical Practice May Not Use or Disclose Your Health Information

Except as outlined in this notice, we will not use or disclose your PHI without your written authorization. You may revoke your authorization at any time in writing, except to the extent we have already relied on it.

C. Your Health Information Rights

1. Right to Request Special Privacy Protections

You may request restrictions on certain uses or disclosures. We are not required to agree, except when you pay for services entirely out of pocket and request the information not be disclosed to your health plan.

2. Right to Request Confidential Communications

You may request communication in specific ways (e.g., email, alternate address). We will accommodate reasonable written requests.

3. Right to Inspect and Copy

You have the right to inspect and obtain copies of your health information, with limited exceptions. Requests must be submitted in writing. We may charge reasonable cost-based fees for copies, mailing, or preparing summaries.

4. Right to Amend or Supplement

If you believe your PHI is incorrect or incomplete, you may request an amendment in writing. We may deny the request under certain circumstances, but you may submit a written disagreement to be included in your record.

5. Right to an Accounting of Disclosures

You may request an accounting of certain disclosures of your PHI within the past six years. Some disclosures are exempt from accounting requirements.

6. Right to a Paper or Electronic Copy of this Notice

You may request a paper or electronic copy of this notice at any time, even if you received it electronically.

D. Changes to This Notice of Privacy Practices

We reserve the right to amend this notice at any time. Revised versions will apply to all PHI we maintain and will be posted prominently in our office and on our website.

E. Complaints

If you believe your privacy rights have been violated, you may submit a complaint to:

The Spine Works Chiropractic
301 14th Ave N, Suite 101
Nashville, TN 37203
info@thespineworks.com
(615) 730-8131

Or to the U.S. Department of Health & Human Services Office for Civil Rights:

Email: OCRMail@hhs.gov
Complaint Info: https://www.hhs.gov/hipaa/filing-a-complaint/what-to-expect/

You will not be penalized for filing a complaint.