HIPAA PRIVACY NOTICE
Last updated December 19, 2022
This privacy notice (“HIPAA Privacy Notice”) describes how Boost Medical LLC (“Company,” “we,” “us,” or “our“) may use and/or disclose protected health information about you that may be generated when we provide care and/or health services to you, and how you (or your authorized representatives if permitted under all applicable laws) can get access to this information as is required by the Health Insurance Portability and Accountability Action (“HIPAA”).
- PROTECTED HEALTH INFORMATION
We may be permitted, without your authorization, or required to use or disclose health information, electronic or otherwise, that may identify you and relates to your past, present or future physical or mental health or condition and related health care products and/or services (“PHI”) for treatment, payment or health care operations.
- Treatment. For example, we may use or disclose your PHI and share it with other professionals who are treating you, including but not limited to doctors, nurses, technicians, medical students, or hospital personnel involved in your care. For example, we might disclose information about your overall health condition to physicians who are treating you for a specific injury or condition.
- Payment. For example, we may use and disclose your PHI to bill and get payment from health plans or others. For example, we share your PHI with your health insurance plan so it will pay for the services you receive.
- Health Care Operations. For example, we may use and disclose your PHI to run our practice and improve your care. For example, we may use your PHI to manage the services you receive or to monitor the quality of our health care services.
We may also share your PHI for various other reasons, including for public health, research, or other purposes to contribute to the public good. Additional permitted or required use and/or disclosure of your PHI includes, without limitation:
- appointment reminders and other communications. For example, we may use or disclose your PHI to provide appointment reminders, health care products refill orders, or information about alternative health services and/or products.
- emergencies. We may share your information if we believe it is in your best interest, according to our best judgment, and (i) if you are unable to tell us your preference, for example, if you are unconscious; or (ii) when needed to lessen a serious and imminent threat to health or safety.
- our business associates. For example, we may use and disclose your PHI to outside persons or entities that perform services on our behalf, such as auditing, legal, or transcription (Business Associates). The law requires our business associates and their subcontractors to protect your PHI in the same way we do. We also contractually require these parties to use and disclose your PHI only as permitted and to appropriately safeguard your PHI.
- legal compliance. For example, we will share your PHI in the event of investigations into our compliance with HIPAA or applicable privacy laws, or disclose your PHI for law enforcement purposes if all applicable legal requirements are met.
- public health and safety activities. For example, we may share your PHI to (i) report injuries, births, and deaths, (ii) prevent disease, (iii) report adverse reactions to medications or medical device product defects, (iv) report suspected child neglect or abuse, or domestic violence, and/or (v) avert a serious threat to public health or safety.
- responding to legal actions. For example, we may share your PHI to respond to a court or administrative order or subpoena, discovery request, or another lawful process.
- research. For example, we may share your PHI for some types of health research that do not require your authorization, such as if an institutional review board (IRB) has waived the written authorization requirement.
- medical examiners, funeral directors, or organ and tissue donation. For example, we may share PHI with coroners, medical examiners, or funeral directors when an individual die, or to arrange an authorized organ or tissue donation from you or a transplant for you.
- workers’ compensation, law enforcement, or other government requests. For example, we may use and disclose your PHI for (i) workers’ compensation claims, (ii) health oversight activities by federal or state agencies, including without limitation the Department of Health and Human Services or the Food and Drug Administration (iii) law enforcement purposes or with a law enforcement official, (iv) specialized government functions, such as military and veterans’ activities, national security and intelligence, presidential protective services, or medical suitability.
It is not possible to list every permissible use or disclosure of your PHI. However, when using or disclosing your PHI or requesting your PHI from another source, we will make reasonable efforts to limit our use, disclosure, or request to the minimum needed to accomplish our intended purpose.
- YOUR CHOICES
For certain health information, you may 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, please contact us and we will make reasonable efforts to follow your instructions.
You may have the right to tell us whether to:
- Share information, such as your PHI, general condition, or location, with your family, close friends, or others involved in your care.
- Share information in a disaster relief situation, such as to a relief organization to assist with locating or notifying your family, close friends, or others involved in your care.
- USE OR DISCLOSURE REQUIRING YOUR AUTHORIZATION
In the following cases we will only share your information if you give us written permission:
- Most sharing of a mental health care professional’s notes (psychotherapy notes) from a private counseling session or a group, joint, or family counseling session.
- Marketing our services.
- Selling or otherwise receiving compensation for disclosing your PHI.
- Other uses and disclosures not described in this HIPAA Privacy Notice.
You may revoke your authorization at any time, but it will not affect information that we already used and disclosed.
- YOUR RIGHTS
When it comes to your health information, you (or your authorized representative, if permitted under all applicable laws) may have certain rights. This section explains your rights and some of our responsibilities to help you.
You may have the right to:
- Obtain a copy of this HIPAA Privacy Notice. You may request a paper copy of this HIPAA Privacy Notice by submitting a written request to:
Boost Medical LLC
Attn: Privacy Officer
1500 Weston Rd, #200-16
Weston, FL 33326
- Inspect and Obtain a Copy of Your PHI. You may have a right to see or obtain an electronic or paper copy of the PHI that we maintain about you (right to request access). We will generally respond to your request within thirty (30) days.
- We may (i) require you to make access requests in writing; (ii) charge a reasonable, cost-based fee for the costs of copying, mailing, or other supplies associated with your request; or (iii) deny your request for access in certain limited circumstances. However, if we deny your access request, we will provide a written denial with the basis for our decision and explain your rights to appeal or file a complaint.
- Make Amendments. You may ask us to correct or amend PHI that we maintain about you that you think is incorrect or inaccurate by submitting requests in writing that specify the inaccurate or incorrect PHI and provide a reason that supports your request. We will generally respond to your request within sixty (60) day, and if granted, we will append the material created or submitted in accordance with this paragraph to your designated record.
- We may deny your request for an amendment if you ask us to amend PHI that is not part of our record, that we did not create, that is not part of a designated record set, or that is accurate and complete. However, if we deny your request, we will explain in writing. You will have the right to submit a written statement disagreeing with the denial and, if you opt not to submit this statement, you may request that we provide your original request for amendment and the denial with any future disclosures of PHI subject to the amendment. We may prepare a written rebuttal to any individual’s statement of disagreement.
- Request Additional Restrictions. You may have the right to ask us to limit what we use or share about your PHI (right to request restrictions). You can contact us and request us not to use or share certain PHI for treatment, payment, or operations or with certain persons involved in your care.
- We may (i) require that you submit this request in writing; or (ii) deny your request if we believe, in our sole discretion, such a request would affect your care. Additionally, we are not required to grant your request, except we will agree not to disclose information to a health plan for purposes of payment or health care operations if the requested restriction concerns a health care item or service for which you or another person, other than the health plan, paid in full out-of-pocket, unless it is otherwise required by law.
- Request an Accounting of Disclosures. You may have the right to request an accounting of certain PHI disclosures that we have made. We will respond no later than sixty (60) days after receiving the request, however we may ask for an additional (thirty) 30 days to comply with you’re a request, with a written explanation and the date by which we intend to send the response.
- We will (i) provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within twelve (12) months. We will notify you about the costs in advance and you may choose to withdraw or modify your request at that time; and (ii) 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.
- Choose someone to Act for You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI. We will confirm the person has this authority and can act for you before we take any action.
- Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. We will accommodate reasonable requests provided that you specify how or where you wish to be contracted.
- Make Complaints. You have the right to complain if you feel we have violated your rights. We will not retaliate against you for filing a complaint. All complaints must be submitted in writing. You may file a complaint (i) directly with us by contacting email@example.com; or (ii) with the Office for Civil Rights at the US Department of Health and Human Services here or at:
Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
- DATA BREACH NOTIFICATION
We will promptly notify you if a data breach occurs that may have compromised the privacy or security of your PHI. We may notify you in writing or we may notify you by email if you have provided us with your current email address and you have previously agreed to receive notices electronically. In some circumstances, our business associates may provide the notification. In limited circumstances when we have insufficient or out-of-date contact information, we may provide notice in a legally acceptable alternative form.
- DO WE MAKE UPDATES TO THIS NOTICE?
We may update this HIPAA Privacy Notice from time to time. The updated version will be indicated by an updated “Revised” date and the updated version will be effective as soon as it is accessible. If we make material changes to this HIPAA Privacy Notice, we may notify you either by prominently posting a notice of such changes or by directly sending you a notification. We encourage you to review this HIPAA Privacy Notice frequently to be informed of how we are protecting your information.
- HOW CAN YOU CONTACT US ABOUT THIS NOTICE?
If you have questions or comments about this HIPAA Privacy Notice, you may email us or contact us by post to:
Boost Medical LLC
Attn: Privacy Officer
1500 Weston Rd, #200-16
Weston, FL 33326