skip to content skip to footer

HIPAA Policy

Backsmart Health Chiropractic – 5610 Bethelview Road #300A, Cumming GA 30040

Gregory King D.C. – (770) 888-4288

Effective Date: 8-8-13

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.

Backsmart Health Chiropractic maintains medical and billing information in paper and/or electronic form as part of providing health care and operating the practice. We use these records to provide care, obtain payment, run the practice, and meet our professional and legal obligations. We are required by law to maintain the privacy of protected health information, provide this notice of our legal duties and privacy practices, and notify affected individuals following a breach of unsecured protected health information when required by law.

If you have questions about this notice, contact Gregory King D.C. at (770) 888-4288, or 5610 Bethelview Road #300A, Cumming GA 30040.

1. Our Duties

  • Backsmart Health Chiropractic is required by law to maintain the privacy and security of your protected health information.
  • Backsmart Health Chiropractic will provide you with this notice of its legal duties and privacy practices with respect to your protected health information.
  • Backsmart Health Chiropractic will follow the duties and privacy practices described in the current version of this notice.
  • Backsmart Health Chiropractic will notify affected individuals following a breach of unsecured protected health information when required by law.

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

The law permits us to use or disclose your health information for the following purposes and in the following circumstances:

  • Treatment. We may use and disclose your medical information to provide, coordinate, or manage your care. For example, we may share information with physicians, specialists, imaging providers, pharmacies, laboratories, or other health care professionals involved in your treatment.
  • Payment. We may use and disclose your medical information to obtain payment for services we provide. For example, we may submit information to health plans, billing services, or other entities involved in claims processing or reimbursement.
  • Health care operations. We may use and disclose your information to operate the practice, evaluate quality, train staff, conduct audits, manage risk, support compliance, pursue business planning, and improve care delivery.
  • Business associates. We may share information with service providers that perform functions on our behalf, such as billing companies, EHR vendors, secure form providers, IT vendors, or consultants. We will require business associates and their subcontractors to protect the confidentiality and security of protected health information through written agreements where required by law.
  • Appointment reminders and care communications. We may contact you about appointments, follow-up care, treatment alternatives, health-related benefits and services, or other care-related communications. If you ask us to communicate with you in a particular way, we will evaluate that request as described below.
  • Sign-in sheets and office communications. We may ask you to sign in when you arrive and may call your name in the waiting area when we are ready to see you, consistent with applicable law and office workflow.
  • Individuals involved in care or payment. We may share relevant information with a family member, caregiver, personal representative, or another person involved in your care or payment for care when permitted by law and consistent with professional judgment. In a disaster or emergency, we may share information with a relief organization to coordinate notification efforts.
  • Required by law. We may use or disclose health information when federal, state, or local law requires it.
  • Public health and safety. We may disclose information for public health reporting, abuse or neglect reporting, adverse event monitoring, product recalls, communicable disease reporting, or to prevent a serious threat to health or safety where permitted or required by law.
  • Health oversight, judicial, administrative, and law enforcement purposes. We may disclose information for audits, investigations, licensing reviews, judicial proceedings, administrative proceedings, subpoenas, court orders, law enforcement requests, or other legal processes when permitted or required by law.
  • Workers’ compensation and similar programs. We may disclose information as authorized by workers’ compensation or similar laws.
  • Research, medical examiners, organ donation, specialized government functions, and other special situations. We may use or disclose information for specialized purposes where law permits or requires it. Delete any item that is not relevant to the clinic’s workflow.
  • Marketing. We may communicate with you about treatment-related products or services, care coordination, case management, or health-related benefits and services as permitted by law. For other marketing uses that require authorization, we will obtain your written authorization first.
  • Sale of protected health information. We will not sell your protected health information without your prior written authorization.

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

Except as described in this notice or otherwise permitted or required by law, Backsmart Health Chiropractic will not use or disclose health information that identifies you without your written authorization. If you authorize us to use or disclose your health information for another purpose, you may revoke that authorization in writing at any time, except to the extent we have already relied on it.

4. Your Rights

  • Right to request special privacy protections. You may ask us to restrict certain uses or disclosures of your health information by submitting a written request that identifies what information you want to limit and how you want the limitation to apply. We are not required to agree to every request. If you request that we not disclose information to your health plan about an item or service for which you paid in full out of pocket, we will comply when the law requires us to do so unless disclosure is otherwise required for treatment or by law.
  • Right to request confidential communications. You may ask us to communicate with you in a specific way or at a specific location, such as only at work, only by mail, only by portal, or only at a particular phone number or email address. We will comply with reasonable requests submitted in writing.
  • Right to inspect and copy. You may ask to inspect or obtain a paper or electronic copy of your medical record and certain other health information maintained by the clinic. Reasonable, cost-based fees may apply where permitted by law.
  • Right to amend or supplement. You may ask us to correct health information you believe is inaccurate or incomplete. If we deny the request, we will respond as required by law.
  • Right to an accounting of disclosures. You may request a list of certain disclosures of your protected health information made by the clinic, subject to the exclusions and limits allowed by law.
  • Right to a paper or electronic copy of this notice. You may ask for a paper copy of this notice at any time, even if you previously agreed to receive it electronically.
  • Right to choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian or personal representative, that person may exercise certain rights and make choices on your behalf, consistent with the law.
  • Right to file a complaint. You may complain directly to Backsmart Health Chiropractic and to the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. Backsmart Health Chiropractic will not retaliate against you for filing a complaint.

5. Complaints

Complaints about this notice or how Backsmart Health Chiropractic handles your health information should be directed to Gregory King D.C. at (770) 888-4288, or 5610 Bethelview Road #300A, Cumming GA 30040. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Backsmart Health Chiropractic will not retaliate against you for filing a complaint.

6. Changes to This Notice

Backsmart Health Chiropractic may change the terms of this notice at any time, and the new terms will apply to all protected health information maintained by the clinic. The current notice will be available upon request, in the clinic, and on backsmarthealth.com.