Overview
This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
Elevated Health Augusta is required by law to maintain the privacy of your Protected Health Information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to notify you in the event of a breach of your unsecured PHI.
Our Responsibilities
- Maintain Privacy & Security – We are required to maintain the privacy and security of your Protected Health Information (PHI).
- Breach Notification – We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
- Follow This Notice – We are required to abide by the terms of this Notice currently in effect.
How We May Use and Disclose PHI
Treatment
To coordinate or manage your healthcare and related services with doctors, nurses, technicians, pharmacies, and other healthcare providers.
Payment
To bill and receive payment from you, your insurance company, or third-party payers for the treatment and services you receive.
Healthcare Operations
To support business activities including quality assessment, employee review, training, licensing, and business planning.
Appointment Reminders
To contact you with appointment reminders, treatment-related information, or recommendations for alternative treatments.
Required & Permitted Disclosures
We may also use or disclose your PHI without your authorization in the following situations:
- •As Required by Law – When required by federal, state, or local law
- •Public Health Activities – To prevent disease, injury, or disability; report vital statistics
- •Health Oversight – To a health oversight agency for activities authorized by law
- •Legal Proceedings – In response to a court order or administrative tribunal
- •Law Enforcement – To report certain types of wounds, injuries, or crimes
- •Serious Threat to Health or Safety – To prevent or lessen a serious and imminent threat
Your Rights
You have the following rights regarding your Protected Health Information:
- •Right to Inspect and Copy – Obtain a copy of your medical record
- •Right to Amend – Request corrections to your medical record if you believe it is incorrect
- •Right to Confidential Communications – Request that we communicate with you in a specific way or at a specific location
- •Right to Request Restrictions – Request restrictions on certain uses and disclosures of your PHI
- •Right to Accounting of Disclosures – Request a list of certain disclosures we have made of your PHI
- •Right to a Paper Copy – Obtain a paper copy of this Notice at any time
Questions or Complaints
If you have questions about this Notice or wish to file a complaint about our privacy practices, please contact our Privacy Officer:
Privacy Officer
Elevated Health Augusta
7013 Evans Town Center Blvd, Suite 203
Evans, GA 30809
(706) 760-3470
care@elevatedhealthaugusta.comYou may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
You will not be retaliated against for filing a complaint.