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.
Nano Back Institute ("we," "us," or "our") is committed to protecting the privacy of your protected health information ("PHI"). This Notice describes our privacy practices and your rights regarding your PHI under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and related state laws.
How We May Use and Disclose Your PHI
Treatment
We use and disclose PHI to provide, coordinate, and manage your medical care. This includes sharing your PHI with physicians, nurses, imaging centers, surgical facilities, and other healthcare providers who are involved in your care, including consulting specialists and providers with whom we coordinate referrals.
Payment
We may use and disclose your PHI to obtain payment for the services we provide. This may include sharing information with your health plan, insurance company, or another third party to confirm coverage, obtain prior authorization, or submit claims.
Healthcare Operations
We may use and disclose your PHI for our internal operations, including quality assessment and improvement, training, credentialing, accreditation, legal and auditing services, and general administrative activities.
Other Permitted or Required Disclosures
We may also use or disclose your PHI:
- When required by federal, state, or local law;
- For public health activities (e.g., disease reporting, FDA-regulated product tracking);
- To report suspected abuse, neglect, or domestic violence as required by law;
- For health oversight activities authorized by law;
- In response to a court or administrative order, subpoena, or other lawful process;
- To law enforcement officials as permitted or required by law;
- To coroners, medical examiners, and funeral directors;
- For organ and tissue donation purposes;
- For approved research that has been reviewed by an Institutional Review Board;
- To avert a serious threat to health or safety;
- For specialized government functions, including military, national security, and protective services.
Uses and Disclosures That Require Your Written Authorization
Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. This includes most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of PHI. You may revoke an authorization at any time, in writing, except to the extent that we have already acted in reliance on it.
Your Rights Regarding Your PHI
- Right to Access. You have the right to inspect and obtain a copy of your PHI maintained by us, subject to limited exceptions.
- Right to Amend. You have the right to request that we amend PHI we maintain about you if you believe it is incorrect or incomplete.
- Right to Request Restrictions. You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request except in limited circumstances.
- Right to Confidential Communications. You have the right to request that we communicate with you about your PHI by alternative means or at alternative locations (for example, by mail to a specific address or by phone at a specific number).
- Right to an Accounting of Disclosures. You have the right to receive a list of certain disclosures we have made of your PHI.
- Right to a Paper Copy. You have the right to receive a paper copy of this Notice upon request, even if you have agreed to receive it electronically.
- Right to Be Notified of a Breach. You have the right to be notified following a breach of your unsecured PHI.
Our Legal Duties
We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices, and to abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make new provisions effective for all PHI we maintain. Any revised Notice will be posted on our website and made available in our office.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. To file a complaint with us, contact our Privacy Officer using the information below. To file with HHS, visit hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.
Contact
To exercise any of your rights, ask questions about this Notice, or file a complaint with our Privacy Officer:
Nano Back Institute — Privacy Officer
800-956-6724 · inbox@backinstitute.com