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.
At Longevity Holistic Wellness, we are committed to protecting the privacy of your Protected Health Information (PHI). This Notice of Privacy Practices describes how we may use and disclose your PHI to carry out treatment, payment, or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI. We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices with respect to your PHI, and abide by the terms of the Notice currently in effect.
We may use and disclose your PHI for purposes of providing you with treatment, obtaining payment for services, and conducting our healthcare operations. For example, we may use your PHI to provide counseling services, coordinate your care with other healthcare providers with your consent, or to bill your insurance company for the services you receive. We may also use your PHI for activities such as quality improvement, staff training, and business planning. In some instances, Wisconsin law may provide additional protections for certain types of health information, such as mental health treatment records and information related to substance use, and we will adhere to these stricter requirements.
Other uses and disclosures of your PHI will only be made with your specific written authorization. This includes disclosures for marketing purposes or the sale of your PHI. You have the right to revoke any authorization you provide at any time, in writing, although this will not affect any uses or disclosures made in reliance on your authorization prior to its revocation. We are also required to obtain your specific written authorization for the disclosure of "psychotherapy notes," as defined by HIPAA, with limited exceptions.
You have several rights regarding your PHI. These rights include the right to inspect and obtain a copy of your PHI, request an amendment to your PHI if you believe it is inaccurate or incomplete, request restrictions on certain uses and disclosures of your PHI, receive confidential communications by alternative means or at alternative locations, and obtain an accounting of certain disclosures of your PHI. If you have any questions about this Notice or your rights, please contact our Privacy Officer at Address: 121 E. Silver Spring Drive Whitefish Bay, WI 53217, Phone: (262) 292-1018. We reserve the right to change the terms of this Notice at any time, and any changes will apply to all PHI we maintain. A copy of the current Notice will be available upon request and on our website.