We are committed to maintaining the privacy of your protected health information (“PHI”). We are required by law to maintain the privacy of your PHI, provide you with this Notice of Privacy Practices and notice of our legal duties regarding your PHI. We are also required to follow the practices described in our Notice of Privacy Practices currently in effect.Theory Health, LLC
We may use or disclose PHI about you for our TPO, including for example:
We may also disclose your PHI for treatment activities of other health care providers, for payment activities of other health care providers, payors or health care clearinghouses, or for the health care operations of one of those entities if we and that entity each have (or had) a relationship with you and the PHI relates to that relationship.
We may use or disclose PHI about you without your authorization for several other purposes required or permitted by law. Subject to certain requirements, we may use or disclose your PHI without your authorization as follows:
preparing reports to the FDA; maintaining vital health records such as for births and deaths, etc.);
We may also contact you about appointment reminders, treatment alternatives or for fundraising purposes.
In any other situation, we will ask for your written authorization before using or disclosing any of your PHI. If you sign an authorization to use or disclose information, you can later revoke that authorization to stop further uses and disclosures.
In most cases, you have the right to look at or obtain a copy of PHI that we maintain about you. We may charge a fee for costs related to your request. We may, under certain circumstances, deny your request but if we do, you can obtain a review of that denial by another licensed health care professional that we designate.
You also have the right to receive an “accounting,” which lists certain instances when we have disclosed PHI about you for reasons other than treatment, payment, or health care operations. The request can cover a time period no longer than six years from the date of disclosure. Your first request in a 12-month period is free. After that, we may charge for costs related to additional requests.
If you believe that information in your record is incorrect, or if important information is missing, you also have the right to request that we correct the existing information or add the missing information. We have the right to deny such a request under certain circumstances.
You have the right to request that your health information be communicated to you in a confidential manner such as asking that we contact you at work rather than at home.
You may request that we restrict how we use or disclose information about you for treatment, payment, or health care operations or to persons involved in your care (except when specifically authorized by you, when required by law, or in emergency circumstances). We will consider your request for such restrictions, but are only bound by them if we agree to them.
To exercise any of the rights described above, please make a request in writing to our Privacy Official/Contact Person listed on page one of this Notice.
We may change our privacy practices at any time and the new terms shall apply to all PHI about you that we have at the time of the change and to all PHI about you that we maintain in the future. If we make any material changes, we will change our Notice of Privacy Practices and post it in the waiting area of our office. The changes will not take effect until they are reflected in a revised Notice of Privacy Practices. You can request a copy of our Notice of Privacy Practices at any time. If this Notice of Privacy Practices was sent to you electronically, you have the right to obtain a paper copy upon request. For more information about our privacy practices, contact our Privacy Official/Contact person listed on the first page of this Notice.
If you are concerned that we have violated your privacy rights, you may contact the Privacy Official/Contact Person listed on the first page of this Notice. You may also send a written complaint to the Secretary of the United States Department of Health and Human Services. You will not be retaliated against for filing a complaint.