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HIPAA Notice of Privacy Practices

H2 Total Health
Notice of Privacy Practices (HIPAA Compliance Notice)

Effective Date: [Insert Date]

This Notice of Privacy Practices ("Notice") describes how medical and health information about you may be used and disclosed by H2 Total Health ("H2 Total Health," "we," "us," or "our"), and how you can get access to this information. Please review it carefully.

OUR LEGAL DUTY

H2 Total Health is required by law to:

  • Maintain the privacy and security of your Protected Health Information (PHI)
  • Provide you with this Notice of our legal duties and privacy practices regarding your PHI
  • Follow the terms of this Notice currently in effect

We reserve the right to change this Notice and make the revised Notice effective for all PHI we maintain. Any updated Notice will be made available on our website and upon request.

WHAT IS PROTECTED HEALTH INFORMATION (PHI)?

Protected Health Information includes information about you that may be used to identify you and that relates to:

  • Your past, present, or future physical or mental health or condition
  • The provision of healthcare services to you
  • Payment for healthcare services

PHI may be in written, electronic, or oral form.

HOW WE MAY USE AND DISCLOSE YOUR PHI

We may use and disclose your PHI for the following purposes without your written authorization, as permitted or required by HIPAA:

1. Treatment

We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This may include communication with physicians, healthcare providers, laboratories, pharmacies, or other professionals involved in your care.

2. Payment

We may use and disclose your PHI to obtain payment for healthcare services provided to you. This may include billing, eligibility determinations, claims management, and collection activities.

3. Healthcare Operations

We may use and disclose your PHI for healthcare operations, including but not limited to:

  • Quality assessment and improvement activities
  • Medical reviews and audits
  • Licensing and credentialing
  • Business planning and administrative activities

OTHER PERMITTED OR REQUIRED DISCLOSURES

We may also use or disclose your PHI in the following situations, as permitted or required by law:

  • As required by law, including reporting to public health authorities
  • Public health activities, such as preventing or controlling disease
  • Health oversight activities, audits, investigations, or inspections
  • Judicial or administrative proceedings, pursuant to legal process
  • Law enforcement purposes, as required by law
  • To avert a serious threat to health or safety
  • Workers' compensation or similar programs
  • Coroners, medical examiners, and funeral directors
  • Organ and tissue donation

USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, including:

  • Marketing purposes
  • Sale of PHI
  • Certain uses of psychotherapy notes (if applicable)

You may revoke an authorization at any time in writing, except to the extent that action has already been taken based on your authorization.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights under HIPAA:

Right to Access

You have the right to inspect and obtain a copy of your PHI, with limited exceptions.

Right to Request Amendment

You may request correction or amendment of your PHI if you believe it is incorrect or incomplete.

Right to an Accounting of Disclosures

You may request a list of certain disclosures of your PHI made by us.

Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your PHI. We are not required to agree to all requests, but will comply when required by law.

Right to Request Confidential Communications

You may request that we communicate with you in a certain way or at a certain location (for example, by email or phone).

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.

BREACH NOTIFICATION

We are required by law to notify you if a breach occurs that may have compromised the privacy or security of your PHI.

ELECTRONIC COMMUNICATIONS & WEBSITE USE

While we take reasonable safeguards to protect electronic communications, please be aware that email and online communications may carry inherent risks. Submission of information through our website contact forms does not establish a physician-patient relationship and should not include urgent or emergency medical information.

TELEHEALTH & NATIONWIDE SERVICES

H2 Total Health may provide services through telehealth platforms where legally permitted. Telehealth services are subject to additional privacy and security safeguards consistent with HIPAA and applicable state and federal laws.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

  • H2 Total Health, using the contact information below
  • The U.S. Department of Health and Human Services, Office for Civil Rights (OCR)

You will not be retaliated against for filing a complaint.

CONTACT INFORMATION

For questions about this Notice or to exercise your rights, contact:

H2 Total Health
Email: heather@h2totalhealth.com

ACKNOWLEDGMENT

By receiving services from H2 Total Health, you acknowledge that you have been provided with this Notice of Privacy Practices.