HIPAA Notice of Privacy Practices

Your Rights Regarding Your Health Information

This notice describes how medical information about you may be used and disclosed and how you can get access to this information at Vita Nova Ketamine & Wellness Clinic. Please review it carefully.

Our Legal Duty

We are required by law to maintain the privacy of your health information and to provide you with notice of our legal duties and privacy practices with respect to your health information. We are required to abide by the terms of this Notice of Privacy Practices.

How We May Use and Disclose Your Health Information

Treatment

We may use your health information to provide you with medical treatment or services. We may disclose your health information to doctors, nurses, technicians, or other personnel who are involved in taking care of you at our clinic.

Payment

We may use and disclose your health information to obtain payment for the treatment and services you receive from us. This may include contacting your insurance company to verify coverage or to obtain prior authorization for treatment.

Healthcare Operations

We may use and disclose your health information for healthcare operations. These activities include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, and conducting training programs.

Your Individual Rights

Right to Request Restrictions

You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or healthcare operations. We are not required to agree to your request.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

Right to Inspect and Copy

You have the right to inspect and copy your health information. Usually, this includes medical and billing records, but does not include psychotherapy notes.

Right to Amend

If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our clinic.

Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our clinic or with the Secretary of the Department of Health and Human Services. To file a complaint with our clinic, contact our Privacy Officer at the address below.

You will not be penalized for filing a complaint.

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future.

Contact Information

If you have any questions about this Notice of Privacy Practices, please contact us: