Notice of Privacy Practices (HIPAA Compliance)

1. Our Legal Duty

We are required by law to:

• Maintain the privacy and security of your PHI

• Provide you with this Notice of Privacy Practices

• Follow the terms of this notice currently in effect

• Notify you promptly if a breach occurs that may have compromised your PHI

• Accommodate reasonable requests you may make to communicate PHI by alternative means or at alternative locations

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2. Your Rights Regarding Your Health Information

You have the right to:

a. Get a Copy of Your Medical Records

• You can request to see or receive an electronic or paper copy of your medical record and other health information we have about you.

• We will provide a copy or a summary, usually within 30 days of your request.

• A reasonable, cost-based fee may apply.

b. Request an Amendment

• If you believe that your PHI is incorrect or incomplete, you may request that we correct the information.

• We may deny your request, but we’ll tell you why in writing within 60 days.

c. Request Confidential Communications

• You can ask us to contact you in a specific way (e.g., home or office phone) or send mail to a different address.

• We will accommodate all reasonable requests.

d. Request Restrictions on Disclosures

• You can ask us not to use or share certain PHI for treatment, payment, or healthcare operations.

• We are not required to agree to your request, except if you request that we not share information with your health insurer about a service you paid for out-of-pocket in full.

e. Get a List of Those With Whom We’ve Shared Your PHI

• You can request an “accounting of disclosures” — a list of disclosures of your PHI, excluding those related to treatment, payment, and healthcare operations.

• This applies to the past six years and is free once every 12 months. A fee may apply to additional requests.

f. Get a Copy of This Privacy Notice

• You may request a paper or electronic copy of this notice at any time.

g. Choose Someone to Act for You

• If you’ve given someone medical power of attorney or have a legal guardian, that person can exercise your rights and make choices about your PHI.

h. File a Complaint

• You can complain if you feel your rights are violated by contacting us at the information below.

• You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

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3. Our Uses and Disclosures

We typically use or share your PHI in the following ways:

a. Treatment

We can use your PHI to provide, coordinate, or manage your health care and related services. For example:

Sharing your health information with another healthcare provider or specialist involved in your care.

b. Payment

We can use and disclose your PHI to bill and collect payment from you, your insurance company, or a third party. For example:

Sending your diagnosis and treatment codes to your insurance provider for reimbursement.

c. Healthcare Operations

We use and disclose your PHI for our healthcare operations, such as quality assessment, staff performance evaluations, and administrative functions.

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4. Other Uses and Disclosures Allowed by Law

We may also share your PHI without your authorization in the following situations:

• Public Health and Safety: To prevent disease, report adverse reactions, or prevent serious threats to health or safety

• Law Enforcement: In response to a court order, warrant, or subpoena

• Legal Proceedings: In response to legal processes or to defend against legal claims

• Workers’ Compensation: To comply with workers' compensation laws

• Health Oversight Activities: For audits, investigations, inspections, and licensure

• Coroners, Medical Examiners, and Funeral Directors: To identify a deceased person or determine the cause of death

• Organ and Tissue Donation: To facilitate organ donation and transplant

• Military and National Security: As required for national security or military purposes

• Correctional Institutions: If you are in custody and PHI is necessary for your care or safety

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5. Uses and Disclosures That Require Your Authorization

We will not use or disclose your PHI for the following without your explicit written consent:

• Marketing purposes

• Sale of your health information

• Most sharing of psychotherapy notes (if applicable)

If you give us authorization, you may revoke it at any time in writing.

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6. Data Breach Notification

In the event of a breach involving your unsecured PHI, we will notify you without unreasonable delay and no later than 60 days after discovery, as required by law.

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7. Security of Your Information

We implement administrative, physical, and technical safeguards to protect your PHI against unauthorized access, use, or disclosure. These include:

• Secure electronic medical records systems

• Role-based access for staff

• Encrypted communications when applicable

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8. Changes to This Notice

We reserve the right to change the terms of this notice and apply those changes to all PHI we maintain. The most current version will be posted on our website and available in our office.

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9. Contact Us

If you have any questions about this Notice of Privacy Practices or wish to file a complaint, please contact:

Diamond State Chiropractic
📍 11220 N. Rodney Parham Rd. Ste #6
📞 501-246-3844
📧 info@diamonstatechiro.com
🌐 https://www.diamondstatechiro.com

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Last Updated: July 15, 2025