HIPAA Privacy Statement

IMPORTANT: PLEASE READ CAREFULLY – INFORMATION ABOUT YOUR PRIVACY

Who Is Covered by This Notice

This notice applies to our medical facility and any programs associated with A Good Drip.

Our Commitment to Your Privacy

We understand that your medical information is personal, and we are dedicated to safeguarding it. We create and maintain records of the care and services you receive at our facility, which are necessary for quality care and legal compliance. This notice applies to all your records.

We are obligated by law to:

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

Description of Privacy Practices

This Notice of Privacy Practices outlines how we may use and disclose your protected health information for:

  • Treatment
  • Payment
  • Healthcare operations
  • Other purposes permitted or required by law.

“Protected Health Information” refers to information that identifies you and relates to your physical or mental health, including past, present, or future care.

Changes to This Notice

We reserve the right to modify this notice. Any changes will apply to existing and future medical information.

  • The current notice will be available at our facility and on our website: https://agooddrip.com.
  • You will receive a copy of the current notice when you visit our facility for treatment.

Complaints

If you believe that your privacy rights have been violated, you can file a complaint with our facility or directly with the United States Department of Health and Human Services:

Office for Civil Rights
200 Independence Avenue, S.W., Washington D.C. 20201
Toll-Free: (877) 696-6775
Visit: www.hhs.gov/ocr/privacy/hipaa/complaints/

To file a complaint with our facility, please submit a written complaint within 180 days of the suspected violation to info@mywellnessstudio.com. Include as much detail as possible about the incident.

Use and Disclosure of Your Medical Information

Treatment

We may use and disclose your protected health information to provide, coordinate, or manage your healthcare. This includes:

  • Sharing information with other healthcare providers involved in your care.
  • Disclosing information to external parties involved in your medical care or related services.
  • In certain cases, we will obtain your authorization before disclosing your information.

Only the minimum necessary information will be shared.

Communication With Family

We may disclose relevant health information to family members or personal friends involved in your care.

  • In emergency situations or when you are unable to object, we may disclose your information in your best interest.
  • After an emergency, you will be informed of the disclosure and given the opportunity to object to further disclosures.

Healthcare Operations

We may use your medical information to support:

  • Quality assessment and improvement activities.
  • Provider evaluation and educational purposes.
  • Accreditation, business planning, and development.

Payment

We may use and disclose your medical information to:

  • Bill for services rendered.
  • Collect payment from you, insurance companies, or third parties.
  • Share information with your health plan to facilitate payment or prior approval.

Business Associates

We may engage business associates to provide specific services. To ensure your privacy, we require them to safeguard your information in accordance with the law.

Appointment Reminders

We may contact you to remind you of upcoming appointments or to reschedule missed appointments.

Treatment Aftercare

We may use and disclose your medical information to:

  • Assess your satisfaction.
  • Recommend treatment aftercare options.
  • Inform you about health-related benefits or services.

Legal Requirements

We will disclose your information when required by federal, state, or local law.

Public Health Risks

We may disclose your medical information for public health activities, including:

  • Disease control.
  • Reporting child abuse.
  • Medication reactions.
  • Notifying exposed individuals.
  • Reporting domestic violence.

Health Oversight Activities

We may disclose your medical information to health oversight agencies authorized by law for:

  • Audits.
  • Investigations.
  • Inspections.
  • Licensure purposes.

Lawsuits and Disputes

In legal proceedings, we may disclose your medical information in response to a:

  • Court order.
  • Lawful process.

Law Enforcement

We may release your medical information to law enforcement officials under certain circumstances, such as:

  • Court orders.
  • Subpoenas.
  • Reporting criminal conduct.
  • Emergencies related to crime or safety.

Correctional Institutions

If you are an inmate, we may disclose your protected health information to correctional institutions or law enforcement officials for:

  • Healthcare purposes.
  • Safety or security.

Medical Examiners

We may release your medical information to medical examiners for:

  • Identification purposes.
  • Determining the cause of death.

National Security and Intelligence Activities

In compliance with the law, we may release your medical information to authorized federal officials for national security and intelligence activities.

Your Rights Regarding Your Medical Information

Right to Inspect and Copy

You have the right to review and receive a copy of your medical information maintained by our facility.

  • To request access, please submit a written request to agooddrip@yahoo.com.
  • We may charge a reasonable fee for copying and associated supplies.

Right to Amend

If you believe that your medical information is incorrect or incomplete, you may request an amendment.

  • Your request must be in writing, explaining the reason, and submitted to agooddrip@yahoo.com.
  • We may deny your request under certain circumstances.

Right to Accounting of Disclosures

You have the right to request a list of disclosures we have made of your medical information.

  • Your request should be in writing, specifying the desired time period, and sent to agooddrip@yahoo.com.

Right to Request Confidential Communications

You have the right to request confidential communication regarding your medical matters.

  • To make this request, please submit it in writing to info@mywellnessstudio.com or our address provided.
  • Specify the desired communication method.

Breach Notification

In the event of a breach of your unsecured Protected Health Information, we will notify you as required by law.

Right to Request Restrictions

You have the right to request restrictions on the use or disclosure of your medical information for treatment, payment, or healthcare operations.

  • We are not obligated to agree to your request, except in certain circumstances.
  • To request restrictions, please submit your written request to info@mywellnessstudio.com or our address provided.

Right to a Copy of This Notice

You have the right to request a paper copy of this notice at any time.

Contact Information

Contact Person: Ashley Young, RN
Email: agooddrip@yahoo.com
Phone: (352) 932-3042

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