Notice Of Privacy Practices
Live Life Now Health Group, P.A.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices (the “Notice”) describes how Live Life Now Health Group, P.A. (“we” or “our”) may use and disclose your protected health information to carry out treatment, payment or business operations and for other purposes that are permitted or required by law. We are not a “Covered Entity” as that term is defined in the Health Insurance Portability and Accountability Act (“HIPAA”), but we have elected to voluntarily substantially comply with the standards set forth in HIPAA. “Protected health information” or “PHI” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical health or condition, treatment or payment for health care services. This Notice also describes your rights to access and control your protected health information.
Your Rights With Respect To Your Protected Health Information:
Right to View / Right to Inspect and Copy
You have the right to inspect and copy your protected health information. You have the right to request Monument for an electronic or paper copy of your medical records and other health information we have about you. This can be done through sending a request to our Privacy Team at privacy@joinmonument.com.
Monument will provide a copy or a summary of your health information, after you identity has been confirmed and within 30 days of receiving and confirming your request. We may charge a reasonable, cost-based fee.
Right to Request Restrictions
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request. We may deny your request for restriction as the impact of the request would impact the quality of your care, deny efficient payment for your treatment, and have a justifiable negative operational impact deemed necessary. We may say “no” if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Right to Access or Amend
You may request access to or an amendment of your protected health information. You have the right to request to receive confidential communications from us by alternative means or at an alternate location. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
You have the right to request an amendment of your protected health information. We may deny your request, but we’ll tell you why in writing within 60 days. If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to our statement and we will provide you with a copy of any such rebuttal.
Right to Receive Confidential Communications
You have the right to request to receive confidential communications from any method of your choosing. This can be done through alternative means or at an alternate location. This means that you can make a request for us to send your health information in any form or format you would like or ask us to send the information to a trusted alternate site for you to pick up. We will comply with all reasonable requests which specify how or where you wish to receive these communications.
Right to Amend to Receive and Accounting of Disclosures
You have the right to receive a list (accounting) of who Monument has shared your health information with for six years prior to the date you request, who it was shared with, and the reason why.
We will include all disclosures of your protected health information that we have made, paper or electronic, except for certain disclosures which were pursuant to an authorization, for purposes of treatment, payment, healthcare operations (unless the information is maintained in an electronic health record); or for certain other purposes. We will provide the accounting once a year for free but will charge a reasonable, cost-based fee if you ask for another within 12 months.
Right to Request a Paper Copy of This Notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
You have the right to obtain a paper copy of this Notice, upon request, even if you have previously requested its receipt electronically by e-mail.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
How Monument Uses And Disclosures Your Protected Health Information:
The following list describes how we may use and share (disclose) your information.
- TREATMENT: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your protected health information may be provided to a health care provider to whom you have been referred to ensure the necessary information is accessible to diagnose or treat you.
- PAYMENT: Your protected health information may be used to bill or obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for your services, such as: making a determination of eligibility or coverage for insurance benefits and reviewing services provided to you for medical necessity.
- HEALTH CARE OPERATIONS: We may use or disclose, as needed, your protected health information in order to support our business activities and operations. These activities include, but are not limited to, improving quality of care, providing information about treatment alternatives or other health-related benefits and services, development or maintaining and supporting computer systems, legal services, and conducting audits and compliance programs, including fraud, waste and abuse investigations. Those business activities and operations may be conducted by Live Life Now Health Group or by its third party vendors.
Your protected health information may be used and disclosed by our health care providers, our staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to support our business operations, to obtain payment for your care, and any other use authorized or required by law.
Uses And Disclosures That Monument is Not Required to Obtain Your Authorization:
We may use or disclose your protected health information in the following situations without your authorization. These situations include the following uses and disclosures:
- as required by law;
- to legally protect ourselves or respond to lawsuits and legal actions for public health purposes;
- for health care oversight purposes;
- for abuse or neglect reporting;
- pursuant to Food and Drug Administration requirements;
- in connection with legal proceedings;
- for law enforcement purposes;
- to coroners, funeral directors and organ donation agencies;
- for certain research purposes;
- for certain criminal activities;
- for certain military activity and national security purposes;
- for workers’ compensation reporting;
- relating to certain inmate reporting; and other required uses and disclosures.
Under the law, we must make certain disclosures to you upon your request, and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of the Health Insurance Portability and Accountability Act (HIPAA). State laws may further restrict these disclosures.
Your Choices
Other permitted and required uses and disclosures will be made only with your consent, authorization or opportunity to object unless permitted or required by law.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising:
- We will never use your information for fundraising activities.
Revision to this Notice
We reserve the right to revise this Notice and to make the revised Notice effective for protected health information we already have about you as well as any information we receive in the future. You are entitled to a copy of the Notice currently in effect. Any significant changes to this Notice will be posted on our web site. You then have the right to object or withdraw as provided in this Notice.
Breach of Health Information Notice
We will notify you if a reportable breach of your unsecured protected health information is discovered. Notification will be made to you no later than 60 days from the breach discovery and will include a brief description of how the breach occurred, the protected health information involved and contact information for you to ask questions.
Complaints
If you are not satisfied with the manner in which a complaint is handled you may submit a formal complaint to the Department of Health and Human Services, Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
Complaints about this Notice or how we handle your protected health information directly to our organization should be directed to our HIPAA Privacy Officer at [privacy@joinmonument.com]
We will not retaliate against you for filing a complaint. We must follow the duties and privacy practices described in this Notice. We will maintain the privacy of your protected health information and to notify affected individuals following a breach of unsecured protected health information.
If you have any questions about this Notice, please contact us at (646) 960-3553 and ask to speak with our HIPAA Privacy Officer. If you would like to contact us via mail, please mail any requests to:
Monument Privacy Officer
350 7th Ave, Suite 600
New York, NY 10001
Acknowledgment Of Receipt Of Notice Of Privacy Practices
- I have received or been given an opportunity to receive Live Life Now Health Group, P.A.’s Notice of Privacy Practices.
