Notice of Privacy Practices

You have the right to:

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Get a copy of your health information.

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You may request a paper or electronic copy of your medical record and other health information we maintain about you, subject to applicable law.

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Ask us to correct your health information.

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You may ask us to correct health information about you that you believe is incorrect or incomplete.

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We may deny your request in certain circumstances, but we will provide you with a written explanation.

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Request confidential communications.

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You may ask us to contact you in a specific way or at a specific location. We will accommodate reasonable requests.

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Ask us to limit what we use or share.

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You may ask us not to use or share certain health information for treatment, payment, or healthcare operations. We are not required to agree to every request.

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If you pay for a healthcare service or item entirely out of pocket and in full, you may ask us not to disclose information about that service to your health plan for payment or healthcare operations, and we will agree unless disclosure is required by law.

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Get a list of disclosures.

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You may request an accounting of certain disclosures of your health information made by us during the six years before your request. Certain disclosures are excluded, including disclosures for treatment, payment, and healthcare operations and certain other disclosures permitted by law.

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Get a copy of this notice.

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You may request a paper copy of this Notice of Privacy Practices at any time, even if you have agreed to receive it electronically.

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Choose someone to act for you.

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If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information when legally authorized to do so.

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File a complaint.

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You may file a complaint if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.​

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Your Choices

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For certain health information, you may tell us your preferences about what we share.​

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You may ask us to:

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Share information with a family member, close friend, or other person involved in your care or payment for your care.

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Share information in a disaster-relief situation.

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We may also contact you regarding your care, treatment, appointments, services, or other healthcare-related matters.

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If you have a preference about how we communicate with you, please let us know.

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How We May Use and Disclose Your Health Information

 

We may use or share your health information without your written authorization for the following purposes:

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Treatment

We may use and share your health information to provide, coordinate, or manage your healthcare.

For example, we may share relevant information with another healthcare professional involved in your care.

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Payment

We may use and share your health information to obtain payment for healthcare services.

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Healthcare Operations

We may use and share your health information to operate our practice, improve the quality of care, conduct administrative activities, and manage our services.

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Business Associates and Service Providers

We may share your health information with trusted third-party service providers that perform services on our behalf, when permitted by law. These services may include secure patient communication and records management, prescription management, laboratory ordering, genetic testing, supplement fulfillment, payment processing, and practice administration. These organizations may include Practice Better, Push Health, Rupa Health, 3X4 Genetics, Fullscript, Stripe, QuickBooks, and other service providers used by healthcare à la carte. Where required by law, we enter into appropriate agreements with vendors that handle protected health information on our behalf.

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We may also use your information to contact you regarding appointments, treatment options, healthcare services, or other communications related to your care.

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Other Permitted Uses and Disclosures

 

We may also use or disclose your health information when permitted or required by law, including:

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As required by federal, state, or local law.

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For public health activities, such as reporting certain diseases or conditions.

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To report suspected abuse, neglect, or domestic violence when required or permitted by law.

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For health oversight activities, such as audits, investigations, inspections, and licensing activities.

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For judicial and administrative proceedings when legally authorized.

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For law enforcement purposes when permitted by law.

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To prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

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For workers' compensation purposes as permitted by law.

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For specialized government functions when authorized by law.

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For organ, eye, or tissue donation and transplantation purposes when applicable.

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For coroners, medical examiners, or funeral directors when permitted by law.

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We may also disclose health information for other purposes when required or permitted by applicable law.

Uses and Disclosures Requiring Your Authorization

 

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and disclosures that constitute a sale of protected health information require your written authorization.

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Other uses and disclosures not described in this Notice of Privacy Practices will be made only with your written authorization when required by law.

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You may revoke an authorization in writing at any time, except to the extent we have already relied on that authorization.

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SUBSTANCE USE DISORDER RECORDS

If Healthcare à la carte receives or maintains substance use disorder records that are protected under federal law, those records may be subject to additional confidentiality protections under 42 CFR Part 2.

When applicable, we will comply with the additional protections required for those records.

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Our Responsibilities

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healthcare à la carte is required by law to:

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Maintain the privacy and security of your protected health information.

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Provide you with this Notice of Privacy Practices describing our legal duties and privacy practices.

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Notify you promptly if a breach occurs that may have compromised the privacy or security of your protected health information.

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Follow the terms of the Notice of Privacy Practices currently in effect.

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We will not use or disclose your health information other than as described in this notice unless you provide written authorization or the use or disclosure is otherwise permitted or required by law.

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We may change the terms of this Notice of Privacy Practices. If we make a material change, the updated notice will be made available on our website and upon request.

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Your Rights Regarding Your Health Information

 

Depending on the circumstances and applicable law, you may exercise the rights described above by submitting a written request to healthcare à la carte.

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We may require you to provide information necessary to verify your identity before processing certain requests.

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We will generally respond to requests for access to your health information within 30 days. In certain circumstances, additional time may be permitted by law.

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How To Contact Us

 

If you have questions about this Notice of Privacy Practices or would like to exercise your privacy rights, please contact:

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healthcare à la carte
Sarah Gates, MSN, FNP-C
hello@healthcarealacarte.org
Cedar Rapids, Iowa

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HOW TO FILE A PRIVACY COMPLAINT:

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If you believe your privacy rights have been violated, you may file a complaint with healthcare à la carte using the contact information above.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775

You may also submit a complaint through the HHS Office for Civil Rights website.

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Healthcare à la carte will not retaliate against you for filing a complaint.