Notice of Privacy Practices

This notice contains important information about Ease Balance Acupuncture and its affiliates’ privacy practices. 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.

  1. What is this notice?

    To run our practice, Ease Balance Acupuncture along with its affiliates must collect, maintain and use non- public personal information on patients to whom we provide services. We consider this information private and confidential and have policies and procedures in place to protect the information against unlawful use and disclosure. This notice describes information our practice utilizes, our legal duties and privacy practices. It also describes your rights to access and control your non-public personal information (NPI).

    We are required to abide by the terms of this notice. However, we may modify the terms of this notice at any time, and the new notice will be effective for all NPI in our possession at the time of the change, and any created or received thereafter.

    Information Ease Balance Acupuncture and its affiliates collect, use and maintain on you is protected by Federal and state laws: the Health Insurance Portability and Accountability Act (HIPAA) and New York State Public Health Law. Ease Balance Acupuncture does not disclose NPI to anyone, except with your authorization or otherwise permitted by law.

    If you believe your privacy rights under the Health Insurance Portability and Accountability Act (HIPAA) have been violated you can submit a written complaint to the Ease Balance Acupuncture Privacy Office at the address of the practice. You may also complain to the Secretary of Health and Human Services if you believe your privacy rights have been violated. There will be no retaliation for filing a complaint.

  2. What is “non-public personal information” (NPI)?

    Non-public personal information (NPI) is information that identifies you as an individual and relates to your participation in treatment, your physical or mental health/condition, the provision of treatment or healthcare to you or payment to us for the provision of services provided to you.

  3. How we protect NPI?

    We restrict access to NPI to members of our workforce (staff and trainees) who need to provide care or services to you or are engaged in important agency operations. We maintain physical and procedural safeguards to protect your information against unauthorized access and use. We also commit to developing, educating our workforce about and overseeing the implementation and enforcement of policies and procedures to safeguard your health information against inappropriate access, use and disclosure, consistent with applicable law.

  4. How does Ease Balance Acupuncture use non-public personal information (NPI) and for what purpose?

    Here are some examples of what we do with the information we collect and the reasons it might be used.

    Treatment: We may use information about you to provide medical treatment and services to you. We may use and share NPI with our staff and trainees who are involved with providing care to you. For example, information obtained by our staff and trainees will be recorded in a treatment record and used to determine your course of treatment.

    Payment: We may use and disclose NPI so that treatment and services you receive may be billed to and payment collected from you or a third party. For example, we may complete and submit to your healthcare plan or insurance company a description of treatment provided to you. We may also use and disclose your NPI to obtain payment from other third parties that may be responsible for the costs, such as family members.

    Health Care Operations: We may also use and disclose NPI to perform health care operations. This is necessary to make sure that all of our patients receive quality care. For example, we may use NPI to review our treatment and services and to evaluate the performance of our staff and trainees. We may also use and share NPI with other personnel for review and learning purposes.

  5. What use and disclosures do not require your authorization?

    We may use and disclose NPI without your authorization for the following purposes:

    Business Associates: We may contract with outside individuals and organizations that perform business services for us such as billing, management consultants, quality assurance reviewers, accountants or attorneys. In certain circumstances, we may need to share your information with business associates so they can perform a service on our behalf. We will limit the disclosure of information to business associates to the amount of information that is the minimum necessary for the business associates to perform services for us. In addition, we will have a written contact in place with business associates requiring it to protect the privacy of your information.

    As Required by Law: We will disclose NPI when required to do so by federal, state or local law.

    Public Health Activities/Risks: We may disclose NPI to public health authorities that are authorized by

    law to collect information for the purpose of:

    • Reporting child abuse or neglect;
    • Preventing or controlling disease, injury or disability;
    • Notifying a person regarding potential exposure to a communicable disease;
    • Notifying a person regarding the potential risk for spreading or contracting a disease or condition;
    • Reporting reactions to drugs or problems with products or devices;
    • Notifying individuals if a product or device we may be using has been recalled;
    • Notifying appropriate government agencies and authorities regarding the potential abuse or neglect of a patient (including domestic violence); and
    • Notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.

    Health Care Oversight Activities: We may disclose NPI to a health oversight agency for activities authorized by law. Oversight activities can include: investigations, inspections, audits, surveys, licensure and disciplinary actions; civil administrative and criminal procedures or actions; or other activities necessary for the government to monitor compliance with civil rights laws and the health care system in general.

    Lawsuits and Disputes: We may use and disclose NPI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We may also disclose your NPI in response to a discovery request, subpoena or other lawful processes by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain a court order protecting the information the party has requested.

    Law Enforcement: We may disclose NPI if asked to do so by a law enforcement official as part of law enforcement activities; in investigations of criminal conduct at Ease Balance Acupuncture or of victims of crime; in emergency situations to report a crime (including the location or victims(s) of the crime, or the description, identity or location of the perpetrator); or when required to do so by law.

    Serious Threats to Health or Safety: We may use and disclose your NPI when necessary to reduce or to prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.

    Military: We may use and disclose NPI if you are a member of the Unites States or foreign military forces (including veterans) and if required by the appropriate military command authorities.

    Protective Services for the President, National Security and Intelligence Activities: We may use and disclose NPI to federal officials for intelligence and national security activities authorized by law. We may also disclose your NPI to federal officials in order to protect the President, other officials, or foreign heads of state or to conduct investigations.

    Worker’s Compensations: We may release NPI for worker’s compensation or similar programs.

  6. What uses and disclosures of NPI require your authorization?

    Individuals Involved in Your Care or Payment for Your Care: We may release NPI to a friend or family member identified by you, that is helping you pay for your treatment or who assists in taking care of you.

  7. What are your rights governing the information that we collect, use and maintain on you?

    The Right to Inspect and Copy: You have the right to inspect and obtain a copy of your NPI that we maintain and have in our possession, including treatment records and billing records. If you request copies, we will charge you a fee for the costs of copying, mailing, labor and supplies associated with your request. To inspect and copy your NPI, you must submit your request in writing to our practice address.

    Under certain circumstances we may deny your request to inspect and copy your NPI. If you are denied access to this information, you have the right to have that determination reviewed. A licensed health care professional chosen by Ease Balance Acupuncture will review your request and the denial. The person conducting the review will not be the person who denied your request. Ease Balance Acupuncture will comply with the outcome of the review.

    The Right to Amend or Correct NPI: If you feel that any NPI we have about you is not correct or incomplete, you may ask us to correct or amend the information. You have the right to request an amendment for as long as the information is kept (seven years) by us. To request an amendment, your request must be made in writing to the practice address. Additionally, you must provide a reason that supports your request.

    Ease Balance Acupuncture reserves the right to deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

    • Was not created by us;
    • Is not part of the medical information kept by us;
    • Is not part of the information which you would be permitted to inspect and copy; or
    • Is accurate and complete.

    The Right to an Accounting of Disclosures: An accounting of disclosures is a list of the disclosures we have made, if any, of your NPI.

    You have the right to request an accounting of disclosures made by us. This right applies to disclosures for purposes other than those made to carry out treatment, payment and health care operations as described in this notice. It also excludes communications of NPI made to you or disclosures authorized by you.

    Your request must be made in writing and state a time period that cannot be longer than (6) years. We may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred.

    The Right to Receive Communications of NPI by Alternative Means or at Alternative Locations:

    You have the right to request that we communicate with you about your treatment and related issues in a particular manner or at a certain location. For example, you may ask that we contact you at work rather than at home. We will accommodate all reasonable requests made in writing.

    The Right to Request Restrictions: You have the right to request a restriction or limitation on the NPI we use or disclose about you for treatment, payment or health care operations as described in this notice. You also have the right to request a limit on the treatment information we disclose about you to someone who is involved in your care or the payment for your care (like a family member or friend).

    We are not required to agree to your request, however, if we do agree, we will comply with your request until we receive notice from you that you no longer want the restriction to apply.

    Any request for a restriction on our use and disclosure of your NPI must be made in writing to the address of the practice. Your request must describe in a clear and concise manner: (a) the information you wish restricted; (b) whether you are requesting to limit our use, disclosure or both; and (c) to whom you want the limits to apply.

    The Right to Provide an Authorization for Other Uses and Disclosures: We will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your NPI may be revoked at any time in writing to the address of the practice. After you revoke your authorization, we will no longer use or disclose your NPI for the purposes described in the authorization, except under the following circumstance:

    • We have taken action in reliance upon your authorization before we receive your written revocation

    The Right to Obtain a Paper Copy of This Notice: You have the right to obtain a paper copy of this notice of privacy practices at any time.

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