Holistic Healing Heroes
Notice of Privacy Practices
Effective Date: March 14, 2025

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Your Information. Your Rights. Our Responsibilities.

This notice describes how your medical information may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

When it comes to your health information, you have certain rights. This section explains those rights and our responsibilities to assist you.

• Get an Electronic or Paper Copy of Your Medical Record
  • You can request to see or obtain a copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. A reasonable, cost-based fee may apply.
• Ask Us to Correct Your Medical Record
  • If you believe your health information is incorrect or incomplete, you can request a correction. Ask us how to do this.
  • We may decline your request, but we will provide a written explanation within 60 days.
• Request Confidential Communications
  • You may ask us to contact you in a specific way (e.g., home phone, office phone) or to send mail to a different address.
  • We will accommodate all reasonable requests.
• Ask Us to Limit What We Use or Share
  • You may request that we not use or share certain health information for treatment, payment, or our operations.
  • We are not required to agree to your request, but if you pay for a service or health care item out-of-pocket in full, you can request that we not share this information with your health insurer unless required by law.
• Get a List of Those With Whom We Have Shared Information
  • You can request an accounting of disclosures (a list of when, with whom, and why we have shared your health information) for six years prior to the request date.
  • This excludes disclosures for treatment, payment, health care operations, and certain other purposes. One request per year is free; additional requests may incur a reasonable, cost-based fee.
• Get a Copy of This Privacy Notice
  • You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.
• Choose Someone to Act for You
  • If you have granted someone medical power of attorney or a legal guardian has been appointed, that person can make decisions about your health information.
  • We will verify their authority before taking action.
• File a Complaint If You Feel Your Rights Are Violated
  • You may file a complaint with us using the contact information below.
  • You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you have the right to tell us how you want it shared.

• You have the right to choose whether we:
  • Share information with family, close friends, or others involved in your care.
  • Share information in a disaster relief situation.
  • Include your information in a hospital directory (if applicable).
• We never share your information without written permission for:
  • Marketing purposes.
  • Sale of your information.
  • Most sharing of psychotherapy notes (if applicable).
• In the case of fundraising:
  • We may contact you for fundraising efforts, but you can opt out at any time.

How We Use and Share Your Information

We typically use or share your health information in the following ways:

• Treatment
  • We may use your health information and share it with other professionals treating you.
    • Example: A therapist treating you consults another health professional about your condition.
• Running Our Organization
  • We use and share health information to run our practice, improve your care, and contact you when necessary.
    • Example: We use health information to manage your treatment and services.
• Billing for Services
  • We use and share health information to bill and receive payment from health plans or other entities.
    • Example: We share information with your health insurance to process claims.

Other Ways We May Use or Share Your Information

We are required or allowed to share your information in ways that contribute to the public good, such as public health and research. Strict conditions apply before sharing. More details are available at www.hhs.gov/ocr/privacy/hipaa.

• Public Health and Safety Issues (e.g., disease prevention, product recalls, reporting abuse or domestic violence, preventing serious threats to health/safety)
• Research (approved studies)
• Legal Compliance (e.g., responding to government requests, law enforcement, court orders, lawsuits)
• Organ and Tissue Donation Requests
• Medical Examiners & Funeral Directors (after death)
• Workers’ Compensation and Other Government Requests (e.g., military, national security, presidential protective services)

Our Responsibilities

• We are legally required to maintain the privacy and security of your protected health information.
• We will notify you promptly if a breach occurs that may compromise your information.
• We must follow the duties and privacy practices described in this notice and provide you with a copy upon request.
• We will not use or share your information beyond what is described here unless you provide written authorization. You may revoke authorization at any time in writing.

Changes to This Notice

We reserve the right to modify the terms of this notice. Changes apply to all information we maintain. The updated notice will be available upon request, in our office, and on our website.

Contact Information

For questions, concerns, or to file a complaint, contact:
Holistic Healing Heroes
Arizona
https://holistichealingheroes.com/

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This notice applies to Holistic Healing Heroes and its affiliated practitioners. If additional state or federal laws require stricter limitations on sharing health information, we will comply with those regulations.