This Notice describes how medical information about you may be used and disclosed and how you get access to such information. 

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COMMITMENT TO YOUR PRIVACY

Root Fertility & Wellness and Addie Harbin L.Ac. (collectively, “we,” or “us), are dedicated to protecting the privacy of your protected health information (“PHI”).  PHI is information about you that may be used to identify you (such as your name, social security number, email address, mobile telephone number, address, or date of birth), and that relates (a) to your past, present, or future payment for the provision of healthcare; (b) to the provision of healthcare to you; or (c) to your past, present, or future payment for the provision of healthcare.  In conducting its business we will receive and create records containing your PHI.  We are required by law to maintain the privacy of your PHI and provide you with notice of our legal duties and privacy practices with respect to your PHI.  Healthcare providers involved in your care may have different policies or notices regarding their use and disclosure of your PHI. 

 

We must maintain the privacy of your PHI, give you this Notice of its legal duties and privacy practices, notify you if you are affected by a breach of unsecured PHI, and abide by the terms of this Notice while it is in effect.  Root Fertility & Wellness and its employees, volunteers, and other personnel must also abide by this Notice. 

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This current Notice will take effect on June 1st, 2021, and will remain in effect until we replace it.  We reserve the right to change the terms of this Notice at any time, as long as the changes are in compliance with applicable law.  If we change the terms of this Notice, the new terms will apply to all PHI we maintain, including PHI that was created or received before such changes were made.  If we change this Notice, we will post the new Notice on Root Fertility & Wellness website, https://www.rootfertilitywellness.com (the “Site”), and will make the new Notice available upon request.  Your continued use of the Site after changes to this Notice have been made shall constitute your consent to the new Notice. 

 

USE AND DISCLOSURES OF PHI

To the extent applicable, Root Fertility & Wellness may use and disclose your PHI for the following purposes: 

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Treatment, Payment, and Healthcare Operations. 

We are permitted to use and disclose your PHI for purposes of (a) treatment; (b) payment; and (c) healthcare operations.  For example: 

1. Treatment: We may disclose your PHI to a physician or healthcare provider for purposes of a visit or in connection with the provision of follow-up treatment. 

2.  Payment: We may use and disclose your PHI to your health insurer or health plan in connection with the processing and payment of a claim and other charges.

3.  Healthcare operations: We may use and disclose your PHI in connection with  healthcare operations, such as providing customer services and conducting quality review assessments.  We may engage third parties to provide various services.  If any such third party must have access to your PHI in order to perform its services, we may require that third party to enter into an agreement that binds the third party to the use and disclosure restrictions provided in this Notice.

 

Authorization. 

We are permitted to use and disclose your PHI upon your written authorization to the extent such use or disclosure is consistent with your authorization.  You may revoke such authorization at any time.  To authorize us to disclose your PHI to a third party, please contact Root Fertility & Wellness through the Site.

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As Required by Law. 

We may use and disclose your PHI to the extent required by law.

 

Special Circumstances. 

The following categories describe unique circumstances in which we may use or disclose your PHI:

1. Public Health Authorities: Root Fertility & Wellness may disclose your PHI to public health authorities or other governmental authorities for purposes including preventing and controlling disease, reporting child abuse or neglect, reporting domestic violence, and reporting to the Food and Drug Administration regarding the quality, safety, and effectiveness of a regulated product or activity.  We may, in certain circumstances, disclose PHI to persons who have been exposed to communicable disease or may otherwise be at risk of contacting or spreading a disease or condition.

2. Workers’ Compensation.  We may disclose your PHI as authorized by, and to the extent necessary to comply with, workers’ compensation programs and other similar programs relating to work-related illnesses or injuries. 

3. Health Oversight Activities.  We may disclose your PHI to a health oversight agency for authorized activities such as audits, investigations, inspections, licensing, and disciplinary actions relating to the healthcare system or government benefits programs. 

4. Judicial and Administrative Proceedings.  We may disclose your PHI in certain circumstances, as permitted by applicable law, in response to an order from a court or administrative agency, or in response to a subpoena or discovery request.

5. Law Enforcement.  We may disclose your PHI to a law enforcement official, such as for purposes of identifying or locating a suspect, fugitive, material witness, or missing person.

6. Decedents.  We may, under certain circumstances, disclose PHI to coroners, medical examiners, and funeral directors for purposes such as identification, determining the cause of death, and fulfilling duties related to decedents. 

7. Organ Procurement. We may, under certain circumstances, use or disclose PHI for the purposes of organ donation and transplantation. 

8. Research.  We may, under certain circumstances, use or disclose PHI in a limited data set that does not include direct identifiers such as your name, address, social security number, phone number, and email address, for research purposes.  Such uses may include activities that are preparatory to research or informing you of research studies that may be of interest to you.  You will not be enrolled in a research study without your prior voluntary informed consent, unless an institutional review board has waived the need to obtain informed consent. 

9. Threat to Health or Safety.  We may, in certain circumstances, use or disclose PHI, if necessary, to prevent or lessen a serious imminent threat to the health or safety of a person or the public. 

10. Specialized Government Functions.  We may, in certain circumstances, use and disclose PHI of persons who are, or were, in the Armed Forces for purposes such as ensuring proper execution of a military mission or determining entitlement to benefits.  We may also disclose PHI to federal officers for intelligence and national security purposes.