Effective Date: March 30,2025
Optimal Life (“we,” “us,” or “our”) is committed to protecting the privacy and confidentiality of your health information. We are required by law (the Health Insurance Portability and Accountability Act of 1996, or HIPAA) to maintain the privacy of your Protected Health Information (PHI) and to provide you with this Notice of Privacy Practices (“Notice”) explaining our legal duties and privacy practices.
1. Purpose of This Notice
This Notice describes how we may use and disclose your PHI to carry out treatment, payment, or healthcare operations, or for other purposes permitted or required by law. It also describes your rights regarding your PHI and how you can exercise those rights.
2. Understanding Your Health Information
Protected Health Information (PHI)
refers to information that identifies you and relates to your past, present, or future physical or mental health or condition; the provision of healthcare to you; or payment for the provision of healthcare.
Common examples of PHI include:
- Your name, address, birth date, phone number, and insurance information.
- Your medical history, diagnoses, treatment records, test results, and prescriptions.
3. Our Responsibilities
Under HIPAA, we are required to:
1. Maintain the privacy and security of your PHI.
2. Provide you with this Notice of our legal duties and privacy practices.
3. Abide by the terms of the Notice currently in effect.
4. Notify you in the event of a breach of unsecured PHI that affects you.
We may change the terms of this Notice at any time. The new Notice will apply to all PHI we maintain. If we make a material change, we will post the revised Notice in our office, on our website, and provide you with a copy upon request.
4. How We May Use and Disclose Your PHI
We typically use or share your PHI for the following purposes without your written authorization:
1. Treatment
- We may use and disclose your PHI to provide, coordinate, or manage your medical care. For example, we may share your PHI with a specialist or laboratory for additional diagnosis or treatment.
2. Payment
- We may use and disclose your PHI to bill for services we provide and to obtain payment from you, your insurance company, or a third party. This may include verifying insurance coverage, processing claims, or disclosing PHI to insurance adjusters.
3. Healthcare Operations
- We may use and disclose your PHI for our healthcare operations. These activities include, for example, quality assessment, employee performance evaluation, staff training, or auditing functions.
4. Required by Law
- We may disclose your PHI when required to do so by federal, state, or local law.
5. Public Health and Safety
- We may disclose PHI to public health authorities in connection with preventing or controlling disease, reporting adverse drug reactions, or as otherwise permitted by law. We may also disclose PHI to avert a serious threat to the health or safety of a person or the public.
6. Health Oversight Activities
- We may disclose PHI to governmental or licensing agencies for audits, investigations, inspections, or other oversight activities authorized by law.
7. Lawsuits and Disputes
- We may disclose PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process, in accordance with applicable law.
8. Law Enforcement
- We may release PHI to law enforcement officials for purposes such as identifying a suspect or missing person, or in connection with reporting a crime.
9. Coroners, Medical Examiners, and Funeral Directors
- We may share PHI with these entities as necessary for them to carry out their duties.
10. Organ and Tissue Donation
- If you are an organ donor, we may release PHI to organizations that facilitate organ, eye, or tissue procurement.
11. Workers’ Compensation
- We may disclose PHI for workers’ compensation or similar programs as required or authorized by law.
12. Business Associates
- We may share PHI with third parties (our “Business Associates”) who perform functions on our behalf (e.g., billing services, IT providers) and who are contractually required to protect the confidentiality of your PHI.
5. Uses and Disclosures That Require Your Written Authorization
We will not use or disclose your PHI for any reason not covered by the above categories without your written authorization. Specifically, disclosures for marketing purposes, the sale of PHI, and most uses of psychotherapy notes require your prior written authorization. If you provide authorization, you may revoke it at any time by submitting a written request to us. However, revocation will not affect any disclosures made before we received your revocation.
6. Your Rights Regarding Your PHI
You have the following rights regarding your PHI:
1. Right to Inspect and Copy
- You have the right to inspect and obtain a copy of your PHI maintained in your designated record set, with limited exceptions. You may request a paper or electronic copy, and we will provide it in a format you request if it is readily producible.
2. Right to Request an Amendment
- If you believe your PHI is incorrect or incomplete, you have the right to request that we amend it. We may deny your request under certain circumstances, but we will explain the reason in writing.
3. Right to an Accounting of Disclosures
- You have the right to receive a list (an “accounting”) of certain disclosures of your PHI made by us during a specific period. This list will not include disclosures for treatment, payment, or healthcare operations, or certain other exceptions.
4. Right to Request Restrictions
- You may request that we restrict the use or disclosure of your PHI for treatment, payment, or healthcare operations. While we will consider your request, we are not required to agree to it unless the request is to restrict disclosure of PHI to a health plan when you have paid in full for a healthcare service, and the disclosure is not otherwise required by law.
5. Right to Request Confidential Communications
- You can request that we communicate with you through alternative means or at alternative locations (e.g., sending mail to a P.O. Box instead of your home address). We will accommodate all reasonable requests.
6. Right to a Paper Copy of This Notice
- You have the right to receive a paper copy of this Notice at any time, even if you agreed to receive it electronically.
7. Right to Revoke Authorization
- If you have given us authorization to use or disclose your PHI, you may revoke it at any time in writing, except to the extent we have already taken action based on your authorization.
7. Data Security
We have implemented physical, administrative, and technical safeguards designed to protect the confidentiality, integrity, and availability of your PHI. However, no method of transmission or storage is entirely secure, and we cannot guarantee absolute security.
8. Complaints
If you believe your privacy rights have been violated or you disagree with a decision we made about your PHI, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
File a Complaint with Us:
Optimal Life
Attn: HIPAA Officer
254 Ren Mar Dr., Suite 200, Pleasant View, TN 37146
9. Contact Us
If you have questions about this Notice, your rights, or want to request forms for submitting written requests, please contact us at:
Optimal Life
Attn: HIPAA Officer
Optimal Life
254 Ren Mar Dr., Suite 200, Pleasant View, TN 37146
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