Seaside Chiropractic Important Health Notice
Seaside Chiropractic offers the information on this website for educational purposes only. This information is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. If you have any questions or concerns about your health, please contact your healthcare provider promptly. Seaside Chiropractic, Dr. David Klein and the operators of this site specifically disclaim all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any of the material on this website.

SEASIDE CHIROPRACTIC’S NOTICE OF PRIVACY PRACTICES
Effective March 6, 2007

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.

A federal regulation, known as the Health Information Portability and Accountability Act (“HIPAA”) Privacy Rule, requires that we provide detailed noticed in writing of our privacy practices.

I. OUR COMMITMENT TO PROTECTING HEALTH INFORMATION ABOUT YOU

Seaside Chiropractic is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. In this Notice, we describe the ways that Seaside Chiropractic may use and disclose health information about you.

II. PERMITTED USES AND DISCLOSURES OF HEALTH INFORMATION

A. TREATMENT, PAYMENT, HEALTH CARE OPERATIONS: We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations.

Treatment: On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with Seaside Chiropractic. It is our policy to provide a substitute health care provider, authorized by Seaside Chiropractic to provide assessment and/or treatment to our patients, without advance notice, in the event of your primary health care provider’s absence due to vacation, sickness, or other emergency situation.

Payment: Your health care records as well as your billing records may be disclosed to another party, such as an insurance carrier, an HMO, a PPO, or your employer, if they are or may be responsible for the payment of your services.

Health Care Operations: We may use and disclose your health information in connection with our health care operations. Health care operations include quality assessment and improvement activities, reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance, and other business operations. For example, we may wish to review the quality of care that you receive or we may audit our management practices so that they become even more efficient.

B. AUTHORIZATIONS: We may use and disclose protected health information about you in some circumstances where you have the opportunity to agree or object to certain uses and disclosures about you. If you do not object, then we may use and disclose these types of protected health information.

C. DISCLOSURES TO FAMILY AND PERSONAL REPRESENTATIVES:

We may disclose health information about you to your family member, close friend, or any other person identified by you if that information is directly relevant to the person's involvement in your care or payment for your care.

D. USES OR DISCLOSURE REQUIRED BY LAW:

Workers’ Compensation: We may disclose your health information as necessary to comply with State Workers’ Compensation Laws.

Emergencies: We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or of your death.

Public Health: As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Judicial and Administrative Proceedings: We may disclose your health information in the course of any administrative or judicial proceeding.

Law Enforcement: We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.

Deceased Persons: We may disclose your health information to coroners or medical examiners.

Organ Donation: We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.

Research: We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.

Public Safety: It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.

Specialized Government Agencies: We may disclose your health information for military, national security, prisoner and government benefits purposes.

Change of Ownership: In the event that Seaside Chiropractic is sold or merged with another organization, your health information/record will become the property of the new owner.

D. OPEN ADJUSTING ENVIRONMENT:

History, initial examinations and reports of findings are done in a private closed room with a shut door except when agreed to by the patient. You may have the option in our office to receive chiropractic care, exams, education and review of exam results for our ongoing patients in an “open room” environment. If you are curious about this, just ask our staff to show you the Open Room. “Open room” involves an option for our patients where more than one person is treated in our large room with our special equipment, at the same time another patient is being treated there similar to a gym setting. Patients may be within sight of one another and some ongoing routine details of care may be discussed within earshot of other patients and staff. If you choose to receive your treatment or any other part of your services in a private room, simply discuss it with the doctor or staff and arrangements will be made.

E. APPOINTMENT REMINDERS:

From time to time, we may call you to provide appointment reminders. If you are not at home to receive an appointment reminder call, a message may be left on your answering machine.

F. BILLING COMPANY/COLLECTION AGENCY:

Seaside Chiropractic uses an outside billing company to prepare bills that are sent to you, your insurance company or your employer. Seaside Chiropractic uses a collection agency to collect past due bills. Whenever an arrangement with an outside billing company and/or collection agency involves the use or disclosure of your protected health information, Seaside Chiropractic will have a written agreement with provisions that protect the privacy of your protected health information.

III. YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU

Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that Seaside Chiropractic is not required to agree to the restriction that you requested.

Right to Receive Confidential Communications: You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.

Right to Inspect and Copy: You have the right to inspect and copy your health information.

Right to Amend: You have the right to request that Seaside Chiropractic amend your protected health information.

Right to Receive an Accounting of Disclosures: You have the right to receive an accounting of disclosures of your protected health information made by Seaside Chiropractic.

Right to a Paper Copy of this Notice: You have the right to a paper copy of this Notice of Privacy Practices at any time upon request.

IV. CHANGES TO THIS NOTICE OF PRIVACY PRACTICES:

Seaside Chiropractic reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, Seaside Chiropractic is required by law to comply with this Notice. If you have questions about any part of this notice or if you want more information about your privacy rights, please contact: Dr. David Klein by calling this office at 858-459-3132. If Dr. David Klein is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days. If changes are made to this Notice, we will notify you in writing as soon as practicable following the changes. Any change in our privacy notice will apply to all of your health information in our files.

V. COMPLAINTS:

Complaints about your Privacy rights, or how Seaside Chiropractic has handled your health information should be directed to Dr. David Klein, by calling this office at 858-459-3132. If Dr. David Klein is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.

If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to:

Office for Civil Rights
U.S. Department of Health & Human Services
50 United Nations Plaza - Room 322
San Francisco, CA 94102
(415) 437-8310; (415) 437-8311 (TDD)
(415) 437-8329 FAX
Seaside Chiropractic will not retaliate or take action against you for filing a formal complaint.