HIPPA Notice of 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.

At Stillpoint Acupuncture, we make every effort to keep your personal and medical information confidential.  We are required by law to maintain the privacy of our patients’ Protected Health Information and to provide our patients with notice of our legal duties and privacy practices.  The following explains what we do with the information we ask you to provide:

·       Your name and contact information (e.g. name, email address and phone number) will be seen by the practitioner, our office staff and Acuity Scheduling in order to schedule appointments and contact you with reminders for your appointments.  Our office staff may also send you health related newsletters or information regarding health-related benefits and services.

·       Your medical information is kept in a file and accessed by the practitioners in order to make medical decisions and to document your treatments.  Your file may also be seen by our office staff in order to a) file the chart, b) contact you regarding scheduling, c) prepare your chart for your next visit, or d) to prepare an herbal formula the practitioner has prescribed.

·       Each person who has access to your chart has signed a confidentiality agreement.   A copy of this agreement can be made available to you upon request. 

·       We may periodically access your chart in order to conduct research that helps us improve our care.  For example, we may look at all the charts of people with back pain in order to determine how often those treatments are effective.

We will not disclose your Protected Health Information for any purpose other than treatment, payment or health care operations unless you have signed a form authorizing such use or disclosure, except for the items below:

·       Court or administrative ordered subpoena or discovery request

·       Law enforcement officials as required by law if we believe you have been the victim of abuse, neglect, or domestic violence.  We will only make this disclosure if you agree or when required or authorized by law.

·       To workers’ compensation agencies for workers’ compensation benefits determination.

·       We may forward information regarding your treatments to your insurance company or Veterans Affairs to arrange payment for services provided to you.

·       We will not provide information from your chart to anyone outside our office unless that is specifically requested by you in writing and you may also revoke such written authorization.

·       We will not discuss your case with anyone else unless you specifically give us permission to do so.  This includes your family members and other medical providers.

Patients’ rights regarding Protected Health Information:

·       You may request a copy of your Protected Health Information.

·       You have the right to request that your Protected Health Information be amended or corrected.

·       You have the right to receive an accounting of certain disclosures of your Protected Health Information.

·       You have the right to request restrictions on uses and disclosures of your Protected Health Information.

·       You have the right to be notified of any breach of your Protected Health Information.

·       You have the right to receive confidential communications from Stillpoint Acupuncture by alternative means or at alternative locations.

·       You have the right to file a complaint if you feel that your rights have been violated.  There will be not retaliation for filing a complaint.  Complaints can be filed with our Privacy Officer or with:

Office for Civil Rights

Department of HHS

Jacob Javits Federal Building

26 Federal Plaza – Suite 3313

New York, NY 10278

Voice Phone (212)264-3313    Fax (212)264-3039

 Special note to participants in the acupuncture clinic:

As you know, the clinic setting is less private than our office setting.  In order to protect your privacy here, we use check in forms for expressing to your practitioner anything you may not want to be overheard.

Stillpoint Acupuncture is required to abide by the terms of this Notice of Privacy Practices.                                                      

Stillpoint Acupuncture retains the right to update the Notice of Privacy Practices and will notify the patients of the update in writing when they next visit the office.