* Advanced Healthcare Chiropractic Notice of Privacy Practices *
9194 W. Golf Road, Niles, IL 60714
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.
Advanced Healthcare is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information.
** DISCLOSURE OF YOUR HEALTH CARE INFORMATION **
Treatment
We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations. For example:
“On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with Advanced Healthcare. It is our policy to provide a substitute healthcare provider, authorized by Advanced Healthcare, to provide assessment and/or treatment to our patients, without advanced notice, in the event of your primary healthcare provider’s absence (due to vacation, sickness, or other emergency situations).”
Payment
We may disclose your health information to your insurance provider for the purpose of payment or healthcare operations.
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, 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 & 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, in compliance with a court order or subpoena, and/or 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 Advanced Healthcare is sold or merged with another organization, your health information/record will become the property of the new owner.
Changes to this Notice of Privacy Practices
Advanced Healthcare 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, Advanced Healthcare is required by law to comply with this Notice.
Advanced Healthcare 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. If you have questions about any part of this notice or if you want more information about your privacy rights, please contact Dr. Poulos by calling this office at 847.795.1700. If Dr. Poulos is not available, you may make an appointment for a personal conference in person or by telephone within 2 working days.
Complaints
Complaints about your Privacy Rights, or how Advanced Healthcare has handled your health information should be directed to Dr. Poulos, by calling this office at 847.795.1700. If Dr. Poulos 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 by which this office handles your complaint, you may submit a formal complaint to:
DHHS, Office of Civil Rights
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
