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.

Sacred Rose Medicinals, LLC is required, by law, to maintain the privacy and confidentiality of your protected health information and how 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.

(Example)
“On occasion, it may be necessary to seek consultation regarding your condition from other health care providers associated with Sacred Rose Medicinals, LLC.”

Community Treatment Setting

Due to the nature of Community Acupuncture, some personal information may be disclosed during conversation with your Provider. Every attempt will be made to keep this at a minimum, and no information such as birth dates, SSN, or financial information will be included during these conversations. If you have concerns regarding this, please consider booking only Private appointments.

Payment

We expect payment at the time the services are rendered but in the event you file an insurance claim, we may disclose your health information to your insurance provider for the purpose of payment or health care operations.

(Example)
“Since you pay for your health care services personally, we will as a courtesy, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you. The billing statement contains medical information, including diagnosis, date of injury or condition, and codes which describe the health care services received.”

Worker’s 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.

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 translating organs and tissues.

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.

Marketing

We may contact you for marketing purposes or fundraising purposes, as described below.

(Example)
“As a courtesy to our patients, it is our policy to call your home, usually the day prior to your scheduled appointment to remind you of your appointment time. If you are not at home, we leave a reminder message on your answering machine or with the person answering the phone. No personal health information will be disclosed during this recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment.”

“It is our practice to participate in charitable events to raise awareness, food donations, gifts, money etc. During these times, we may send you a letter, post card, invitation or call your home to invite you to participate in the charitable activity. We will provide you with information about the type of activity, the dates and times, and request your participation in such an event. It is not our policy to disclose any personal information about your condition for the purpose of Sacred Rose Medicinals, LLC sponsored fund-raising events”

Change of Ownership

In the event that Sacred Rose Medicinals, LLC is sold or merged with another organization, your health information/record will become the property of the new owner.

Your Health Information Rights

  • You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that Sacred Rose Medicinals, LLC is not required to agree to the restriction that you requested.

  • 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.'

  • You have the right to inspect and copy your health information. We will charge you reasonable cost-based fee expenses such as copies and staff time. The fee is set as base fee of $30.00 for 10 pages or less; additional fee of $1.00 per page for pages 11-60, 50 cents per page for pages 61-400. The base fee must be paid at the time of the request and the balance paid at the time of pick up.

  • You have a right to request that Sacred Rose Medicinals, LLC amend your protected health information. Please be advised, however, that Sacred Rose Medicinals, LLC is not required to agree to amend your protected health information. If you request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial.

  • You have a right to received an accounting of disclosures of your protected health information made by Sacred Rose Medicinals, LLC.

  • You have a right to a paper copy of this Notice of Practices at any time upon request.

Change to this Notice of Privacy Practices

Sacred Rose Medicinals, LLC 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, Sacred Rose Medicinals, LLC is required by law to comply with this Notice.

Sacred Rose Medicinals, LLC 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 Sarah Beth Adel at 812-329-2588.

Complaints

Complaints about your privacy rights or how Sacred Rose Medicinals, LLC has handled your health information should be directed to Sarah Beth Adel by calling 812-329-2588. If you are not satisfied with the manner in which our office handled your complaint, you may submit a formal complaint to:

DHHS, Office of Civil Rights
200 Independence Avenue, SW
Room 509 F HHHF
Washington, VA 20201