The Summary of Joint Notice of Privacy Practices summarizes how AC Wellness may use or disclose patients’ protected health information, informs patients of their rights, and advises patients of AC Wellness’ responsibilities to them with respect to their protected health information. Please review this carefully.
Summary of Joint Notice of Privacy Practices
Effective Date: May 24, 2023
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.
This summary notice describes the Joint Notice of Privacy Practices (“Notice”). This Notice applies to all health care providers in our Organized Health Care Arrangement (“OHCA”) and to all records containing your protected health information that are created, received or retained by members of the OHCA. We are dedicated to maintaining the privacy of your protected health information. The complete Notice is available here. You should review the complete Notice carefully.
Individual Responsibility of Members of the OHCA
Each member of the OHCA is individually responsible for our actions and we are required to provide you with this notice of our legal duties and the privacy practices that we maintain concerning your protected health information (“PHI”). Tap here for more information regarding our responsibilities. In addition:
We are required by law to maintain the privacy and security of your PHI
We must follow the duties and privacy practices described in this Notice
We must give you a copy of this Notice, including a paper copy if you request it
We must comply with all privacy laws
We will only use and share your information as described in this Notice or as you may otherwise tell us in writing when you exercise your rights
We May Use and Disclose your Protected Health Information
Tap here for more information on how we may use and disclose your PHI. We may use and disclose your health information as follows:
To provide to you.
To treat you - including to contact you to remind you of appointments, inform you of potential treatment alternatives or health-related benefits, to release your PHI to a friend or family member that is involved in your care.
For our payment purposes – including, to bill and collect payment for the services and items that you receive from us.
To operate our business– including, to evaluate and improve the quality of care we provide to you and our patients, including through the use of innovation and technology, and reviewing health outcomes based on certain protocols.
To comply with federal, state or local law, including to disclose your PHI to the Department of Health and Human Services, if necessary.
To respond to lawsuits and legal actions and requests from law enforcement officials and government agencies or authorities.
To help with or respond to public health and safety issues. We support public health activities by participating in the California Immunization Registry (CAIR); the CAIR notice can be accessed at https://www.acwellness.com/cair-notice
To provide assistance to a medical examiner or funeral director.
To respond to organ and tissue donation requests.
For our research purposes.
For workers’ compensation and similar programs.
For purposes of enabling our third-party vendors known as “business associates” to perform functions on our behalf.
To enable a sale, merger, or acquisition of our business and practice.
To enable us to de-identify your PHI so that we may use or share your PHI once it has been “de-identified.”
To enable us to receive health information about you from other healthcare entities and their business associates.
Additionally, we may also use and disclose your PHI for the following treatment and healthcare operations purposes:
Connect My Care: If you opt in to our Connect My Care feature, we may access and share your medical history with outside providers in an effort to give you the best possible care. Even if you do not opt in to Connect My Care, please note that certain external clinics or hospitals could override your Connect My Care preference if you are participating in one of their health data exchange programs.
Medication History: We may receive your medication history from pharmacies for patient safety and treatment purposes. You may opt-out by contacting staff@acwellness.com.
Claims Data: We may receive information about your health care from your Apple sponsored health plans to provide better medical care to you. You may opt-out by contacting info@acwellness.com.
Your Written Permission and Authorizations
Except as described in this Notice, we must obtain your written permission prior to sharing any PHI that identifies you. There are certain uses and disclosures of your information that generally require your specific permission:
How we use and disclose some of your mental health care information.
Whether and how we can market our services and sell your information.
Tap here for more information on providing Your Permission and/or Authorization.
Other Restrictions
Note that there are state laws that may further limit use and disclosure of your health information. Tap here for more information.
Your Rights
You have the right to:
Get a copy of your paper or electronic medical record
Ask us to correct or amend your paper or electronic medical record
Request confidential communications
Ask us to limit the information we share
Get a list of those with whom we’ve shared your information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you believe your privacy rights have been violated
Provide an authorization for other uses and disclosures
Receive notification if a breach occurs that may have compromised the privacy or security of your information
Tap here for more information on these rights and how to exercise them.
Questions
If you have a question about this Notice or to exercise any of your rights, you should contact:
AC Wellness Network
Privacy Officer
20730 Valley Green Drive
Cupertino, CA 95014
(669) 244-0875
privacy@acwellness.com