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.
Your information. Your rights. Our responsibilities.
Kifah Integrative Health is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to follow the notice currently in effect. This notice applies to the health information we create or receive as your health care provider. It does not apply to this website, which collects no personal information — see our Website Privacy Policy.
Your rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
- Get a copy of your health and claims records. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
- Ask us to correct your record. You can ask us to correct health information that you think is incorrect or incomplete. We may say "no", but we will tell you why in writing within 60 days.
- Request confidential communications. You can ask us to contact you in a specific way (for example, a home or cell phone) or to send mail to a different address. We will say "yes" to all reasonable requests.
- Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and we may say "no" if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information with your health insurer for payment or operations; we will say "yes" unless a law requires us to share it.
- Get a list of those with whom we have shared information. You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another one within 12 months.
- Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide you with a paper copy promptly.
- Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
- File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information at the end of this notice. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
Your choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
- In these cases, you have both the right and choice to tell us to: share information with your family, close friends, or others involved in your care; share information in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
- In these cases we never share your information unless you give us written permission: marketing purposes; sale of your information; most sharing of psychotherapy notes.
- We do not conduct fundraising.
Our uses and disclosures
We typically use or share your health information in the following ways.
- Treat you. We can use your health information and share it with other professionals who are treating you. Example: we share your medication list with your pharmacy or a specialist you are referred to.
- Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: we use health information about you to manage your treatment and services.
- Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: we give information about you to Medicare or your health insurance plan so it will pay for your services.
We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers.
- Help with public health and safety issues, such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
- Do research — we can use or share your information for health research.
- Comply with the law — we will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
- Respond to organ and tissue donation requests and work with a medical examiner or funeral director.
- Address workers' compensation, law enforcement, and other government requests — for workers' compensation claims; for law enforcement purposes or with a law enforcement official; with health oversight agencies for activities authorized by law; and for special government functions such as military, national security, and presidential protective services.
- Respond to lawsuits and legal actions — we can share health information about you in response to a court or administrative order, or in response to a subpoena.
Stronger protections under Illinois and federal law
Some kinds of information have extra protection, and we follow the stricter law. In Illinois these include mental health and developmental disabilities records (Mental Health and Developmental Disabilities Confidentiality Act, 740 ILCS 110), HIV/AIDS information (AIDS Confidentiality Act, 410 ILCS 305) and genetic testing information (Genetic Information Privacy Act, 410 ILCS 513); we will get your written permission or follow the specific rules those laws set before sharing such information.
If we receive records about substance use disorder treatment that are protected by federal law (42 CFR Part 2), we will not use or share those records, or testimony about their content, in any civil, criminal, administrative, or legislative proceeding against you unless you give written consent or a court orders it after giving you notice and an opportunity to be heard, as that law requires. Information we disclose under this notice may be redisclosed by the recipient and may then no longer be protected by federal privacy law.
Other uses
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind; that will not undo anything we already did with your permission.
Our responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing.
Changes to the terms of this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on this website, and we will give it to you at your next visit.
Contact
Privacy contact: the practice owner, Kifah Integrative Health — phone (872) 243-8886 (TTY: 711), email kifahintegrativehealth@gmail.com, mail Kifah Integrative Health, 9114 Waukegan Rd, PMB #11, Morton Grove, IL 60053. Please do not send health details by email; call us instead.
Language assistance
Free language assistance and auxiliary aids are available. Call (872) 243-8886 (TTY: 711). See Nondiscrimination and language assistance.
If this is a medical emergency, call 911 or go to the nearest emergency room.