HIPAA NOTICE OF PRIVACY PRACTICES
This Wholeness in Motion Notice of Privacy Practices describes how medical information about our patients may be used and disclosed, and how our patients can get access to this information. This information is provided to patients as part of their registration process.
When it comes to our patients’ health information, our patients have certain rights. Our patients may:
(1) receive an electronic or paper copy of their medical record;
(2) ask us to correct the medical record;
(3) request that we communicate with them in a specific way;
(4) ask us to limit what we use or share;
(5) ask for a list of the times we’ve shared their health information for six years prior to the date requested, who we shared it with, and why;
(6) receive a copy of this privacy notice;
(7) choose someone to act for them; or
(8) file a complaint if they feel their rights have been violated.
Our patients can also tell us their choices about to whom we share, for example,
(1) to share information with family, close friends, or others involved in their care; or
(2) to share information in a disaster relief situation.
We typically use or share patient’s health information in the following ways:
(1) to treat;
(2) to run our clinic; and
(3) to bill for services.
We are allowed or required to share information in other ways – usually in ways that contribute to the public good, for example we will share information if state or federal laws require it. We can share information about a patient for:
(1) workers’ compensation claims;
(2) for law enforcement purposes;
(3) with oversight agencies for activities authorized by law, and
(4) in response to a court or administrative order.
We are required by law to maintain the privacy and security of our patients’ protected health information.
We will let our patients know promptly if a breach occurs that may have compromised the privacy or security of information.
We can change the terms of this notice, and the changes will apply to all information we have about a patient.
For questions or concerns, please contact Israel Sostrin, MSPT.
Israel@WholenessInMotion.com, (503)231-3633, 5909 SE Division St., Suite 3, Portland, OR 97206.
For more information about HIPAA and your rights, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
HIPAA NOTICE OF ACKNOWLEDGEMENT & CONSENT
When you become a patient with we will ask you to sign a HIPAA Notice of Acknowledgement & Consent that contains the below language:
"ACKNOWLEDGEMENT: I have received and read the Notice of Privacy Practices for the office Wholeness In Motion and understand my rights contained in the notice.
CONSENT: I hereby give my consent for Wholeness In Motion to use and disclose protected health information (PHI) about me to carry out treatment, payment and health care operations (TPO).
- The Notice of Privacy Practices provided by the practice named above describes such uses and disclosures more completely.
- I have the right to review the Notice of Privacy Practices prior to signing this consent.
- Wholeness In Motion reserves the right to revise its Notice of Privacy Practices at any time.
- I have the right to request that Wholeness In Motion restrict how it uses or discloses my information to carry out TPO.
- A Notice of Privacy Practices may be obtained by forwarding a written request to Israel Sostrin, 5909 SE Division St., Portland OR 97206."
SMS OPT-IN & OPT-OUT INTRODUCTION
When you become a patient you sign a registration form that confirms your consent to certain kinds of communication, authorizing Wholeness In Motion to:
• Call your home or other alternative location and leave a message on voicemail or in person in reference to any items that assist the practice in carrying out office procedures, such as appointment reminders, insurance items and any calls pertaining to my clinical care, including examination findings, test results, among others.
• Contact you by phone, mail, text or email to inform you of physical therapy related services offered by Wholeness In Motion.
• E-mail, mail or text message to your home or mobile device or other alternative location any items that assist the practice in carrying out office procedures, such as appointment reminders, patient billing statements, home exercise programs or reminders and updates from my therapist and their team.
During the registration process you will receive an SMS OPT-IN AGREEMENT that specifically gives you the opportunity to accept or decline SMS Texts relating to appointments and care. If you choose to receive SMS you will receive a text notification with the below message outlining the guidelines for "Opting-In" and "Opting-Out" of texting:
"This is a message from WHOLENESS IN MOTION confirming your text Opt-In during your registration. We may text you appointment and account service information. At any time you may respond STOP to Opt-Out (unsubscribe) or HELP for more information. MESSAGE FREQUENCY may vary, but typically you will receive a confirmation for and a reminder of each appointment and follow-up information after each session. Message and data rates may apply. Our privacy policy and terms and conditions can be found here: http://www.wholenessinmotion.com/p/privacy-and-opt-in-or-out.html."
Data Collection: We will collect your name, email address, mailing address, and mobile phone number when you sign up for SMS updates. The information will be collected via the website software contact form.
Data Usage: we will use your data solely for sending updates and reminders related to our services.
Data Security: we will protect your data with secure storage measures to prevent unauthorized access.
Data Retention: we retain your information as long as you are subscribed to our SMS service. You may request deletion at any time.
MESSAGE AND DATA RATES MAY APPLY. Your mobile carrier may charge fees for sending or receiving text messages, especially if you do not have an unlimited data plan.
Messages are recurring, and message frequency varies.
Contact Integrative Spine & Body Medicine PC DBA Wholeness in Motion at 503-231-3633 or Israel@WholenessInMotion.com for HELP or to STOP receiving messages.
Opt-Out: you can opt out of the SMS list anytime by texting, emailing, or replying STOP to Israel@WholenessInMotion.com or 503-231-3633. After unsubscribing, you will receive a final SMS to confirm you have unsubscribed and we will remove your number from our list within 24 hours.
You can send HELP for additional assistance, and you will receive a text, including our phone number, email and website. We are here to help you.
Non-Sharing Clause: We do not share your data with third parties for marketing purposes. Integrative Spine & Body Medicine PC DBA Wholeness in Motion will not sell, rent, or share collected phone numbers.
OUR COMMITMENT
We do not share your mobile information with third parties for marketing purposes for any reason.
We commit not to transfer your data to external organizations without explicit consent, except as required by law.
We implement strict access controls and regularly audit our data handling practices to ensure your data is not shared without authorization.
