HIPAA Notice of
Privacy Practices

Wandering Michelle LLC is required by law to maintain the privacy of your protected health information (PHI), to provide you with notice of our legal duties and privacy practices with respect to your PHI, and to notify you following a breach of your unsecured PHI. We are required to abide by the terms of this Notice while it is in effect.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. For example, we may share your information with other healthcare providers involved in your treatment.

Payment

We may use and disclose your PHI to obtain payment for the healthcare services we provide. For example, we may share information with your insurance company to verify coverage or obtain reimbursement for your treatment.

Healthcare Operations

We may use and disclose your PHI for our healthcare operations, including quality assessment, treatment review, training, accreditation, and other business activities necessary to operate our practice.

Other Permitted Uses and Disclosures

We may also use or disclose your PHI without your written authorization for the following purposes:

• As required by law
• For public health activities
• To report abuse, neglect, or domestic violence
• For health oversight activities
• In response to judicial or administrative proceedings
• For law enforcement purposes
• To avert a serious threat to health or safety
• For workers' compensation purposes

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not covered by this Notice will be made only with your written authorization. You may revoke your authorization in writing at any time, except to the extent that we have already taken action in reliance on that authorization.

We will not sell your PHI without your written authorization. We will not use or disclose your PHI for marketing purposes without your written authorization.

Your Rights Regarding Your Health Information

Right to Access

You have the right to inspect and obtain a copy of your PHI that is maintained in our records. We may charge a reasonable fee for providing copies.

Right to Request Amendments

You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your PHI during the six years prior to your request.

Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request in most cases, but we will comply if you request that we restrict disclosure to a health plan for payment or healthcare operations purposes and the PHI pertains solely to services you paid for out-of-pocket in full.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your PHI in a certain way or at a certain location. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.

Right to Notification of a Breach

You have the right to receive notification in the event of a breach of your unsecured PHI.

Our Duties

We are required by law to maintain the privacy of your PHI and to provide you with notice of our legal duties and privacy practices. We are required to abide by the terms of this Notice currently in effect. We reserve the right to change our privacy practices and the terms of this Notice and to make the new Notice provisions effective for all PHI that we maintain. If we make a material change to our privacy practices, we will post the revised Notice on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact us using the information below. We will not retaliate against you for filing a complaint.

To file a complaint with the U.S. Department of Health and Human Services, visit www.hhs.gov/ocr/privacy/hipaa/complaints or call 1-800-368-1019.

Contact Our Privacy Officer

For questions about this Notice or to exercise your rights, please contact us: