Your Rights

You have certain rights regarding your health information.
 

Get a Copy of Your Medical Record

You may request an electronic or paper copy of your medical record and other health information we maintain about you.

We will generally provide a copy or summary within the timeframe required by law. A reasonable fee may apply when permitted by law.
 

Ask Us to Correct Your Medical Record

You may ask us to correct health information that you believe is inaccurate or incomplete.

We may deny your request in certain circumstances, but we will explain the reason in writing when required.
 

Request Confidential Communications

You may ask us to contact you in a specific way, such as by a particular phone number, email address, or mailing address.

We will accommodate reasonable requests when required by law.
 

Ask Us to Limit What We Use or Share

You may ask us not to use or share certain health information for treatment, payment, or healthcare operations.

We are not always required to agree to your request.

If you pay for a healthcare service completely out-of-pocket, you may ask us not to share information about that service with your health insurer for payment or healthcare operations when applicable law requires us to honor the request.
 

Get a List of Disclosures

You may request a list of certain disclosures we have made of your health information.

This is sometimes called an “accounting of disclosures.”

The list generally does not include disclosures made for treatment, payment, healthcare operations, or certain other purposes permitted by law.
 

Get a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
 

Choose Someone to Act for You

If you have given someone medical power of attorney or another individual has legal authority to act for you, that person may exercise your privacy rights as permitted by law.

We will verify the individual’s authority before taking action.
 

File a Complaint

You may file a complaint if you believe your privacy rights have been violated.

You may contact Empowher Health & Wellness directly or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you may tell us your preferences about what we share.

These situations may include:

• Sharing information with family members, friends, or others involved in your care

• Sharing information during disaster-relief situations

• Certain marketing communications

• Certain uses or disclosures requiring your authorization

If you are unable to tell us your preference, we may share information when we believe it is in your best interest and permitted by law.
 
How We May Use and Share Your Health Information

We typically use or disclose your health information in the following ways.
 

Treatment

We may use and share your health information with healthcare professionals involved in your care.

Example: We may share relevant medical information with a laboratory, pharmacy, specialist, or other healthcare professional involved in your treatment.
 

Healthcare Operations

We may use and share your health information to operate our practice, improve care, train staff, conduct quality assessment, and manage our healthcare services.
 

Payment

We may use and share health information as necessary to bill for healthcare services or coordinate payment-related matters.

Although Empowher Health & Wellness operates as a self-pay practice, health information may still be used when necessary for pharmacy, laboratory, prior authorization, payment, or other healthcare-related purposes.
 

Pharmacies and Prescriptions

We may provide information necessary for a pharmacy to process, prepare, dispense, or ship medications prescribed as part of your care.

This may include information necessary to coordinate prescription fulfillment, medication questions, pharmacy billing, and treatment monitoring.
 

Laboratories and Other Healthcare Providers

We may share relevant health information with laboratories, imaging centers, specialists, pharmacies, or other healthcare providers when necessary for your care.

Other Uses and Disclosures

We may use or disclose your health information when permitted or required by law, including situations involving:

• Public health and safety activities

• Reporting suspected abuse, neglect, or domestic violence as required by law

• Preventing or reducing serious threats to health or safety

• Health oversight activities

• Workers’ compensation claims

• Certain law-enforcement requests

• Judicial or administrative proceedings

• Medical examiners, coroners, or funeral directors

• Organ and tissue donation

• Research permitted by applicable law

• Compliance with federal or state law

We will comply with applicable legal limitations on these disclosures.

Substance Use Disorder Records

Certain records relating to substance use disorder treatment may receive additional protections under federal law.

When applicable, Empowher Health & Wellness will handle such records in accordance with HIPAA and applicable federal confidentiality requirements, including 42 CFR Part 2.

Information protected by these additional requirements will not be used or disclosed except as permitted or required by applicable law.

Marketing and Sale of Information

Empowher Health & Wellness will not sell your protected health information.

We will obtain your written authorization before using or disclosing protected health information for purposes that require authorization under applicable law.
 

Electronic Communications and Telehealth

EmpowHer Health & Wellness may use secure electronic health record systems, patient portals, telehealth platforms, pharmacy systems, laboratories, payment services, and other healthcare technologies as part of providing services. We use reasonable safeguards designed to protect your information. Patients should use secure communication methods provided by the practice whenever possible when communicating sensitive medical information.

Our Responsibilities

Empowher Health & Wellness is required by law to:

• Maintain the privacy and security of your protected health information

• Follow the privacy practices described in this Notice

• Provide you with a copy of this Notice

• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information when notification is required

• Use and disclose your health information only as permitted by applicable law

We will not use or disclose your health information in ways not described in this Notice unless you provide written authorization or another legal basis permits the use or disclosure.

If you give us written authorization, you may revoke that authorization in writing at any time, except to the extent we have already acted in reliance on it.

Changes to This Notice

Empowher Health & Wellness may change the terms of this Notice.

Any changes may apply to health information we already maintain as well as information we receive in the future.

The current Notice will be available on our website and upon request.

Questions or Complaints

If you have questions about this Notice, would like to exercise your privacy rights, or wish to make a privacy complaint, please contact:

Privacy Contact
Empowher Health & Wellness, PLLC
Email: info@empowher-health-wellness.com
Phone: 918-838-9828
Fax: 918-516-0747
 

You may also submit a complaint to the U.S. Department of Health and Human Services Office for Civil Rights.

Empowher Health & Wellness will not retaliate against you for exercising your privacy rights or filing a complaint.