HIPAA 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.
1. Our Commitment to Your Privacy
Rêve de Kaizen Mobile Wellness ("we," "us," "our") is committed to protecting the privacy of your protected health information ("PHI"). This Notice describes how we may use and disclose your PHI to carry out treatment, payment, and healthcare operations, and for other purposes that are permitted or required by law. It also describes your rights regarding your PHI.
We are required by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and applicable Texas state laws to:
- Maintain the privacy and security of your PHI
- Provide you with this Notice of our legal duties and privacy practices regarding your PHI
- Notify you following a breach of your unsecured PHI
- Follow the terms of the Notice currently in effect
2. How We May Use and Disclose Your PHI
The following describes the ways we may use and disclose PHI about you without your specific authorization.
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare. This includes sharing information with other healthcare providers involved in your care, such as compounding pharmacies that prepare your medication, partner laboratories that perform your blood work, or other providers you may see for related care.
For Payment
We may use and disclose your PHI to obtain payment for the services we provide. This may include sending billing information to our payment processor or, if applicable, to insurance companies, third-party payors, or others responsible for payment of your services.
For Healthcare Operations
We may use and disclose your PHI for our internal operations, including quality assessment and improvement, employee training and review, licensing and credentialing, business planning, and general administrative activities.
To Individuals Involved in Your Care
Unless you object, we may share PHI with family members, friends, or others you have designated as involved in your care or payment for your care, but only to the extent necessary.
For Appointment Reminders and Health-Related Communications
We may contact you by phone, text, or email to remind you of appointments, provide test results, or share information about treatment alternatives or other health-related services and benefits that may be of interest to you.
As Required or Permitted by Law
We may use or disclose your PHI when required or permitted by federal, state, or local law. This may include:
- Public health activities (disease control, reporting required by law)
- Reporting victims of abuse, neglect, or domestic violence
- Health oversight activities (audits, investigations, inspections, licensing)
- Judicial and administrative proceedings (subpoenas, court orders)
- Law enforcement purposes when required
- Coroners, medical examiners, and funeral directors
- Organ and tissue donation
- Research purposes when authorized
- To avert a serious threat to health or safety
- Specialized government functions (military, national security)
- Workers' compensation, when applicable
3. Uses and Disclosures Requiring Your Authorization
Other uses and disclosures of your PHI not covered by this Notice or the laws that apply to us will be made only with your written authorization. Specifically, we will obtain your written authorization for:
- Marketing communications, except as permitted under HIPAA
- Sale of your PHI
- Most uses and disclosures of psychotherapy notes
- Any other use or disclosure not described in this Notice
You may revoke any authorization you give us at any time by submitting a written request, except to the extent we have already taken action in reliance on it.
4. Your Rights Regarding Your PHI
You have the following rights regarding the PHI we maintain about you. To exercise any of these rights, please submit your request in writing to our Privacy Officer (contact information at the end of this Notice).
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your PHI that we maintain in a designated record set, with limited exceptions. We may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
Right to Request an Amendment
You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. You must provide a reason that supports your request. We may deny your request under certain circumstances, in which case we will provide you with a written explanation.
Right to an Accounting of Disclosures
You have the right to request an accounting of certain disclosures we have made of your PHI for purposes other than treatment, payment, healthcare operations, or certain other limited disclosures. Your request must state a time period not longer than six years.
Right to Request Restrictions
You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or healthcare operations. We are not required to agree to your restriction, except in one circumstance: if you pay for a service or item entirely out of pocket and request that we not disclose information about that service to your health insurer, we must honor that request, unless required by law to disclose it.
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you only at home, only by text, or only by email. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice, even if you have agreed to receive it electronically. Request a paper copy at any time by contacting our Privacy Officer.
Right to Be Notified of a Breach
You have the right to be notified if we (or one of our business associates) discover a breach of your unsecured PHI.
5. Changes to This Notice
We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have about you, as well as any information we receive in the future. We will post a copy of the current Notice on our website. The Notice will contain the effective date in the upper portion of the first page. You may obtain a current copy at any time by contacting our Privacy Officer or visiting our website.
6. Texas-Specific Provisions
Under Texas law, we are also subject to additional medical privacy protections, including but not limited to the Texas Medical Records Privacy Act and Texas Health and Safety Code Chapter 181. Where Texas law provides greater privacy protection than HIPAA, we will follow Texas law. This includes provisions regarding the sale, electronic marketing, and re-identification of PHI.
7. Complaints
If you believe your privacy rights have been violated, you may file a written complaint with our Privacy Officer (contact information below) or with the Secretary of the U.S. Department of Health and Human Services:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr
We will not retaliate against you for filing a complaint. You will not be penalized in any way for exercising your privacy rights.
8. Contact Our Privacy Officer
For any questions about this Notice, to exercise any of the rights described above, or to file a complaint, please contact our Privacy Officer:
Privacy Officer
Name: [Privacy Officer Name]
Rêve de Kaizen Mobile Wellness
Phone: [Phone Number]
Email: privacy@revedekaizen.com
Mailing Address: [Mailing Address], Houston, TX [ZIP]
Requests to exercise rights described in this Notice must generally be made in writing. We may require you to complete a specific form or provide certain information to verify your identity before responding.