CONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION FOR TREATMENT, PAYMENT, OR HEALTHCARE OPERATIONS
This notice describes how medical information about you may be used and disclosed, your rights as a patient, and ways for you to get additional information on our policies.
We will always be respectful and protective of your personal information. Under federal regulations (the HIPAA Privacy Act), we have adopted additional guidelines to ensure the proper use, confidentiality and disclosure of your health information.
We may release or disclose your health information:
For treatment purposes to another healthcare provider or clinic if we refer you, or to providers or staff within our clinic that are taking part in your healthcare.
For billing and collection purposes, we may release records of your healthcare and information that you have provided to your insurance carrier or other financially responsible parties.
For operational purposes within our clinic for quality control, office administration, record keeping, and staff training.
We may also use your personal health information to contact you regarding your appointments, to send you information about our clinic or office events, or to share treatment options. You have the right to refuse to provide authorization for us to contact you regarding these matters. If you would like to receive this information at a number or address other than your home, or if you would like the information in a certain form (phone, mail, or email), please advise us in writing.
You have the right to inspect, obtain a copy of, or amend your records at this office. If you do not provide us with this authorization, it will not affect the care provided to you or the reimbursement avenues associated with your care. Requests to inspect, copy or amend your health related information should be provided in writing.
We will not disclose information about you to anyone outside our office without your written approval. Information we use or disclose based on this privacy notice may be subject to re-disclosure by the person to whom we provide the information and may no longer be protected by the federal privacy rules.
PATIENT SMS PRIVACY NOTICE
At Milwaukee Community Acupuncture, we are committed to maintaining the privacy and security of our patients’ personal information. This Privacy Notice outlines our practices and your choices regarding the use of your information for SMS (Short Message Service) communications.
Opt-In: By providing your mobile number, you are opting in to receive SMS communications from Milwaukee Community Acupuncture. These messages may include appointment reminders, changes in schedule, appointment cancellations and other relevant updates. Your mobile number will only be used for healthcare-related communications and will not be shared with third parties for their marketing purposes.
Opt-Out: You may opt-out of receiving SMS communications at any time. To opt-out, reply ‘STOP’ to any message you receive from us or contact our office directly. Once you opt-out, you will no longer receive SMS communications from us. Please note that opting out will not affect other forms of communication such as emails or phone calls.
Fees: While Milwaukee Community Acupuncture does not charge for SMS communications, standard message and data rates may apply depending on your wireless carrier and plan.
Privacy: We respect your privacy and are committed to protecting your information. All SMS communications are compliant with the Health Insurance Portability and Accountability Act (HIPAA), which protects your health information from unauthorized use or disclosure.
Updates: We may change this Privacy Notice from time to time. Any changes will be effective immediately upon posting of the revised notice on our website.
By opting in to our SMS communications, you acknowledge and agree to the practices outlined in this Privacy Notice. If you have any questions, please contact our office at 414-943-2915.