NOTICE OF PRIVACY PRACTICES
Manifest Healing, 2608 Autumn Ave. Memphis, TN 38112, (901) 501-5299, Sarah@ManifestHealingMemphis.com
Effective Date: 02/14/2025
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.
Our Commitment to Your Privacy
At Manifest Healing, we understand that information about your health is personal. We are committed to protecting your privacy and are required by law (HIPAA - Health Insurance Portability and Accountability Act, and applicable Tennessee state laws) to maintain the privacy of your Protected Health Information (PHI). PHI includes information that can be used to identify you and that relates to your past, present, or future physical or mental health condition, the provision of healthcare to you, or payment for that healthcare. This Notice explains how we may use and disclose your PHI, our legal duties concerning your PHI, and your rights regarding your PHI. We are required to follow the terms of the Notice currently in effect.
How We May Use and Disclose Your Protected Health Information (PHI)
The following categories describe different ways we typically use and disclose PHI. Not every use or disclosure in a category will be listed, but all of the ways we are permitted to use and disclose information will fall within one of these categories.
For Treatment: We may use your PHI to provide you with massage therapy treatment and related services. This includes documenting your sessions in your client record, planning your course of treatment, and communicating with you about your care. We may also disclose your PHI to other healthcare providers involved in your care if necessary for coordination (e.g., if you ask us to coordinate with your physical therapist or chiropractor, with your written permission unless required for emergency treatment).
For Payment: We may use and disclose your PHI to bill and collect payment for the services you receive from us. For example, we may need to provide PHI to process credit card payments or to provide you with receipts or documentation if you are seeking reimbursement from an insurance company or health savings account (HSA). (Note: If a client pays entirely out-of-pocket for a service and requests that we not disclose PHI related solely to that service to their health plan, we must honor that request unless disclosure is required by law).
For Healthcare Operations: We may use and disclose your PHI for our business operations. These uses are necessary to run Manifest Healing and ensure quality care. Examples include:
Scheduling appointments and sending reminders (e.g., through Acuity Scheduling, with whom we have a Business Associate Agreement ensuring they protect your PHI).
Reviewing our treatment and services for quality assessment.
Business planning and administrative activities.
Compliance programs, including HIPAA compliance.
Legal or auditing services.
Appointment Reminders and Health-Related Information: We may use and disclose PHI to contact you as a reminder that you have an appointment or to tell you about treatment alternatives or other health-related benefits and services that may be of interest to you.
As Required By Law: We will disclose PHI about you when required to do so by federal, state, or local law. Examples include:
Reporting suspected child abuse or neglect, or abuse of a vulnerable adult, as required by Tennessee law.
Responding to a court order, subpoena, warrant, or similar legal process.
Reporting information related to public health risks (e.g., communicable diseases, if applicable).
Reporting reactions to medications or problems with products (if applicable).
To law enforcement officials, under specific circumstances as required by law.
For Workers' Compensation claims, as authorized by law.
Uses and Disclosures Requiring Your Written Authorization
Other uses and disclosures of PHI not covered by this Notice or the laws that apply to us will be made only with your written permission (Authorization). Examples include most uses and disclosures of PHI for marketing purposes or disclosures that constitute a sale of PHI. If you provide us authorization to use or disclose PHI about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose PHI about you for the reasons covered by your written authorization, except to the extent that we have already taken action in reliance on your permission.
Your Rights Regarding Your Protected Health Information
You have the following rights regarding the PHI we maintain about you:
Right to Inspect and Copy: You have the right to inspect and obtain a copy of your PHI contained in your client record. We may charge a reasonable, cost-based fee for copying and mailing. We may deny your request in certain limited circumstances; if denied, you may request a review of the denial.
Right to Amend: If you believe that PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You must provide a reason that supports your request. We may deny your request if the information was not created by us, is not part of the information you are permitted to inspect/copy, or is accurate and complete.
Right to an Accounting of Disclosures: You have the right to request a list (accounting) of certain disclosures we have made of your PHI. This typically does not include disclosures for treatment, payment, healthcare operations, or disclosures made pursuant to your authorization.
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. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or payment for your care, like a family member or friend. We are not required to agree to your request, except for the required restriction regarding disclosures to health plans for services paid out-of-pocket (as mentioned under "For Payment"). If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location (e.g., contacting you only at work or via email). Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically.
Right to Be Notified of a Breach: You have the right to be notified following a breach of your unsecured PHI.
Our Legal Duties
We are required by law to maintain the privacy of your PHI.
We are required to provide you with this Notice of our legal duties and privacy practices.
We are required to abide by the terms of the Notice currently in effect.
We reserve the right to change the terms of this Notice and make the new provisions effective for all PHI we maintain. If we make significant changes, we will post the revised Notice in our office (if applicable) and on our website, and provide a copy upon request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services (HHS).
To file a complaint with us: Contact Sarah Solarez, Owner/Operator at (901) 501-5299 or Sarah@ManifestHealingMemphis.com.
To file a complaint with HHS: Visit www.hhs.gov/ocr/privacy/hipaa/complaints/, or call 1-877-696-6775.
You will not be penalized or retaliated against for filing a complaint.
Contact Information
If you have any questions about this Notice, please contact:
Sarah Solarez, Owner/Operator, Licensed Massage Therapist, Manifest Healing, (901) 501-5299, Sarah@ManifestHealingMemphis.com