Privacy
Take Back Your Health
| 902 W. Grand Ave Grover Beach, CA 93433 Office (805) 481-1566 Fax (805) 481-5281 Hours: Monday - Friday 9:00 - 1:00 & 3:00 - 6:00 |
Tullius Chiropractic & Pilates Center
Stephen Tullius, D.C.
902 W. Grand Ave
Grover Beach, CA 93433
805-481-1566
805-481-5281 fax
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. THE PRIVACY OF YOUR MEDICAL
INFORMATION IS IMPORTANT TO US.
Our Legal Duty
We are required by applicable federal and state laws to maintain
the privacy of your protected health information. We are also
required to give you this notice about our privacy practices, our
legal duties, and your rights concerning your protected health
information. We must follow the privacy practices that are
described in this notice while it is in effect. This notice takes
effect April 14, 2003, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the
terms of this notice at any time, provided that such changes are
permitted by applicable law. We reserve the right to make the
changes in our privacy practices and the new terms of our notice
effective for all protected health information that we maintain,
including medical information we created or received before we
made the changes.
You may request a copy of our notice (or any subsequent revised
notice) at any time. For more information about our privacy
practices, or for additional copies of this notice, please contact
us using the information listed at the end of this notice.
Uses and Disclosures of Protected Health Information
We will use and disclose your protected health information about
you for treatment, payment, and health care operations. Following
are examples of the types of uses and disclosures of your
protected health care information that may occur. These
examples are not meant to be exhaustive, but to describe the
types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health
information to provide, coordinate or manage your health care
and any related services. This includes the coordination or
management of your health care with a third party. For example,
we would disclose your protected health information, as
necessary, to a home health agency that provides care to you. We
will also disclose protected health information to other
physicians who may be treating you. For example, your protected
health information may be provided to a physician to whom you
have been referred to ensure that the physician has the
necessary information to diagnose or treat you.
In addition, we may disclose your protected health information
from time to time to another physician or health care provider
(e.g., a specialist or laboratory) who, at the request of your
physician, becomes involved in your care by providing
assistance with your health care diagnosis or treatment to your
physician.
Payment: Your protected health information will be used, as
needed, to obtain payment for your health care services. This
may include certain activities that your health insurance plan may
undertake before it approves or pays for the health care services
we recommend for you, such as: making a determination of
eligibility or coverage for insurance benefits, reviewing services
provided to you for protected health necessity, and undertaking
utilization review activities. For example, obtaining approval for a
hospital stay may require that your relevant protected health
information be disclosed to the health plan to obtain approval for
the hospital admission.
Health Care Operations: We may use or disclose, as needed, your
protected health information in order to conduct certain business
and operational activities. These activities include, but are not
limited to, quality assessment activities, employee review
activities, training of students, licensing, and conducting or
arranging for other business activities.
For example, we may use a sign-in sheet at the registration desk
where you will be asked to sign your name. We may also call you
by name in the waiting room when your doctor is ready to see
you. We may use or disclose your protected health information,
as necessary, to contact you by telephone or mail to remind you
of your appointment.
We will share your protected health information with third party
"business associates" that perform various activities (e.g.,
billing, transcription services) for the practice. Whenever an
arrangement between our office and a business associate
involves the use or disclosure of your protected health
information, we will have a written contract that contains terms
that will protect the privacy of your protected health information.
We may use or disclose your protected health information, as
necessary, to provide you with information about treatment
alternatives or other health-related benefits and services that
may be of interest to you. We may also use and disclose your
protected health information for other marketing activities. For
example, your name and address may be used to send you a
newsletter about our practice and the services we offer. We may
also send you information about products or services that we
believe may be beneficial to you. You may contact us to request
that these materials not be sent to you.
Uses and Disclosures Based On Your Written Authorization:
Other uses and disclosures of your protected health information
will be made only with your authorization, unless otherwise
permitted or required by law as described below.
You may give us written authorization to use your protected
health information or to disclose it to anyone for any purpose. If
you give us an authorization, you may revoke it in writing at any
time. Your revocation will not affect any use or disclosures
permitted by your authorization while it was in effect. Without
your written authorization, we will not disclose your health care
information except as described in this notice.
Others Involved in Your Health Care: Unless you object, we may
disclose to a member of your family, a relative, a close friend or
any other person you identify, your protected health information
that directly relates to that person's involvement in your health
care. If you are unable to agree or object to such a disclosure, we
may disclose such information as necessary if we determine that
it is in your best interest based on our professional judgment. We
may use or disclose protected health information to notify or
assist in notifying a family member, personal representative or
any other person that is responsible for your care of your
location, general condition or death.
Marketing: We may use your protected health information to
contact you with information about treatment alternatives that
may be of interest to you. We may disclose your protected health
information to a business associate to assist us in these
activities. Unless the information is provided to you by a general
newsletter or in person or is for products or services of nominal
value, you may opt out of receiving further such information by
telling us using the contact information listed at the end of this
notice.
Research; Death; Organ Donation: We may use or disclose your
protected health information for research purposes in limited
circumstances. We may disclose the protected health information
of a deceased person to a coroner, protected health examiner,
funeral director or organ procurement organization for certain
purposes.
Public Health and Safety: We may disclose your protected health
information to the extent necessary to avert a serious and
imminent threat to your health or safety, or the health or safety of
others. We may disclose your protected health information to a
government agency authorized to oversee the health care
system or government programs or its contractors, and to public
health authorities for public health purposes.
Health Oversight: We may disclose protected health information
to a health oversight agency for activities authorized by law, such
as audits, investigations and inspections. Oversight agencies
seeking this information include government agencies that
oversee the health care system, government benefit programs,
other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your protected health
information to a public health authority that is authorized by law
to receive reports of child abuse or neglect. In addition, we may
disclose your protected health information if we believe that you
have been a victim of abuse, neglect or domestic violence to the
governmental entity or agency authorized to receive such
information. In this case, the disclosure will be made consistent
with the requirements of applicable federal and state laws.
Food and Drug Administration: We may disclose your protected
health information to a person or company required by the Food
and Drug Administration to report adverse events, product
defects or problems, biologic product deviations; to track
products; to enable product recalls; to make repairs or
replacements; or to conduct post marketing surveillance, as
required.
Criminal Activity: Consistent with applicable federal and state
laws, we may disclose your protected health information, if we
believe that the use or disclosure is necessary to prevent or
lessen a serious and imminent threat to the health or safety of a
person or the public. We may also disclose protected health
information if it is necessary for law enforcement authorities to
identify or apprehend an individual.
Required by Law: We may use or disclose your protected health
information when we are required to do so by law. For example,
we must disclose your protected health information to the U.S.
Department of Health and Human Services upon request for
purposes of determining whether we are in compliance with
federal privacy laws. We may disclose your protected health
information when authorized by workers' compensation or similar
laws.
Process and Proceedings: We may disclose your protected health
information in response to a court or administrative order,
subpoena, discovery request or other lawful process, under
certain circumstances. Under limited circumstances, such as a
court order, warrant or grand jury subpoena, we may disclose
your protected health information to law enforcement officials.
Law Enforcement: We may disclose limited information to a law
enforcement official concerning the protected health information
of a suspect, fugitive, material witness, crime victim or missing
person. We may disclose the protected health information of an
inmate or other person in lawful custody to a law enforcement
official or correctional institution under certain circumstances.
We may disclose protected health information where necessary
to assist law enforcement officials to capture an individual who
has admitted to participation in a crime or has escaped from
lawful custody.
Patient Rights
Access: You have the right to look at or get copies of your
protected health information, with limited exceptions. You must
make a request in writing to the contact person listed herein to
obtain access to your protected health information. You may also
request access by sending us a letter to the address at the end
of this notice. If you request copies, we will charge you $25.00 for
each page or $10.00 per hour to locate and copy your protected
health information, and postage if you want the copies mailed to
you. If you prefer, we will prepare a summary or an explanation of
your protected health information for a fee. Contact us using the
information listed at the end of this notice for a full explanation of
our fee structure.
Accounting of Disclosures: You have the right to receive a list of
instances in which we or our business associates disclosed your
protected health information for purposes other than treatment,
payment, health care operations and certain other activities after
April 14, 2003. After April 14, 2009, the accounting will be provided
for the past six (6) years. We will provide you with the date on
which we made the disclosure, the name of the person or entity
to whom we disclosed your protected health information, a
description of the protected health information we disclosed, the
reason for the disclosure, and certain other information. If you
request this list more than once in a 12-month period, we may
charge you a reasonable, cost-based fee for responding to these
additional requests. Contact us using the information listed at the
end of this notice for a full explanation of our fee structure.
Restriction Requests: You have the right to request that we place
additional restrictions on our use or disclosure of your protected
health information. We are not required to agree to these
additional restrictions, but if we do, we will abide by our
agreement (except in an emergency). Any agreement we may
make to a request for additional restrictions must be in writing
signed by a person authorized to make such an agreement on our
behalf. We will not be bound unless our agreement is so
memorialized in writing.
Confidential Communication: You have the right to request that
we communicate with you in confidence about your protected
health information by alternative means or to an alternative
location. You must make your request in writing. We must
accommodate your request if it is reasonable, specifies the
alternative means or location, and continues to permit us to bill
and collect payment from you.
Amendment: You have the right to request that we amend your
protected health information. Your request must be in writing,
and it must explain why the information should be amended. We
may deny your request if we did not create the information you
want amended or for certain other reasons. If we deny your
request, we will provide you a written explanation. You may
respond with a statement of disagreement to be appended to the
information you wanted amended. If we accept your request to
amend the information, we will make reasonable efforts to inform
others, including people or entities you name, of the amendment
and to include the changes in any future disclosures of that
information.
Electronic Notice: If you receive this notice on our website or by
electronic mail (e-mail), you are entitled to receive this notice in
written form. Please contact us using the information listed at the
end of this notice to obtain this notice in written form.
Questions and Complaints
If you want more information about our privacy practices or have
questions or concerns, please contact us using the information
below. If you believe that we may have violated your privacy
rights, or you disagree with a decision we made about access to
your protected health information or in response to a request you
made, you may complain to us using the contact information
below. You also may submit a written complaint to the U.S.
Department of Health and Human Services. We will provide you
with the address to file your complaint with the U.S. Department
of Health and Human Services upon request.
We support your right to protect the privacy of your protected
health information. We will not retaliate in any way if you choose
to file a complaint with us or with the U.S. Department of Health
and Human Services
Name of Contact Person: Stephen Tullius, D.C.
Address: 902 W. Grand Ave, Grover Beach, CA 93433
Stephen Tullius, D.C.
902 W. Grand Ave
Grover Beach, CA 93433
805-481-1566
805-481-5281 fax
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. THE PRIVACY OF YOUR MEDICAL
INFORMATION IS IMPORTANT TO US.
Our Legal Duty
We are required by applicable federal and state laws to maintain
the privacy of your protected health information. We are also
required to give you this notice about our privacy practices, our
legal duties, and your rights concerning your protected health
information. We must follow the privacy practices that are
described in this notice while it is in effect. This notice takes
effect April 14, 2003, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the
terms of this notice at any time, provided that such changes are
permitted by applicable law. We reserve the right to make the
changes in our privacy practices and the new terms of our notice
effective for all protected health information that we maintain,
including medical information we created or received before we
made the changes.
You may request a copy of our notice (or any subsequent revised
notice) at any time. For more information about our privacy
practices, or for additional copies of this notice, please contact
us using the information listed at the end of this notice.
Uses and Disclosures of Protected Health Information
We will use and disclose your protected health information about
you for treatment, payment, and health care operations. Following
are examples of the types of uses and disclosures of your
protected health care information that may occur. These
examples are not meant to be exhaustive, but to describe the
types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health
information to provide, coordinate or manage your health care
and any related services. This includes the coordination or
management of your health care with a third party. For example,
we would disclose your protected health information, as
necessary, to a home health agency that provides care to you. We
will also disclose protected health information to other
physicians who may be treating you. For example, your protected
health information may be provided to a physician to whom you
have been referred to ensure that the physician has the
necessary information to diagnose or treat you.
In addition, we may disclose your protected health information
from time to time to another physician or health care provider
(e.g., a specialist or laboratory) who, at the request of your
physician, becomes involved in your care by providing
assistance with your health care diagnosis or treatment to your
physician.
Payment: Your protected health information will be used, as
needed, to obtain payment for your health care services. This
may include certain activities that your health insurance plan may
undertake before it approves or pays for the health care services
we recommend for you, such as: making a determination of
eligibility or coverage for insurance benefits, reviewing services
provided to you for protected health necessity, and undertaking
utilization review activities. For example, obtaining approval for a
hospital stay may require that your relevant protected health
information be disclosed to the health plan to obtain approval for
the hospital admission.
Health Care Operations: We may use or disclose, as needed, your
protected health information in order to conduct certain business
and operational activities. These activities include, but are not
limited to, quality assessment activities, employee review
activities, training of students, licensing, and conducting or
arranging for other business activities.
For example, we may use a sign-in sheet at the registration desk
where you will be asked to sign your name. We may also call you
by name in the waiting room when your doctor is ready to see
you. We may use or disclose your protected health information,
as necessary, to contact you by telephone or mail to remind you
of your appointment.
We will share your protected health information with third party
"business associates" that perform various activities (e.g.,
billing, transcription services) for the practice. Whenever an
arrangement between our office and a business associate
involves the use or disclosure of your protected health
information, we will have a written contract that contains terms
that will protect the privacy of your protected health information.
We may use or disclose your protected health information, as
necessary, to provide you with information about treatment
alternatives or other health-related benefits and services that
may be of interest to you. We may also use and disclose your
protected health information for other marketing activities. For
example, your name and address may be used to send you a
newsletter about our practice and the services we offer. We may
also send you information about products or services that we
believe may be beneficial to you. You may contact us to request
that these materials not be sent to you.
Uses and Disclosures Based On Your Written Authorization:
Other uses and disclosures of your protected health information
will be made only with your authorization, unless otherwise
permitted or required by law as described below.
You may give us written authorization to use your protected
health information or to disclose it to anyone for any purpose. If
you give us an authorization, you may revoke it in writing at any
time. Your revocation will not affect any use or disclosures
permitted by your authorization while it was in effect. Without
your written authorization, we will not disclose your health care
information except as described in this notice.
Others Involved in Your Health Care: Unless you object, we may
disclose to a member of your family, a relative, a close friend or
any other person you identify, your protected health information
that directly relates to that person's involvement in your health
care. If you are unable to agree or object to such a disclosure, we
may disclose such information as necessary if we determine that
it is in your best interest based on our professional judgment. We
may use or disclose protected health information to notify or
assist in notifying a family member, personal representative or
any other person that is responsible for your care of your
location, general condition or death.
Marketing: We may use your protected health information to
contact you with information about treatment alternatives that
may be of interest to you. We may disclose your protected health
information to a business associate to assist us in these
activities. Unless the information is provided to you by a general
newsletter or in person or is for products or services of nominal
value, you may opt out of receiving further such information by
telling us using the contact information listed at the end of this
notice.
Research; Death; Organ Donation: We may use or disclose your
protected health information for research purposes in limited
circumstances. We may disclose the protected health information
of a deceased person to a coroner, protected health examiner,
funeral director or organ procurement organization for certain
purposes.
Public Health and Safety: We may disclose your protected health
information to the extent necessary to avert a serious and
imminent threat to your health or safety, or the health or safety of
others. We may disclose your protected health information to a
government agency authorized to oversee the health care
system or government programs or its contractors, and to public
health authorities for public health purposes.
Health Oversight: We may disclose protected health information
to a health oversight agency for activities authorized by law, such
as audits, investigations and inspections. Oversight agencies
seeking this information include government agencies that
oversee the health care system, government benefit programs,
other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your protected health
information to a public health authority that is authorized by law
to receive reports of child abuse or neglect. In addition, we may
disclose your protected health information if we believe that you
have been a victim of abuse, neglect or domestic violence to the
governmental entity or agency authorized to receive such
information. In this case, the disclosure will be made consistent
with the requirements of applicable federal and state laws.
Food and Drug Administration: We may disclose your protected
health information to a person or company required by the Food
and Drug Administration to report adverse events, product
defects or problems, biologic product deviations; to track
products; to enable product recalls; to make repairs or
replacements; or to conduct post marketing surveillance, as
required.
Criminal Activity: Consistent with applicable federal and state
laws, we may disclose your protected health information, if we
believe that the use or disclosure is necessary to prevent or
lessen a serious and imminent threat to the health or safety of a
person or the public. We may also disclose protected health
information if it is necessary for law enforcement authorities to
identify or apprehend an individual.
Required by Law: We may use or disclose your protected health
information when we are required to do so by law. For example,
we must disclose your protected health information to the U.S.
Department of Health and Human Services upon request for
purposes of determining whether we are in compliance with
federal privacy laws. We may disclose your protected health
information when authorized by workers' compensation or similar
laws.
Process and Proceedings: We may disclose your protected health
information in response to a court or administrative order,
subpoena, discovery request or other lawful process, under
certain circumstances. Under limited circumstances, such as a
court order, warrant or grand jury subpoena, we may disclose
your protected health information to law enforcement officials.
Law Enforcement: We may disclose limited information to a law
enforcement official concerning the protected health information
of a suspect, fugitive, material witness, crime victim or missing
person. We may disclose the protected health information of an
inmate or other person in lawful custody to a law enforcement
official or correctional institution under certain circumstances.
We may disclose protected health information where necessary
to assist law enforcement officials to capture an individual who
has admitted to participation in a crime or has escaped from
lawful custody.
Patient Rights
Access: You have the right to look at or get copies of your
protected health information, with limited exceptions. You must
make a request in writing to the contact person listed herein to
obtain access to your protected health information. You may also
request access by sending us a letter to the address at the end
of this notice. If you request copies, we will charge you $25.00 for
each page or $10.00 per hour to locate and copy your protected
health information, and postage if you want the copies mailed to
you. If you prefer, we will prepare a summary or an explanation of
your protected health information for a fee. Contact us using the
information listed at the end of this notice for a full explanation of
our fee structure.
Accounting of Disclosures: You have the right to receive a list of
instances in which we or our business associates disclosed your
protected health information for purposes other than treatment,
payment, health care operations and certain other activities after
April 14, 2003. After April 14, 2009, the accounting will be provided
for the past six (6) years. We will provide you with the date on
which we made the disclosure, the name of the person or entity
to whom we disclosed your protected health information, a
description of the protected health information we disclosed, the
reason for the disclosure, and certain other information. If you
request this list more than once in a 12-month period, we may
charge you a reasonable, cost-based fee for responding to these
additional requests. Contact us using the information listed at the
end of this notice for a full explanation of our fee structure.
Restriction Requests: You have the right to request that we place
additional restrictions on our use or disclosure of your protected
health information. We are not required to agree to these
additional restrictions, but if we do, we will abide by our
agreement (except in an emergency). Any agreement we may
make to a request for additional restrictions must be in writing
signed by a person authorized to make such an agreement on our
behalf. We will not be bound unless our agreement is so
memorialized in writing.
Confidential Communication: You have the right to request that
we communicate with you in confidence about your protected
health information by alternative means or to an alternative
location. You must make your request in writing. We must
accommodate your request if it is reasonable, specifies the
alternative means or location, and continues to permit us to bill
and collect payment from you.
Amendment: You have the right to request that we amend your
protected health information. Your request must be in writing,
and it must explain why the information should be amended. We
may deny your request if we did not create the information you
want amended or for certain other reasons. If we deny your
request, we will provide you a written explanation. You may
respond with a statement of disagreement to be appended to the
information you wanted amended. If we accept your request to
amend the information, we will make reasonable efforts to inform
others, including people or entities you name, of the amendment
and to include the changes in any future disclosures of that
information.
Electronic Notice: If you receive this notice on our website or by
electronic mail (e-mail), you are entitled to receive this notice in
written form. Please contact us using the information listed at the
end of this notice to obtain this notice in written form.
Questions and Complaints
If you want more information about our privacy practices or have
questions or concerns, please contact us using the information
below. If you believe that we may have violated your privacy
rights, or you disagree with a decision we made about access to
your protected health information or in response to a request you
made, you may complain to us using the contact information
below. You also may submit a written complaint to the U.S.
Department of Health and Human Services. We will provide you
with the address to file your complaint with the U.S. Department
of Health and Human Services upon request.
We support your right to protect the privacy of your protected
health information. We will not retaliate in any way if you choose
to file a complaint with us or with the U.S. Department of Health
and Human Services
Name of Contact Person: Stephen Tullius, D.C.
Address: 902 W. Grand Ave, Grover Beach, CA 93433
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| Tullius Chiropractic & Pilates Center 902 West Grande Avenue Grover Beach, California 93433 Tel: (805) 481-5281 - Fax: (805) 481-4541 Grover Beach Arroyo Grande Pismo Beach San Luis Obispo Santa Maria Atascadero Paso Robles Templeton Nipomo Oceano Los Osos Morro Bay Avila Cayucos Orcutt Shandon Creston Santa Margarita California chiropractic chiropractor chiropractors wellness health fitness gym workout Pilates yoga massage tai chi cranioscaral reflexology acupuncture weight loss orthotics laser therapy spine subluxation healing wellness natural healthcare alternative |
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