HIPAA Compliance Notice
At The Walk-In on Church St, we are committed to protecting the privacy and security of your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable New York State laws.
This notice explains how your health information may be used, disclosed, and accessed, and outlines your rights regarding this information.
1. Use and Disclosure of Health Information
We may use and disclose your Protected Health Information (PHI) for the following purposes:
- Treatment: To provide, coordinate, or manage your healthcare and related services.
- Payment: To bill and collect payment from insurance companies or other entities.
- Healthcare Operations: For activities necessary to maintain high-quality care, such as audits, training, and quality assessments.
We may also use or disclose your PHI as required by law, such as for public health reporting, legal proceedings, or law enforcement purposes.
2. Patient Rights
Under HIPAA and New York State law, you have the following rights regarding your health information:
- Access: You may request copies of your medical records in paper or electronic form.
- Amendment: You can request corrections to your health information if you believe it is incomplete or inaccurate.
- Restrictions: You can ask us to limit how we use or disclose your information, though we are not required to agree in all cases.
- Confidential Communications: You may request that we communicate with you through specific means (e.g., by mail instead of phone).
- Accounting of Disclosures: You have the right to receive a list of certain disclosures of your PHI made outside of treatment, payment, or operations.
- Complaints: You may file a complaint if you believe your rights have been violated. Complaints can be submitted to us or directly to the U.S. Department of Health and Human Services.
3. Safeguarding Your Information
We implement physical, administrative, and technical safeguards to protect your PHI against unauthorized access, use, or disclosure.
4. Changes to This Notice
We reserve the right to revise this notice. Updates will be posted in our office and on our website. The revised notice will apply to all PHI we maintain.
5. Contact Information
If you have questions about this notice or your rights, or if you wish to file a complaint, please contact us:
The Walk-In on Church St
214 Church St. 2nd Floor, Carthage NY, 13619
(315) 909-8007
6. Filing a Complaint
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at:
Office for Civil Rights
U.S. Department of Health and Human Services
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.