Offering IV Hydration and Wellness

HIPAA Notice of Privacy Practices & Policies

This notice outlines your protected health information (PHI), how it may be used, and what your rights are.  Please review carefully and ask any questions you have, prior to signing it.  Please direct all questions to Indy IV, LLC at IndyIV@yahoo.com

We, Indy IV, LLC, understand that PHI about you and your health is very personal.  We are committed to protecting your PHI.  This notice applies to ALL of the records of your care/coaching generated by Indy IV Drip Spa and our personnel.  This notice will explain the ways in which we could use and disclose PHI about you.  We also describe your rights and certain obligations we have regarding the use and disclosure of PHI.  The law requires us to:

• make sure that your PHI that identifies you is kept private
• notify you about how we protect your PHI
• explain how, when, & why we use and disclose PHI
• follow the terms of the notice that is currently in effect

We are required to follow the procedures in this notice. We reserve the right to change the terms of this notice and to make new notice provisions effective for all PHI that we maintain by:

• providing copies of this notice upon registration as a client of Indy IV, LLC
• providing copies of this notice upon request
• posting a copy of this notice on our Facebook page or website.

How we may use and disclose protected health information about you:

The following categories describe different ways that we use and disclose PHI without your written authorization.

For TREATMENT & Continuity of Care:  We may use PHI about you to provide you with, coordinate, or manage your medical or health treatments or associated services.  We may disclose PHI about you to health care providers, or other health care team members that are involved in providing your health care.  Indy IV Drip Spa may also share PHI in order to coordinate the different parts of your treatment plan you need, such as pharmaceuticals, lab work; this provision of care may also extend to providers outside Indy IV Drip Spa staff as it relates to your health care and continuity of such care.

For PAYMENT:  Indy IV Drip Spa may disclose certain health information to others for billing, invoicing, and/or receiving payment for services you receive from Indy IV Drip Spa. Only the minimal information required by such third party will be disclosed.

As required by Law:  Indy IV, LLC may disclose your health information as required by law as in cases pursuant to legal authority, to report information as related to victims of abuse, neglect or domestic violence, and/or to assist law enforcement officials in standard law enforcement duties. 

For Public Health:  Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability or for other health oversight activities.

Your Written Authorization is REQUIRED for other uses & disclosures

Including:

Uses & disclosures for PHI for marketing purposes; and
Disclosures that constitute a sale of your PHI.

Your PHI Rights:

You have the right:

• to request restrictions to certain uses & disclosures of your PHI; however, Indy IV, LLC may not be required to agree to such requested restrictions.
• Obtain a paper copy of this Notice of Privacy Practices upon request
• Inspect and obtain a copy of your health record as provided for under the law
• Amend your health record, according to law, by submitting a written request
• Request communications of your PHI by alternative means, (i.e. email, fax, etc)
• Receive an accounting of disclosures made of your PHI
• Request an electronic copy of your record be provided to you.

Obligations of Indy IV Drip Spa:

Indy IV, LLC is required by law to:

• Maintain the privacy of PHI and notify you in the event of a breach, if the breach poses significant risk to you
• Provide you with THIS notice of our legal duties & privacy practices with respect to your PHI
• Abide by the terms of this notice
• Notify you if we are unable to agree to a requested restriction on how your information is used
• Accommodate reasonable requests you make to communicate PHI by alternative means
• Obtain your written consent to use or disclose your PHI for any reason other than listed herein

Complaints & Information

You may submit any written complaints regarding potential breaches in privacy or requests for further information by contacting Indy IV Drip Spa at IndyIV@yahoo.com

Indy IV Drip Spa reserves the right to change its information practices & to make new provisions effective for all PHI that we maintain.  Revised notices will be made available on our Facebook page and/or website.