HIPAA Privacy Notice

HIPAA NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this notice, please contact:
RCA Nutrition and Suzi Dobias, CN, PT
President and Owner
phone: (808) 392-5407, fax: (530) 537-2383
e-mail info@RCANutrition.com

OUR PLEDGE REGARDING PROTECTED HEALTH INFORMATION:

We, RCA Nutrition, understand that protected health information about you and your health is personal. We are committed to protecting health information about you. This Notice applies to all of the records of your care generated by RCA Nutrition, whether made by RCA Nutrition personnel or your personal doctor. This Notice will tell you about the ways in which we may use and disclose protected health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of protected health information. The law requires us to:

  • make sure that protected health information that identifies you is kept private;
  • notify you about how we protect protected health information about you;
  • explain how, when and why we use and disclose protected health information;
  • 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 protected health information that we maintain. Changes will apply to all information we have about you. This will be implemented by:

  • posting the revised Notice in our office
  • making copies of the revised Notice available upon request;
  • posting the revised Notice on our Web site.

HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU.

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


For Treatment. We may use protected health information about you to provide you with, coordinate or manage your medical treatment or services. We may disclose protected health information about you to doctors, nurses, technicians, medical students, or other RCA Nutrition personnel who are involved in taking care of you.


RCA Nutrition staff may also share protected health information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose protected health information about you to people outside RCA Nutrition who may be involved in your medical care, such as clergy or others we use to provide services that are part of your care.


We may use and disclose protected health information to contact you as a reminder that you have an appointment for treatment or medical care at RCA Nutrition. We may use and disclose protected health information to tell you about or recommend possible treatment options or alternatives or health-related benefits or services that may be of interest to you.


For Payment for Services. We may use and disclose protected health information about you so that the treatment and services you receive at RCA Nutrition may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about nutrition services you received at RCA Nutrition so your health plan will pay us or reimburse you for the service. We may also tell your health plan about the nutrition services you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.


For Health Care Operations. We may use and disclose protected health information about you for RCA Nutrition health care operations, such as our quality assessment and improvement activities, case management, coordination of care, business planning, customer services and other activities. These uses and disclosures are necessary to run the facility, reduce health care costs, and make sure that all of our patients receive quality care.


For example, we may use protected health information to review our treatment and services and to evaluate the performance of the dietitian who is providing your services. We may also combine protected health information about many RCA Nutrition patients to decide what additional services RCA Nutrition should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other RCA Nutrition personnel for review and learning purposes. We may also combine the protected health information we have with protected health information from other health care facilities to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of protected health information so others may use it to study health care and health care delivery without learning who the specific patients are. We may also contact you as part of a fundraising effort.


Subject to applicable state law, in some limited situations the law allows or requires us to use or disclose your health information for purposes beyond treatment, payment, and operations. However, some of the disclosures set forth below may never occur at our facilities.


As Required By Law. We will disclose protected health information about you when required to do so by federal, state or local law.


Research. We may disclose your PHI to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.


Health Risks. We may disclose protected health information about you to a government authority if we reasonably believe you are a victim of abuse, neglect or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent or lessen a serious and imminent threat to you or another person.


Judicial and Administrative Proceedings. If you are involved in a lawsuit or dispute, we may disclose your information in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made, either by us or the requesting party, to tell you about the request or to obtain an order protecting the information requested.


Business Associates. We may disclose information to business associates who perform services on our behalf (such as billing companies;) however, we require them to appropriately safeguard your information.


Public Health. As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.


To Avert a Serious Threat to Health or Safety. We may use and disclose protected health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.


Health Oversight Activities. We may disclose protected health information to a health oversight agency for activities authorized by law. These activities include audits, investigations, and inspections, as necessary for licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.


Law Enforcement. We may release protected health information as required by law, or in response to an order or warrant of a court, a subpoena, or an administrative request. We may also disclose protected health information in response to a request related to identification or location of an individual, victims of crime, decedents, or a crime on the premises.


Organ and Tissue Donation. If you are an organ donor, we may release protected health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.


Special Government Functions. If you are a member of the armed forces, we may release protected health information about you if it relates to military and veterans activities. We may also release your protected health information for national security and intelligence purposes, protective services for the President, and medical suitability or determinations of the Department of State.


Coroners, Medical Examiners, and Funeral Directors. We may release protected health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose protected health information to funeral directors consistent with applicable law to enable them to carry out their duties.


Correctional Institutions and Other Law Enforcement Custodial Situations. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release protected health information about you to the correctional institution or law enforcement official as necessary for your or another person’s health and safety.


Worker’s Compensation. We may disclose information as necessary to comply with laws relating to worker’s compensation or other similar programs established by law.


Food and Drug Administration. We may disclose to the FDA, or persons under the jurisdiction of the FDA, protected health
information relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

YOU CAN OBJECT TO CERTAIN USES AND DISCLOSURES

Unless you object, or request that only a limited amount or type of information be shared, we may use or disclose protected health information about you in the following circumstances:

  • We may share with a family member, relative, friend, or other person identified by you protected health information directly relevant to that person’s involvement in your care or payment for your care. We may also share information to notify these individuals of your location, general condition or death
  • We may share information with a public or private agency (such as the American Red Cross) for disaster relief purposes. Even if you object, we may still share this information if necessary for the emergency circumstances.

If you would like to object to use and disclosure of protected health information in these circumstances, please call or write to our contact person listed on page 1 of this Notice.

YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU

You have the following rights regarding protected health information we maintain about you:

Right to Inspect and Copy. You have the right to inspect and copy protected health information that may be used to make decisions about your care. In addition, you have a right to get an electronic or paper copy of your medical records. Usually, this includes medical and billing records.

To inspect and copy protected health information that may be used to make decisions about you, you must submit your request in writing to Suzi Dobias CN, PT. If you request a copy of the information, we may charge a fee for the costs of
copying, mailing or other supplies associated with your request, and we will respond to your request no later than 30 days after receiving it. There are certain situations in which we are not required to comply with your request. In these circumstances, we will respond to you in writing, stating why we will not grant your request and describe any rights you may have to request a review of our denial.

Choose Someone to Act for You.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure that person has this authority and can act for you before we take any action.

Restrictions unless prior written permission obtained.
RCA Nutrition never shares your information unless you provide written permission under the following circumstances: marketing purposes, sale of your information, and most sharing of psychotherapy notes.

Right to Amend. If you feel that protected health information we have about you is incorrect or incomplete, you may ask us to amend or supplement the information.


To request an amendment, your request must be made in writing and submitted to Suzi Dobias CN, PT. In addition, you must provide a reason that supports your request. We will act on the/ your request for an amendment no later than 60 days after receiving the request.


We may deny your request for an amendment if it is not in writing or does not include a reason to support the request, and will provide a written denial to you. In addition, we may deny your request if you ask us to amend information that:

  • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
  • Is not part of the protected health information kept by RCA Nutrition;
  • Is not part of the information which you would be permitted to inspect and copy; or
  • We believe is accurate and complete.
  • For your treatment
  • For billing and collection of payment for your treatment

Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of protected health information about you.

To request this list or accounting of disclosures, you must submit your request in writing to Suzi Dobias CN, PT. You may ask for disclosures made up to six years before your request (not including disclosures made before April 14, 2003). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We are required to provide a listing of all disclosures except the following:

  • For health care operations
  • Made to or request by you, or that you authorized
  • Occurring as a by product of permitted use and disclosures
  • For national security or intelligence purposes or to correctional institutions or law enforcement regarding inmates
  • As part of a limited data set of information that does not contain information identifying you

Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information we use
or disclose about you for treatment, payment or health care operations or to persons involved in your care.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to
provide you emergency treatment, the disclosure is to the Secretary of the Department of Health and Human Services.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. RCA Nutrition will say yes unless the law requires otherwise
To request restrictions, you must make your request in writing to Suzi Dobias CN, PT.


Right to Request Confidential Communications. You have the right to request that we communicate with you about medical
matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to Suzi Dobias CN, PT. We will accommodate all
reasonable requests.


Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice at any time by contacting Suzi Dobias CN, PT.

OTHER USES AND DISCLOSURES

We will obtain your written authorization before using or disclosing your protected health information for purposes other than those provide for above (or as otherwise permitted or required by law). You may revoke this authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your information, except to the extent that we have already taken action in reliance on the authorization.

YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES

If you believe your privacy rights have been violated, you may file a complaint with Suzi Dobias CN, PT or file a written complaint with the Secretary of the Department of Health and Human Services. A complaint to the Secretary should be filed within180 days of the occurrence or action that is the subject of the complaint. If you file a complaint, we will not take any action against you or change our treatment of you in any way.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

RCA Nutrition and Suzi Dobias CNT, PT is not a medical doctor. I understand that RCA Nutrition and Suzi Dobias do not claim to diagnose, treat, cure, or prevent any medical conditions or pathologies, nor prescribe medicine, nor in any way represent as so doing. The services of a Nutrition Professional cannot replace those of a licensed physician. For any medical condition, you are advised to seek care from an appropriate medical practitioner. Whether you choose to engage a medical practitioner or not, to assist you in your care is your right and RCA Nutrition and Suzi Dobias CNT, PT, assume no responsibility for your decision in this matter. I have informed RCA Nutrition of all my known physical conditions, medical conditions, and medications, and I will keep them informed of any changes.


I, the undersigned, assume all responsibility for decisions I make regarding my health, recognizing that:

(a) No claims are made that herbal, nutritional, or dietary recommendations can treat or cure any medical
condition,
(b) All recommendations are given for informational purposes only,
(c) There is no implied or stated guarantee of success or effectiveness of any specific dietary, nutritional, or
herbal recommendations,
(d) I am free to act upon or disregard the recommendations of RCA Nutrition and Suzi Dobias as I so choose.


Limitation of Liabilities
In no event shall RCA Nutrition, its affiliates or any of their respective directors, officers, employees, agents, mandataries, consultants or other representatives be liable for any direct, indirect, special, incidental, consequential, punitive or aggravated damages (including without limitation damages for loss of data, goodwill, income or profit, loss of or damage to property and third party claims) or any other damages of any kind, arising out of or in connection with: the Services or Site; any RCA Nutrition materials, information, qualification and recommendations appearing on the site; any tools, tips, links, functionalities or services offered through, contained in or advertised on the Services or Site; your account and password; failure of performance, error, omission, interruption, defect, delay in operation, computer virus, communication line failure, theft, destruction or unauthorized access to, or alteration of, or inability to use the Site whether or not arising from breach of contract, tort, civil liability or otherwise and even if RCA Nutrition has been advised of the possibility of such damages. This exclusion of liability shall apply to the fullest extent permitted by law. You acknowledge that you will be fully liable for all damages resulting directly or indirectly from your use of the Services or Site and your Content. RCA Nutrition shall not be responsible for your Content or the content of any other users submitted to the Site. You acknowledge that RCA Nutrition is not liable for any libelous, defamatory, offensive or illegal conduct of other members and/or users of the Services or Site or third parties and that the risk of injury from the foregoing rests entirely with you. You use the Services or Site at your sole risk.

WHY NUTRITION COACHING?


The reason I do what I do is simple. I want to see people set free from what is holding them back. To replace healing where there is sickness and peace where there is pain. In the hustle and bustle of everyday life I want you to know:


That I have been exactly where you are at. I have struggled with health issues when nobody understood. I had reached out for help and wasn’t getting the answers I needed. I knew there was something wrong and I didn’t want another medicine to take.


I wanted to know what was causing my problems so they could be fixed, not ignored and put a band-aid over them. I have learned not only through my life experiences, but through my advanced training as a nutritionist how to find the root causes of people’s issues. 


Most people struggle with their weight and make no connection with the fact that something is not working right in their bodies. Making that connection for them and watching their lives change for the better is worth it’s weight in gold. God has healed me and equipped me to help others so they can be free from the diseases, illnesses, and weight issues. I do what I do because I love helping others in ways that no one else can.