Under HIPAA, you have certain rights with respect to your protected health information. The following is a brief overview of your rights and our duties with respect to enforcing those rights.
- Obtain a Paper Copy of This Notice
You can request a copy of our current Notice at any time. If agreed to receive the Notice electronically, you are still entitled to a paper copy. You may obtain a copy at our facilities and on our website.
- Notification of a Breach
You have the right to be notified following a breach of your unsecured PHI, and we will notify you in accordance with applicable law.
- Inspect & Obtain a Copy of PHI
You have the right to access and obtain a copy of your PHI that we maintain. If we maintain your PHI in an electronic health record, you have the right to request to obtain the PHI in an electronic format. To inspect or obtain a copy of your PHI, submit a written request. You may ask us to send a copy of your PHI to other individuals or entities. We may charge you a reasonable fee for the costs of copying, mailing, or other supplies associated with the request. We may deny your request to inspect and copy in certain circumstances. If you are denied access to your PHI, you may request that the denial be reviewed.
- Request a Restriction on Uses & Disclosures of PHI
You have the right to request additional restrictions on our use or disclosure of your PHI by submitting a written request to the Privacy Officer. We are not required to agree to the restrictions, except in the case where the disclosure is a health plan for purposes of carrying out payment or healthcare operations, is not otherwise required by law, and the PHI pertains solely to a healthcare item or service for which you, or a person on your behalf, has paid in full.
- Request an Amendment of PHI
If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. To request an amendment, you must send a written request to the Privacy Officer and include a reason that supports your request. If we deny your request for an amendment, we will provide you with a written explanation. You have the right to file a statement of disagreement with us, and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
- Receive an Accounting of Disclosures of PHI
With the exception of certain disclosures, restrictions, and limitations, you have a right to receive a list of the disclosures we have made of your PHI, in the six years prior to the date of your request, to entities or individuals other than you, to individuals involved in your care, or for notification purposes. Limitations may differ for electronic health records. To request an accounting, you must submit a request in writing to the Privacy Officer, and specify a time period. The first accounting you request within any 12-month period will be provided free of charge. For additional requests within the same period, we may charge you for reasonable costs. We will inform you of the costs, and you may choose to withdraw your request before the costs are incurred.
- Request Confidential Communications of PHI by Alternative Means or At Alternative Locations.
You have the right to request that we communicate with you about health matters in a certain way or location to preserve your privacy. For instance, you may request that we contact you at a different address, via email, or other means. Please note if you choose to receive communications from us via email or other electronic means, those may not be secure. This means there is a risk that your PHI in the emails may be intercepted and read by or disclosed to unauthorized parties. To request confidential communication of your PHI, you must submit a written request to the Privacy Officer. Your request must specify how you would like to be contacted. We will accommodate reasonable requests. However, if we are unable to contact you using the ways or locations you have requested, we may contact you using the information we have.
If you believe your privacy rights have been violated, you can file a grievance in person, or by mail or email with:
vybe urgent care
Attn: Compliance Department
6060 Ridge Ave., Ste 100
Philadelphia, PA 19128
Tel: 215-999-6060 | Email: firstname.lastname@example.org
You can also file a grievance with the Security electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or email with:
U.S. Department of Health & Human Services
200 Independence Avenue SW, Room 509F HHH Bldg.
Washington, D.C. 20201
Grievances must be made in writing and submitted within 180 days of when you knew of, or should have known of, the suspected violation. There will be no retaliation against you for filing a grievance.