HIPAA Notice of Privacy Practices

This Notice of Privacy Practices (“Notice”) describes how Activ8 Health may use and disclose your protected health information (PHI) to carry out treatment, payment, or healthcare operations (TPO), and for other purposes permitted or required by law. It also describes your rights to access and control your PHI.

Your Health Information Rights

Under HIPAA (Health Insurance Portability and Accountability Act), you have the following rights concerning your PHI:

1. Right to Inspect and Copy
   You may inspect and obtain a copy of your PHI, including medical and billing records, for as long as we maintain them. To access your records, submit a written request to the Privacy Officer. In certain circumstances, we may deny your request, but you can request a review of the denial.

2. Right to Amend
   If you believe that the PHI we have about you is incorrect or incomplete, you may request an amendment. Requests must be in writing and provide a reason to support the amendment. We may deny the request if the information:

   • Was not created by us,
   • Is not part of the PHI we maintain, or
   • Is accurate and complete.

3. Right to an Accounting of Disclosures
   You have the right to request an “accounting of disclosures” — a list of disclosures we made of your PHI other than for TPO or authorized by you.

4. Right to Request Restrictions
   You may request restrictions on how we use or disclose your PHI. While we are not required to agree to all requests, we will comply when feasible and not prohibited by law.

5. Right to Request Confidential Communications
   You may request that we communicate with you in a specific way (e.g., only at a specific address or phone number). We will accommodate reasonable requests.

6. Right to a Paper Copy of This Notice
   You may request a paper copy of this notice, even if you agreed to receive it electronically.

How We May Use and Disclose Your PHI

1. For Treatment

We may use and disclose your PHI to provide and coordinate your care. For example:

• Sharing your information with doctors, nurses, or pharmacies involved in your treatment.

2. For Payment

We may use your PHI to bill and receive payment for the services provided. For example:

• Sending health information to your insurance provider for reimbursement.

3. For Healthcare Operations

We may use your PHI for administrative and operational purposes, including:

• Quality improvement activities,
• Staff training,
• Audits, and compliance.

4. For Appointment Reminders

We may use your PHI to contact you about upcoming appointments.

5. As Required by Law

We may disclose PHI when required by federal, state, or local law, including public health reporting, abuse/neglect reporting, or law enforcement investigations.

6. To Prevent a Serious Threat

We may disclose your PHI to prevent or reduce a serious threat to your health, safety, or the safety of others.

7. Business Associates

We may disclose PHI to third-party “business associates” who perform services on our behalf (e.g., billing, data storage). All business associates must agree to protect your PHI.

Your Authorization

We will not use or disclose your PHI for purposes not described in this Notice without your explicit written authorization. You may revoke your authorization in writing at any time.

Your Rights Regarding Breach Notification

In the event of a breach involving your PHI, we will notify you as required by law.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with Activ8 Health or with the U.S. Department of Health and Human Services (HHS). To file a complaint, contact the privacy officer at the following address:

Activ8 Health
3827 N 32nd St Suite 10,
Phoenix, AZ 85018

Filing a complaint will not result in retaliation or affect your care.

Changes to This Notice

We reserve the right to revise this Notice at any time. Changes will apply to all PHI we maintain. The revised Notice will be available at our office and on our website.

Contact Us
If you have questions about this Notice or want more information, please contact our Privacy Officer at 602-932-2888