HIPAA Notice of Privacy Practices
Effective Date: January 1, 2025
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Who We Are
Rooted Health Hormones & MedSpa LLC (“Rooted Health,” “we,” “us,” or “our”) is a covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This Notice explains our legal duties and privacy practices regarding your Protected Health Information (PHI).
Provider: LaDonna Walker, NP
Address: 1120 Hogan Lane, Suite 2B, Conway, AR 72032
Phone: (479) 880-6148
Email: rootedhealthormones@gmail.com
How We May Use and Disclose Your Health Information
We may use and disclose your PHI for the following purposes without your authorization:
Treatment
We may use your PHI to provide, coordinate, or manage your health care and related services, including sharing information with other providers involved in your care.
Payment
We may use and disclose your PHI to obtain payment for services we provide, including billing, collections, and claims submission as applicable.
Health Care Operations
We may use and disclose your PHI for our internal operations, including quality assurance, training, legal compliance, and business management.
As Required by Law
We will disclose your PHI when required by federal, state, or local law, including public health authorities, law enforcement, and judicial proceedings.
Appointment Reminders
We may contact you to remind you of appointments or provide information about treatment alternatives via phone, text, or email.
Uses and Disclosures Requiring Your Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes not described above, including most uses of psychotherapy notes, marketing communications, and sale of your PHI. You have the right to revoke an authorization at any time in writing.
Your Rights Regarding Your Health Information
Right to Access
You have the right to inspect and obtain a copy of your PHI maintained in our records. We may charge a reasonable fee for copies.
Right to Amend
You have the right to request that we amend your PHI if you believe it is inaccurate or incomplete. We may deny your request in certain circumstances.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures of your PHI made by us during the prior six years.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or operations. We are not required to agree, except when the disclosure is to a health plan for payment or operations purposes and you have paid out-of-pocket in full.
Right to Confidential Communications
You have the right to request that we communicate with you by alternative means or at an alternative location if the standard communication would endanger you.
Right to a Paper Copy of This Notice
You have the right to request a paper copy of this notice at any time, even if you have agreed to receive it electronically.
Our Duties
We are required by law to maintain the privacy of your PHI, to provide you with this notice of our legal duties and privacy practices, and to notify you in the event of a breach of your unsecured PHI. We are required to follow the terms of this notice currently in effect. We reserve the right to change this notice and our privacy practices and to make the new provisions effective for all PHI we maintain. Revised notices will be posted in our office and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact:
Privacy Officer: LaDonna Walker, NP
Address: 1120 Hogan Lane, Suite 2B, Conway, AR 72032
Phone: (479) 880-6148
Email: rootedhealthormones@gmail.com
You will not be retaliated against for filing a complaint. To file a complaint with HHS, visit www.hhs.gov/ocr/privacy/hipaa/complaints.
Contact Us
For questions about this notice or your health information privacy rights, please contact us at (479) 880-6148 or rootedhealthormones@gmail.com.