Your Information. Your Rights. Our Responsibilities.
Empower Health Services, LLC (EHS) is committed to protecting the privacy of your health information. EHS has policies and safeguards in place
to protect your information. We are required by law to maintain the privacy and security of your protected health information and to provide
you with this Notice of Privacy Practices (Notice). 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.
How is your health information used?
The confidential health information that we collect as we provide Health and Wellness or Immunization Services is called “Protected Health
Information” or “PHI.” We may use or disclose your PHI for treatment, payment or health care operations. As an example, we may provide you
with your health screening results, or use your PHI to collect payment or verify your insurance.
In addition, we would use your PHI for our health care operations, including, but not limited to, evaluating and improving the quality of our services. We routinely use your PHI for these purposes without any special permission. Except as otherwise described in this Notice, we can only share your PHI with your approval when you sign a valid authorization. You may cancel such authorization at any time unless we have already acted in reliance on it. We do NOT use or disclose your PHI for marketing purposes and we do NOT sell PHI.
How else can we use or share your health information?
We are allowed or required to share your PHI in other ways – usually in ways that contribute to the public good, such as public health and
research. We must meet many conditions in the law before we can share your information for these purposes. For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html. By way of example, we can share information about you without
your authorization if state or federal laws require it, in response to a court or administrative order, or in response to a subpoena, or through our
contracts with business associates acting on our behalf – but if we do so, we require our business associates to take all necessary steps to protect
your privacy, except as required by law.
You have the following rights regarding the use and disclosure of your PHI:
To contact us in the future.
If you wish to obtain or see a copy of your PHI, see an accounting of any disclosures we have made, wish to ask to amend your PHI, wish to
revoke your authorization, or have questions or would like to make any other permissible requests related to your PHI, please contact EHS
Privacy Officer at 1-866-367-6974.
The privacy of your PHI is important to us. We welcome your questions and comments for our continuous improvement. Additional information or if you believe your privacy has not been protected.
If you believe that your privacy has not been protected, you believe there has been a breach of the security of your PHI, or you wish to have
additional information, please contact EHS at 1-866-367-6974. You can also file a complaint with the U.S. Department of Health and Human
Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, or visiting
www.hhs.gov/ocr/privacy/hipaa/complaints/. You will not be retaliated against for filing a complaint.
Changes to the Terms of this Notice
EHS reserves the right to change the terms of this Notice, and the changes will apply to all PHI we may have about you. The new Notice will be available upon request and on our web site at empowerhealthservices.com/privacypolicy .