HIPAA Privacy Policy

Village Therapeutics KC

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Effective Date: May 13, 2025
Last Updated: May 13, 2025

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OUR COMMITMENT TO YOUR PRIVACY

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At Village Therapeutics KC, we respect your privacy and take protecting your health information seriously. This Notice of Privacy Practices explains how we handle your protected health information (PHI), your rights regarding this information, and our legal obligations.

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SUMMARY OF THIS NOTICE

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• We use your health information primarily to provide and coordinate your care, bill for services, and conduct our business operations

• We may share your information with other healthcare providers, health plans, and business associates as allowed by law

• You have the right to see and obtain a copy of your health records, request corrections, and receive an accounting of disclosures

• You may file a complaint if you believe your privacy rights have been violated

• We are required by law to maintain the privacy and security of your protected health information

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WHAT IS PROTECTED HEALTH INFORMATION?

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Protected Health Information (PHI) is information that identifies you and relates to:

• Your past, present, or future physical or mental health condition

• Healthcare services provided to you

• Payment for healthcare services

This includes information in electronic, paper, or verbal form.

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HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

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Treatment

We may use and share your PHI to provide, coordinate, or manage your healthcare. For example:

• Sharing information with other healthcare providers involved in your care

• Consulting with another provider about your treatment

• Referring you to another healthcare professional

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Payment

We may use and disclose your PHI to obtain payment for services, including:

• Submitting claims to your health insurer

• Verifying insurance coverage

• Collecting outstanding balances

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Healthcare Operations

We may use your PHI to support the business activities of our practice, such as:

• Quality assessment and improvement activities

• Staff training and performance evaluation

• Business planning and management

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Required by Law

We will disclose your PHI when required by federal, state, or local laws.

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Public Health and Safety

We may disclose your PHI to authorized officials in these situations:

• To prevent a serious threat to health or public safety

• For public health activities (disease control, injury prevention)

• To report suspected abuse, neglect, or domestic violence

• For health oversight activities authorized by law

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Emergency Situations

If you experience a medical emergency requiring hospitalization, we may disclose your PHI to facilitate emergency treatment. For example, if you fall ill and require immediate medical attention, we may share relevant medical history with emergency medical personnel.

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Threat to Self or Others

If you present an imminent danger to yourself or others, we may disclose relevant information to appropriate persons to prevent or lessen the threat. For example, if you communicate specific threats of harm to an identifiable person, we may notify that person and/or law enforcement.

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Legal Proceedings and Law Enforcement

We may disclose PHI in response to a court order, subpoena, or other lawful processes, and to law enforcement officials under specific circumstances.

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Other Uses and Disclosures

Other uses and disclosures not described in this notice will be made only with your written authorization, which you may revoke at any time.

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YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

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Right to Access and Obtain Copies

You have the right to inspect and obtain copies of your PHI, including electronic health records if we maintain them. We may charge a reasonable fee for copies. You may request that we send your electronic health records to a third party of your choice.

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Right to Request Amendments

If you believe information in your record is incorrect or incomplete, you have the right to request that we amend it. We may deny your request under certain circumstances, but we'll explain the reason for denial.

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Right to an Accounting of Disclosures

You have the right to request a list of when, to whom, and why we disclosed your PHI for up to six years prior to your request.

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Right to Request Restrictions

You have the right to request limits on how we use or disclose your PHI. We are not required to agree to all restriction requests, but if we do agree, we will comply unless the information is needed for emergency treatment.

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Right to Request Confidential Communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will accommodate all reasonable requests.

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Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.

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Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized for filing a complaint.

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OUR RESPONSIBILITIES

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We are required by law to:

• Maintain the privacy and security of your protected health information

• Provide you with this notice of our legal duties and privacy practices

• Follow the terms of this notice

• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information

• Obtain your written acknowledgment that you have received this notice

• Not use or share your information other than as described here unless you authorize us in writing

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CHANGES TO THIS NOTICE

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We reserve the right to change this notice and make the new notice apply to all PHI we already have, as well as any information we receive in the future. We will post the current notice in our office and on our website. The effective date will be clearly marked at the top of the notice. We will offer you a copy of the current notice each time you register at or are admitted to our facility for treatment.

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ACKNOWLEDGMENT OF RECEIPT

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We will ask you to sign a form acknowledging that you have received this Notice of Privacy Practices. If you choose not to sign, we will document our attempt to obtain your acknowledgment and your reason for declining.

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CONTACTING US

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If you have questions about this notice or would like to exercise your rights, please contact:

Privacy Officer: Rebecca Thomas
Village Therapeutics KC
Address: 7501 College Blvd, Suite 100 Overland Park, KS 66210
Phone: 913-308-5400
Email: rthomas@cmr-kc.com
Website: villagetherapeuticskc.com

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CONTACTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES

To file a complaint with the Department of Health and Human Services Office for Civil Rights, send a letter to:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201

Or call 1-877-696-6775, or visit:
www.hhs.gov/ocr/privacy/hipaa/complaints/

This privacy policy is prominently displayed on our website at www.villagetherapeuticskc.com/privacy and is available in print form at our office. We encourage you to read it carefully and discuss any questions or concerns you may have with our staff.