Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
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 say “yes” to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us at 574-293-0052
- You can 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, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/what-to-expect/index.html
- We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to
- Share information with your family, close friends, or others involved in your care.
- Share information in a disaster relief situation.
- Include your information in a hospital directory.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also shareyour information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission
- Marketing purposes.
- Sale of your information.
- Most sharing of psychotherapy notes.
- Other disclosures not described in this notice.
In the case of fundraising
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses & Disclosures
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
- Treat you. We can use your health information and share it with other professionals who are treating you.
- Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary.
- Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities.
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease.
- Helping with product recalls.
- Reporting adverse reactions to medications.
- Reporting suspected abuse, neglect, or domestic violence.
- Preventing or reducing a serious threat to anyone’s health or safety.
Do research
- We can use or share your information for health research.
Comply with the law
- We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
- We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
- We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
- We can use or share health information about you: For workers’ compensation claims.
- For law enforcement purposes or with a law enforcement official in the following circumstances
- If you have incurred certain injuries or wounds that are legally required to be reported.
- In response to a court order, subpoena, warrant, summons, investigative demand, or similar process.
- To identify or locate a suspect, fugitive, material witness, or missing person.
- About the victim of a crime if under certain limited circumstances.
- About a suspicious death that we believe may be the result of criminal conduct.
- About criminal conduct on our premises and in emergency circumstances to report a crime, its location, or information about the person who may have committed the crime.
- With health oversight agencies for activities authorized by law.
- For special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions
- We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Health Oversight Activities
- If you are an inmate of a correctional facility or under the custody of a law enforcement official, we may disclose your health information to the correctional institution or law enforcement official in order to provide you with medical services, protect you or others, or to ensure the safety of the correctional facility.
- We may disclose health information to a health oversight agency authorized by law for audits, investigations, inspections, and licensure. Health oversight agencies generally oversee the health care system, government health programs (such as Medicare and Medicaid), and the enforcement of civil rights laws.
Re-disclosure of PHI
PHI disclosed to a third party pursuant to the HIPAA Privacy Rule may be subject to re-disclosure and no longer protected by the HIPAA Privacy Rule.
HIPAA Privacy Rule to Support Reproductive Health Care Privacy
Heart City Health will not disclose PHI related to lawful reproductive health care to conduct a criminal, civil, or administrative investigation into or impose criminal, civil, or administrative liability on any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care, where such health care is lawful under the circumstances in which it is provided. HCH will also not disclose the identification of any person for the purpose of conducting such an investigation or imposing such liability.
Heart City Health will disclose PHI to defend in an investigation or proceeding related to professional misconduct or negligence where the alleged professional misconduct or negligence involved the provision of reproductive health care. HCH will disclose PHI to defend any person in a criminal, civil, or administrative proceeding where liability could be imposed on that person for providing reproductive healthcare.
Heart City Health must receive a valid attestation before using or disclosing your health information potentially related to reproductive health care for health oversight activities, judicial or administrative proceedings, law enforcement purposes, or to coroners and medical examiners.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/privacy-practices-for-protected-health-information/index.html
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Effective Date: October 6, 2025
This Notice of Privacy Practices applies to the following organizations.
Heart City Health is part of an Organized Health Care Arrangement (OHCA) including participants in the Clinically Integrated Network of Indiana (CINI). A current list of CINI participants is available at www.cinindiana.com. As a business associate of Heart City Health, CINI supplies information technology and related services to Heart City Health and other CINI participants. CINI also engages in quality assessment and improvement activities on behalf of its participants. For example, CINI coordinates clinical review activities on behalf of participating organizations to establish the best practice standards and assess clinical benefits that may be derived from the use of electronic health record systems. CINI also helps participants work collaboratively to improve the management of internal and external patient referrals. Your personal health information may be shared by Heart City Health with other CINI participants or a health information exchange only when necessary for medical treatment or for the health care operations purposes of the organized health care arrangement. Health care operation can include, among other things, geocoding your residence location to improve the clinical benefits you receive.