CoreBalance Health
Notice of Privacy Practices | Effective January 1, 2025
Our commitment to your privacy
CoreBalance Health is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI), provide you with this notice, and follow the terms described here. We reserve the right to change the terms of this notice and make the new provisions effective for all PHI we maintain. A revised notice will be available upon request and on our website.
How we may use your information
We may use and share your health information for the following purposes without requiring your separate authorization:
- Treatment — To provide, coordinate, or manage your healthcare, including GLP-1, peptide, and hormone therapies, and to communicate with other providers involved in your care.
- Payment — To verify insurance eligibility, submit claims, obtain reimbursement, or determine your responsibility for out-of-pocket costs.
- Health care operations — For quality improvement, training, credentialing, audits, business management, and other operational activities necessary to run our practice.
- Appointment reminders — To contact you about upcoming appointments, lab results, care follow-ups, or health-related communications.
- Treatment alternatives — To inform you about possible treatment options, alternatives, or health-related benefits and services.
- As required by law — In response to court orders, subpoenas, public health reporting requirements, abuse reporting obligations, or law enforcement requests as required by applicable law.
- Health oversight activities — To support audits, inspections, investigations, and licensing activities conducted by health oversight agencies.
- Serious threats to health or safety — To prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Uses requiring your written authorization
We will only use or disclose your PHI for the following purposes with your specific written authorization:
- Most uses and disclosures of psychotherapy notes
- Uses and disclosures of PHI for marketing purposes
- Disclosures that constitute a sale of your PHI
- Any other use or disclosure not described in this notice
You may revoke any written authorization at any time, in writing. Your revocation will not apply to uses or disclosures already made in reliance on your prior authorization.
Your rights regarding your health information
You have the following rights with respect to your protected health information. To exercise any of these rights, please contact our Privacy Officer in writing.
Request to inspect or receive a copy of your health record and billing information in paper or electronic format.
Ask us to amend or correct health information you believe is inaccurate or incomplete. We may deny the request in certain circumstances.
Request a list of certain disclosures we have made of your PHI during the past six years.
Ask us to limit how we use or share your information for treatment, payment, or operations. We are not required to agree, except in limited circumstances.
Request that we contact you only at a specific address, phone number, or by a specific method for privacy reasons.
Request a copy of your health information in a portable electronic format to transmit to another provider or entity.
Breach notification & complaints
We are required by law to notify you if your unsecured PHI is breached. If you believe your privacy rights have been violated, you may file a complaint with CoreBalance Health directly or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you in any way for filing a complaint.
1-800-368-1019 | TTY: 1-800-537-7697 | www.hhs.gov/ocr
Patient Acknowledgment of Receipt
By signing below, I acknowledge that I have received and reviewed CoreBalance Health's Notice of Privacy Practices. I understand how my protected health information may be used and disclosed, and I am aware of my rights under HIPAA.