Notice of Privacy Practices

This notice describes how your health information may be used and disclosed and how you can obtain access to this information. Please review it carefully.



At Patient Advocacy Initiative Wellness Group, LLC, (DBA: PAI Wellness Group) we value your relationship with us, and we know that respect for your privacy is the foundation of that relationship. We are committed to protecting the privacy of your Protected Health Information (PHI) that is in our possession, and only using and disclosing your PHI as necessary to providing you with healthcare products and services. PHI is any information that we possess, use, and disclose that identifies you and relates to your past, current, or future physical and mental health condition and the health care products and services that have been provided to you.

Uses and Disclosures

At PAI Wellness Group, LLC, we have and always will respect your privacy and will keep your health information secure and confidential. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) law requires us to continue maintaining your privacy, to give you this notice and to follow the terms of this notice.

The law permits us to use or disclose your health information to those involved in your treatment. For example, reviews of your file by a primary care physician or specialist physician whom we may involve in your care.

We may use or disclose your health information for payment of your services. For example, we may send a report of your progress to your insurance company.

We may use or disclose your health information for our normal healthcare operations. For example, one of our staff will enter your information into our computer.

We may share your medical information with our business associates, such as a billing service. We have a written contract with each business associate that requires them to protect your privacy.

We may use your information to contact you. For example, we may send newsletters or other healthcare- related information. We may also want to call and remind you about your appointments. If you are not home, we may leave this information on your answering machine or with the person who answers the telephone.

In an emergency, we may disclose your health information to a family member or another person responsible for your care.

We may release some or all of your health information when required by law.
If this practice is sold, your information will become the property of the new owner.

Except as described above, this practice will not use or disclose your health information without your prior written authorization.

You may request in writing that we not use or disclose your health information as described above. We will let you know if we can fulfill your request.

You have the right to know of any uses or disclosures we make with your health information beyond the above normal uses.

As we will need to contact you from time to time, we will use whatever address or telephone number you prefer.

You have the right to transfer copies of your health information to another practice. We will mail your files for you.

You have the right to see and receive a copy of your health information, with a few exceptions. Provide a written request regarding the information you want to see. If you also would like an additional copy of your records, we may charge you a reasonable fee for the copies.

You have the right to request an amendment or change to your health information. Give us your request to make changes in writing. If you wish to include a statement in your file, please give it to us in writing. We may or may not make the changes you request, but will be happy to include your statement in your file. If we agree to an amendment or change, we will not remove nor alter earlier documents, but will add new information.

Our Duties

We are required by law to maintain the privacy of your health information. We are also required to provide you with this notice or our legal duties and our privacy practices with respect to your health information. We must abide by the terms in this notice while it is in effect. However, we reserve the right to change the terms of our privacy notices. If we make a change in our privacy terms the change will apply for all of your health information in our files.

For more Information or to Report a Problem

For more information or assistance regarding your health information privacy, please contact our Privacy Officer, Asha Bohannon, at (919) 529-3355.

If you believe your rights have been violated, you can either file a complaint with this office or with the Office of Civil Rights, U.S. Department of Health and Human Services (OCR). There will be no retaliation for filing a complaint with either our practice or the OCR.

The address for the OCR regional office for North Carolina is as follows:
Office for Civil Rights U.S. Department of Health and Human Services

Atlanta Federal Center, Suite 16T70 61 Forsyth Street, S.W. Atlanta, GA 30303-8909. This notice goes into effect as of April 14, 2003.