Hope Integrative Services
NOTICE OF PRIVACY PRACTICES
Effective Date: September 1, 2026
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.
Your health information is private, and no one without a legitimate need to know may have
access to it. Hope Integrative Services (“Practice”) is required by law to maintain the privacy of
your health information and to provide you with a notice of its legal duties and privacy practices.
In the unlikely event that your health information becomes unsecured, Practice will provide you
with prompt notification.
Practice will not use or disclose your health information except as described in this Notice of
Privacy Practices (“Notice”). This Notice applies to all of the medical records generated
during your treatment at Practice.
EXAMPLES OF DISCLOSURE FOR TREATMENT, PAYMENT AND HEALTH
OPERATIONS
The following categories describe the ways that Practice may use and disclose your health
information:
Treatment: Practice will use your health information in the provision and coordination of
your healthcare. We may disclose all or any portion of your medical record information to
your physician, consulting physician(s), nurses and other healthcare providers who have a
legitimate need for such information in the care and continued treatment of the patient. For
example, a healthcare provider treating you for an injury can ask another healthcare provider
about your overall health condition.
Payment: Practice may release medical information about you for the purposes of
determining coverage, billing, claims management, medical data processing and
reimbursement. The information may be released to an insurance company, third-party payor
or other entity (or their authorized representatives) involved in the payment of your medical
bill and may include copies or excerpts of your medical record that are necessary for
payment of your account. For example, to the extent Practice bills for services it provides to
you, a bill sent to a third-party payor may include information that identifies you, your
diagnosis, the procedures and supplies used.
Routine Healthcare Operations: Practice may use and disclose your medical information
during routine health care operations to run our practice, improve your care, and contact you
when necessary. For example, we can use your health information to manage your treatment
and services.
Business Associates: Practice may use and disclose certain health information about you to
its business associates. A business associate is an individual or entity under contract with
Practice to perform or assist Practice in a function or activity that necessitates the use or
disclosure of medical information. Examples of business associates include but are not
limited to, a copy service used by the Clinic to copy medical records, consultants,
independent contractors, accountants, lawyers, medical transcriptionists and third-party
billing companies. Practice requires the business associate to protect the confidentiality of
Hope Integrative Services and your medical information. In addition, Practice requires any subcontractor of Practice’s
business associate to protect the confidentiality of your medical information.
Regulatory Agencies: Practice may disclose your medical information to public health or
legal authorities charged with preventing or controlling disease, injury or disability. For
example, billing practices may be audited by the State Auditor and records are subject to
review by the Secretary of Health and Human Services and his/her authorized
representatives.
Workers’ Compensation: Practice may release medical information about you for workers’
compensation or similar programs that provide benefits for work-related injuries or illnesses.
Military Veterans: Practice may disclose your medical information as required by military
command authorities if you are a member of the armed forces.
Inmates: If you are an inmate of a correctional institution or under the custody of a law
enforcement officer, Practice may release your medical information to the correctional
institution or law enforcement official.
Organ and Tissue Donation Requests: Medical information can be shared with organ
procurement organizations.
Medical Examiner or Funeral Director: Medical information can be shared with a coroner,
medical examiner, or funeral director when an individual dies.
Required by Law: Practice will disclose medical information about you when required to do
so by law, for example, responding to lawsuits and legal actions.
Other Uses:
We will obtain your written authorization before using or disclosing your protected health
information when required by law.
Additional protections apply to substance use disorder treatment records under 42 C.F.R.
Part 2.
You may revoke your authorization in writing at any time, except to the extent we have
already relied upon it.
SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER RECORDS
Some of your protected health information may relate to substance use disorder (SUD)
diagnosis, treatment, or referral for treatment. Federal law (42 C.F.R. Part 2) provides
additional privacy protections for this information.
We may use and disclose substance use disorder records for treatment, payment, and health
care operations as permitted by law. In many situations, we will obtain your written
authorization before using or disclosing this information.
Any use or disclosure of SUD records will be made in compliance with applicable federal
law.
Hope Integrative Services
Restrictions on Legal Proceedings. Federal law generally prohibits the use or disclosure of
substance use disorder treatment records in civil, criminal, administrative, or legislative
proceedings against you unless:
• You provide specific written consent; or
• A court issues an appropriate order after notice and an opportunity to be heard.
This protection applies even when other health information may be legally disclosed.
PATIENT INFORMATION RIGHTS
Although all records concerning your treatment obtained at Practice are the property of Practice,
you have the following rights concerning your medical information:
Right to Confidential Communications: You have the right to receive confidential
communications of your medical information by alternative means or at alternative locations.
For example, you may request that Practice contact you only at work or by mail.
Right to Inspect and Copy: You have the right to inspect and copy your medical
information.
Right to Amend: You have the right to amend your medical information. Any request for
amendment should be submitted to Practice in writing, stating a reason in support of the
amendment.
Right to an Accounting: You have the right to obtain an accounting of the disclosures of
your medical information made during the preceding six (6) year period.
Right to Request Restrictions: You have the right to request restrictions on certain uses and
disclosures of your medical information. Practice is not required to honor your request
except where: (i) the disclosure is for the purpose of carrying out payment or healthcare
operations and is not otherwise required by law, and (ii) the medical information pertains
solely to a healthcare item or service for which you, or person other than the health plan on
your behalf, has paid Practice in full.
Right to Receive a Paper Copy: You have the right to receive a paper copy of this Notice.
Right to Receive Electronic Copies: You have the right to receive electronic copies of
your medical information.
Right to 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.
Right to Revoke Authorization: You have the right to revoke your authorization to use or
disclose your medical information, except to the extent that action has already been taken
in reliance on your authorization.
A request to exercise any of these rights must be
submitted, in writing, to Practice at PMB 177, 5119 Calhoun Memorial Hwy, Easley, SC
29642, or by contacting Practice at 864-770-9707.
Redisclosure Notice: Information disclosed pursuant to the HIPAA Privacy Rule may be
subject to redisclosure by the recipient and may no longer be protected by federal privacy
laws. However, substance use disorder records disclosed pursuant to 42 C.F.R. Part 2
Hope Integrative Services
remain subject to federal confidentiality protections and generally may not be redisclosed
unless permitted by law.
STATE LAWS MORE RESTRICTIVE THAN HIPAA
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions and would like additional information, you may contact our office at 864-
770-9707. If you believe your privacy rights have been violated, you may file a complaint with
us by calling 864-770-9707 and with the U.S. Department of Health and Human Services Office
for Civil Rights by calling 1-800-368-1019, visiting
https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf, emailing OCRComplaint@hhs.gov, or
sending a letter to:
Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
We will not retaliate against you for filing a complaint.
CHANGES TO THIS NOTICE
Practice will abide by the terms of the Notice currently in effect. Practice reserves the right to
change the terms of its Notice and to make the new Notice provisions effective for all health
information that it maintains. An updated version of the Notice may be obtained at Practice.