I Live Well IV, LLC.

Privacy Practices Notification

Last updated: January 22, 2024

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This document outlines the procedures related to the use and disclosure of medical information, referred to as Protected Health Information (PHI), by I Live Well IV, LLC. and its affiliates, including affiliated professional entities and Asklepios, along with their physicians, healthcare practitioners, and personnel (referred to as "we" or "us").

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I. Identity and Privacy Responsibilities

This Privacy Practices Notification ("Notice") identifies I Live Well IV, LLC. and its affiliates, outlining their privacy practices concerning PHI.

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II. Privacy Obligations

As mandated by law, we are obligated to uphold the privacy of your health information (PHI) and provide you with details about our legal duties and privacy practices. In case of a Breach of unsecured PHI, we are committed to notifying you. All uses or disclosures of PHI must adhere to the terms outlined in this Notice or any other notice in effect at the time.

 

III. Permissible Uses and Disclosures Without Authorization

Certain situations outlined in Section IV necessitate obtaining your written authorization. However, for the following uses and disclosures, no authorization is required:

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A. Treatment, Payment, and Health Care Operations: We may use and disclose PHI for treatment, obtaining payment, and conducting healthcare operations.

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• Treatment: To diagnose and treat injuries or illnesses.

• Payment: To obtain payment for provided services.

• Healthcare Operations: Internal administration, planning, quality assessment, and improvement.

 

B. Disclosure to Relatives, Close Friends, and Caregivers: We may disclose PHI to individuals identified by you or in emergency circumstances.

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C. Public Health Activities: PHI may be disclosed for public health activities, such as disease control or reporting child abuse.

 

D. Victims of Abuse, Neglect, or Domestic Violence: If we believe you are a victim, PHI may be disclosed to governmental authorities.

 

E. Health Oversight Activities: Disclosure to health oversight agencies ensuring compliance with government health programs.

 

F. Judicial and Administrative Proceedings: PHI may be disclosed in response to legal orders or processes.

 

G. Law Enforcement Officers: PHI may be disclosed to law enforcement officials as required or permitted by law.

 

H. Decedents: PHI may be disclosed to coroners, medical examiners, or funeral directors as authorized by law.

 

I. Research: PHI may be used or disclosed with approval from an Institutional Review Board or Privacy Board.

 

J. Health or Safety: PHI may be disclosed to prevent or lessen a serious threat to health or safety.

 

K. Specialized Government Functions: PHI may be disclosed to government units with special functions.

 

L. Workers' Compensation: PHI may be disclosed as authorized by state law relating to workers' compensation.

 

M. As Required By Law: PHI may be used and disclosed when required by any other applicable law.

 

IV. Uses and Disclosures Requiring Written Authorization

 

A. Use or Disclosure with Your Authorization: Written authorization is required for marketing purposes and disclosures constituting the sale of PHI. Other uses and disclosures not described in this Notice require your written permission.

 

B. Highly Confidential Information: Special privacy protections apply to Highly Confidential Information, requiring your authorization for disclosure.

 

C. Revocation of Your Authorization: You may withdraw your Authorization for Highly Confidential Information by delivering a written statement to the Privacy Officer.

 

V. Your Rights Regarding Your Protected Health Information

 

A. For Further Information and Complaints: Contact our Compliance and Privacy Officer for information about your privacy rights or to file a complaint.

 

B. Right to Request Additional Restrictions: You have the right to request restrictions on the uses and disclosures of your PHI.

 

C. Right to Receive Confidential Communications: You may request alternative means of receiving your PHI.

 

VI. Effective Date and Duration of This Notice

 

A. Effective Date: This Notice is effective on Jan 22, 2024.

 

B. Right to Change Terms: We may change the terms of this Notice at any time and will post the updated notice on our website.

 

VII. Privacy Officer

Contact the Privacy Officer at:

I Live Well IV, LLC. ATTN: Privacy Officer Email: Info@ilivewelliv.com