Notice of Privacy Practices
Effective Date: March 2026
Last Updated: March 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.
Momentum Wellness PLLC ("Momentum Wellness," "we," "our," or "us") is committed to protecting the privacy of your protected health information ("PHI"). This Notice describes how we may use and disclose your PHI and explains your rights regarding that information.
1. Our Responsibilities
We are required by law to:
- Maintain the privacy and security of your protected health information.
- Provide you with this Notice of our legal duties and privacy practices.
- Follow the terms of the Notice currently in effect.
- Notify you if a breach occurs that may have compromised the privacy or security of your information, when required by law.
2. How We May Use and Disclose Your Health Information
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your care and related services. For example, we may review your intake forms, communicate with you regarding treatment, send prescriptions to a pharmacy, review laboratory results, and coordinate with other healthcare providers involved in your care.
Payment
We may use and disclose your PHI to obtain payment for services we provide. For example, we may use information to verify charges, process payments, maintain billing records, and support payment operations.
Healthcare Operations
We may use and disclose your PHI for healthcare operations, including quality assessment, care coordination, credentialing, legal compliance, auditing, training, business planning, and administrative activities necessary to run our practice.
Business Associates
We may share PHI with third-party service providers that perform functions on our behalf, such as secure technology vendors, patient portal providers, communications providers, billing vendors, and other business associates, as permitted by law and subject to appropriate safeguards.
Pharmacies and Laboratories
We may disclose PHI to pharmacies, laboratories, and related clinical vendors when necessary to process prescriptions, coordinate services, perform testing, or support treatment and monitoring.
As Required by Law
We may disclose PHI when required to do so by federal, state, or local law.
Public Health and Safety
We may disclose PHI for public health activities, to report adverse events, prevent or reduce serious threats to health or safety, or comply with oversight by regulatory agencies.
Health Oversight Activities
We may disclose PHI to health oversight agencies for audits, inspections, investigations, licensure matters, and other oversight activities authorized by law.
Judicial and Administrative Proceedings
We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process when permitted or required by law.
Law Enforcement
We may disclose PHI to law enforcement officials in certain circumstances permitted or required by law.
Research, Organ Donation, Workers’ Compensation, and Other Specialized Uses
We may disclose PHI for certain specialized purposes when permitted by law, including certain research activities, workers’ compensation matters, and other legally authorized purposes.
3. Uses and Disclosures Requiring Your Authorization
We will obtain your written authorization for uses and disclosures not otherwise permitted or required by law, except as allowed by HIPAA. You may revoke a written authorization at any time in writing, subject to the extent we have already acted in reliance on it.
4. Your Rights
Right to Access
You have the right to inspect and obtain a copy of certain PHI that we maintain about you, subject to limited exceptions allowed by law.
Right to Amend
You may request that we amend certain PHI if you believe it is incorrect or incomplete. We may deny the request in certain cases as permitted by law.
Right to Request Restrictions
You may request restrictions on certain uses or disclosures of your PHI. We are not required to agree to every requested restriction, except where required by law.
Right to Request Confidential Communications
You may request that we communicate with you in a certain way or at a certain location.
Right to an Accounting of Disclosures
You may request an accounting of certain disclosures of your PHI made by us, as provided by law.
Right to a Paper Copy of This Notice
You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
5. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us and/or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
6. Changes to This Notice
We reserve the right to change this Notice and make the revised Notice effective for PHI we already have as well as any information we receive in the future. Updated versions will be posted on this page with a revised effective date.
7. Contact Information
Momentum Wellness PLLC
Privacy Contact: [Name or Title]
Email: drobrien@momentumwellnessmd.com
Website: www.momentumwellnessmd.com