NOTICE OF PRIVACY PRACTICES
Your Information. Your Rights. Our Responsibilities.
Effective date: January 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. |
WHO THIS NOTICE APPLIES TO
This Notice applies to Total Health and the workforce members who provide services or perform functions on our behalf, to the extent they handle protected health information (PHI). It describes our privacy practices and your rights under federal law, including the Health Insurance Portability and Accountability Act (HIPAA), and applicable New Jersey law. If different laws provide greater privacy protection, we will follow the law that applies.
Practice/legal entity name: Total Health Physical Medicine and Rehabilitation Center
Telephone: 973-377-6327 Email: info@totalhealthnj.com
Mailing address: 171 Ridgedale Ave Suite A Florham Park, NJ 07932
YOUR RIGHTS
You have the following rights regarding your health information. To exercise a right, contact our Privacy Officer using the information above. We may ask you to submit a request in writing and may verify your identity.
Get a copy of your medical record
You may ask to inspect or obtain a paper or electronic copy of your medical record and other health information we maintain about you. We will provide access in the form and format requested if readily producible, or in another mutually agreed readable format. We generally respond within 30 calendar days. If an extension is legally permitted, we will tell you the reason and expected completion date. We may charge a reasonable, cost-based fee where permitted by law. In limited circumstances, we may deny access; if so, we will explain the decision and any review rights.
Ask us to correct your medical record
You may ask us to amend information you believe is inaccurate or incomplete. Submit the request in writing and explain why the amendment is needed. We generally respond within 60 days; a permitted extension may apply. We may deny the request in certain circumstances, such as when we did not create the information or believe it is accurate and complete. If we deny your request, we will explain why in writing and tell you how to submit a statement of disagreement.
Request confidential communications
You may ask us to contact you in a particular way or at a different address, telephone number, or email address. We will accommodate reasonable requests and will not require you to explain the reason. Tell us how or where you can be safely reached.
Ask us to limit what we use or share
You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are not generally required to agree, and we will tell you if we cannot agree. If you pay out of pocket in full for a specific health care item or service, you may ask us not to disclose information about that item or service to your health insurer for payment or health care operations, unless disclosure is required by law.
Get a list of disclosures
You may ask for an accounting of certain disclosures of your health information made during the six years before your request. The accounting does not include, among other exceptions, disclosures for treatment, payment, and health care operations, disclosures you authorized, and certain other disclosures permitted by law. We will provide one accounting in any 12-month period without charge; we may charge a reasonable, cost-based fee for additional requests within that period, after giving you an opportunity to withdraw or modify the request.
Get a paper copy of this notice
You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
Choose someone to act for you
If you have given someone medical power of attorney, or if someone is your legal guardian or otherwise legally authorized to act as your personal representative, that person may exercise your rights and make choices about your health information to the extent allowed by law. We will verify their authority. Special rules may apply to minors and certain sensitive services.
File a complaint
You may complain to us if you believe your privacy rights have been violated. Contact our Privacy Officer using the information listed above. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), at https://www.hhs.gov/hipaa/filing-a-complaint/index.html, or by calling 1-800-368-1019. We will not retaliate against you for filing a complaint.
YOUR CHOICES
For certain health information, you may tell us your preferences about what we share. If you have a clear preference in the situations below, tell us. We will follow your instructions where required by law.
- Sharing information with family members, close friends, or others involved in your care or payment for your care.
- Sharing information in disaster-relief situations.
If you are unable to express your preference, we may share information if we determine it is in your best interest or is needed to lessen a serious and imminent threat to health or safety, as permitted by law.
We will obtain your written authorization for uses or disclosures not described in this notice when HIPAA requires authorization, including most uses and disclosures for marketing, sale of PHI, and most disclosures of psychotherapy notes. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
For treatment
We may use your health information and share it with health care professionals involved in your care, including physicians, therapists, chiropractors, acupuncturists, nurses, and other providers, as appropriate to your treatment. For example, a provider may share information with another provider to coordinate your care.
For payment
We may use and disclose your health information to bill and collect payment from you, an insurance company, or another responsible party. This may include eligibility checks, claims, utilization review, and obtaining payment approval.
For health care operations
We may use and disclose information to operate our practice, improve care, evaluate staff and services, conduct audits, manage compliance, arrange for legal, accounting, or administrative services, and contact you about appointments, treatment options, health-related benefits, or services we offer.
Appointment reminders and health-related communications
We may contact you by telephone, voicemail, text, email, patient portal, or mail about appointments, care instructions, test results, billing, or other health-related matters, subject to applicable law and your reasonable requests for confidential communications. Please tell us if your contact preferences change.
Business associates
We may share information with vendors and service providers that perform services for us, such as billing, electronic health records, IT support, legal services, or secure document storage. These business associates are required by contract and law to safeguard PHI.
Individuals involved in your care
We may share relevant information with a family member, personal representative, or another person you identify as involved in your care or payment, unless you object or another legal restriction applies. We may also share information to notify, or assist in notifying, such people about your location, general condition, or death when permitted by law.
As required or permitted by law
We may use or disclose information when federal, state, or local law requires or permits it, subject to applicable limits and protections.
OTHER PERMITTED OR REQUIRED DISCLOSURES
- Public health and safety: for public health activities, disease reporting, product recalls, adverse-event reporting, and preventing or reducing a serious threat to health or safety, as allowed by law.
- Abuse, neglect, or domestic violence: to an authorized government authority when legally required or permitted.
- Health oversight: to agencies authorized to conduct audits, investigations, inspections, licensure, or other oversight activities.
- Research: for research when the applicable legal requirements are met.
- Legal proceedings: in response to a court or administrative order, or a subpoena or other lawful process when applicable legal requirements are satisfied.
- Law enforcement: for specified law-enforcement purposes and only as permitted by law.
- Workers’ compensation: for workers’ compensation or similar programs as authorized by law.
- Specialized government functions: for certain military, national security, correctional, or protective-services purposes when legally authorized.
- Organ and tissue donation: to organizations involved in procurement, banking, or transplantation when applicable.
- Medical examiners, coroners, and funeral directors: as needed to perform legally authorized duties.
- Disaster relief: to an authorized organization assisting with disaster-relief efforts.
- Required reports: to comply with mandatory reporting duties and other legal obligations.
We will apply additional restrictions where required by law, including any applicable New Jersey confidentiality requirements.
SPECIAL PROTECTIONS AND NEW JERSEY LAW
Some types of information may receive additional protection under federal or New Jersey law, including certain mental health records, HIV/AIDS-related information, genetic information, substance use disorder treatment records, and records relating to minors or specially protected services. Where a more protective law applies, we will follow that law. The rules governing these categories can be fact-specific; this notice does not replace any separate consent or authorization required by law.
We will not disclose specially protected information merely because a general HIPAA permission exists if another applicable law requires a more specific authorization or imposes a stricter limit.
USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION
We will obtain your written authorization before using or disclosing your PHI for purposes that require authorization under applicable law. These include most uses or disclosures for marketing, disclosures that constitute a sale of PHI, and most uses or disclosures of psychotherapy notes. If you authorize a use or disclosure, you may revoke the authorization in writing at any time. Revocation will not affect actions already taken in reliance on the authorization.
We do not use or disclose your health information for purposes beyond those described in this notice unless you authorize it or the law otherwise permits or requires it.
OUR RESPONSIBILITIES
- We are required by law to maintain the privacy and security of your protected health information.
- We must provide you with this notice of our legal duties and privacy practices.
- We must follow the terms of the notice currently in effect.
- We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
- We will not use or disclose your information other than as described here unless you authorize us in writing or the law permits or requires it.
We reserve the right to change our privacy practices and this notice, consistent with applicable law. Changes may apply to all PHI we maintain. The current notice will be available in our office, on our website if applicable, and upon request.
CONTACT US
For questions, to exercise your rights, to request a copy of this notice, or to file a complaint with the practice, contact:
Practice/legal entity name: Total Health Physical Medicine and Rehabilitation Center
Telephone: 973-377-6327 Email: info@totalhealthnj.com
Mailing address: 171 Ridgedale Ave Suite A Florham Park, NJ 07932
You may also contact the U.S. Department of Health and Human Services, Office for Civil Rights, at https://www.hhs.gov/hipaa/filing-a-complaint/index.html or 1-800-368-1019.