ACCOMPLISHED HEALTH AND WELLNESS

2721 W. 6th St, Suite E | Lawrence, KS 66049 | (785) 200-3535

Effective Date: May 7, 2026

NOTICE OF PRIVACY PRACTICES

As Required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GAIN ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.

 

A. OUR COMMITMENT TO YOUR PRIVACY

Accomplished Health and Wellness is dedicated to maintaining the privacy of your individually identifiable health information (IIHI), including electronic protected health information (ePHI). In conducting our business, we create records regarding you and the treatment and services we provide. We are required by law to maintain the confidentiality of health information that identifies you and to provide you with this Notice of Privacy Practices.

We reserve the right to revise or amend this Notice. Any revision will be effective for all records our practice has created or maintained in the past and any records we may create in the future. Our current Notice is always posted in our office and on our website, and you may request a copy at any time.

 

B. QUESTIONS ABOUT THIS NOTICE

If you have questions about this Notice or our privacy practices, please contact:

Accomplished Health and Wellness

Attn: Privacy Officer

2721 W. 6th St, Suite E

Lawrence, KS 66049

Phone: (785) 200-3535

 

C. TECHNOLOGY PLATFORMS AND ELECTRONIC HEALTH INFORMATION

Accomplished Health and Wellness uses the following HIPAA-compliant technology platforms to manage your health information:

Electronic Health Records (EHR)

We use AtlasMD, a HIPAA-compliant electronic health record platform designed specifically for direct primary care practices, to store and manage your medical records, billing information, and clinical notes. AtlasMD operates under a Business Associate Agreement (BAA) with our practice.

Telehealth Services

We offer virtual visits through Doxy.me, a HIPAA-compliant telehealth platform. During telehealth visits, your protected health information may be transmitted electronically. Doxy.me does not record or store your visit without your explicit consent. Doxy.me operates under a BAA with our practice.

Telehealth services are subject to applicable state laws in the state where you are located at the time of your visit. By participating in a telehealth visit, you consent to the electronic transmission of your health information for treatment purposes.

Virtual Scribe Services

In the future, Accomplished Health and Wellness may utilize virtual medical scribe services to assist with clinical documentation during patient encounters. Any virtual scribe service we engage will be HIPAA-compliant and will operate under a signed Business Associate Agreement with our practice. Virtual scribes are bound by the same confidentiality obligations as our clinical staff and will only access your health information for the purpose of accurate clinical documentation. We will update this Notice when virtual scribe services are implemented.

Electronic Communications

If you communicate with our practice electronically (such as through our patient portal or secure messaging), please be aware that standard email is not a secure form of communication. We encourage you to use our designated secure communication channels for any health-related inquiries. Our website contact form is not intended for the transmission of protected health information.

 

D. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following categories describe the ways in which we may use and disclose your IIHI:

1. Treatment

We may use your IIHI to treat you, including ordering laboratory tests, writing prescriptions, coordinating care with other providers, and documenting clinical encounters. This includes both in-person and telehealth visits.

2. Payment

We may use and disclose your IIHI to collect payment for services, including membership fees and direct-pay services. As a direct primary care practice, we do not bill insurance on your behalf, but may provide documentation (such as a superbill) to assist you in seeking reimbursement.

3. Health Care Operations

We may use and disclose your IIHI to operate our practice, including quality improvement, staff training, credentialing, legal services, and compliance activities.

4. Appointment Reminders

We may contact you to remind you of appointments, including via phone, text, or secure electronic message.

5. Treatment Options and Health Benefits

We may use your IIHI to inform you of treatment alternatives or health-related services that may be of interest to you.

6. Release to Family and Friends

We may release your IIHI to a friend or family member involved in your care, unless you object or restrict this disclosure.

7. Disclosures Required by Law

We will disclose your IIHI when required to do so by federal, state, or local law.

 

E. SPECIAL CIRCUMSTANCES FOR USE AND DISCLOSURE

1. Public Health Risks

We may disclose your IIHI to public health authorities that are authorized by law to collect information for the purpose of:

• Maintaining vital records, such as births and deaths

• Reporting child abuse or neglect

• Preventing or controlling disease, injury, or disability

• Notifying a person regarding potential exposure to a communicable disease

• Notifying a person regarding a potential risk for spreading or contracting a disease or condition

• Reporting reactions to drugs or problems with products or devices

• Notifying individuals if a product or device they may be using has been recalled

• Notifying appropriate government agencies regarding the potential abuse or neglect of an adult patient, including domestic violence — we will only disclose this information if the patient agrees or we are required or authorized by law to do so

• Notifying your employer under limited circumstances related primarily to workplace injury, illness, or medical surveillance

2. Health Oversight Activities

We may disclose your IIHI to health oversight agencies for legally authorized activities such as audits, investigations, and licensure actions.

3. Lawsuits and Legal Proceedings

We may disclose your IIHI in response to a court order, subpoena, or other lawful legal process, provided we make reasonable efforts to notify you.

4. Law Enforcement

We may release IIHI if asked to do so by a law enforcement official in the following circumstances:

• Regarding a crime victim in certain situations, if we are unable to obtain the person's agreement

• Concerning a death we believe has resulted from criminal conduct

• Regarding criminal conduct at our offices

• In response to a warrant, summons, court order, subpoena, or similar legal process

• To identify or locate a suspect, material witness, fugitive, or missing person

• In an emergency, to report a crime, including the location or victim(s) of the crime, or the description, identity, or location of the perpetrator

5. Deceased Patients

We may release IIHI to a medical examiner, coroner, or funeral director as necessary and permitted by law.

6. Organ and Tissue Donation

We may release your IIHI to organ procurement organizations if you are an organ donor.

7. Research

We may use your IIHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your IIHI for research purposes except when:

• Our use or disclosure was approved by an Institutional Review Board or a Privacy Board

• We obtain the oral or written agreement of a researcher that (i) the information being sought is necessary for the research study; (ii) the use or disclosure of your IIHI is being used only for the research; and (iii) the researcher will not remove any of your IIHI from our practice

• The IIHI sought relates only to decedents and the researcher agrees either orally or in writing that the use or disclosure is necessary for the research and, if we request it, provides proof of death prior to access to the IIHI

8. Serious Threats to Health or Safety

We may disclose your IIHI when necessary to prevent a serious and imminent threat to your health, safety, or the health and safety of others.

9. Military

Our practice may disclose your IIHI if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military authorities.

10. National Security

Our practice may disclose your IIHI to federal officials for intelligence and national security activities authorized by law. We may also disclose your IIHI to federal officials in order to protect the President, other officials, or foreign heads of state, or to conduct investigations.

11. Inmates

Our practice may disclose your IIHI to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you; (b) for the safety and security of the institution; and/or (c) to protect your health and safety or the health and safety of other individuals.

10. Workers' Compensation

We may release your IIHI for workers' compensation or similar programs as authorized by law.

 

F. BREACH NOTIFICATION

In the event of a breach of your unsecured protected health information, Accomplished Health and Wellness will notify you as required by the HITECH Act and HIPAA Breach Notification Rule. Notification will be provided without unreasonable delay and no later than 60 days after discovery of the breach.

Notification will include: a description of what occurred, the type of information involved, steps you should take to protect yourself, what we are doing to investigate and mitigate the breach, and contact information for questions.

If the breach affects 500 or more individuals, we will also notify the Secretary of Health and Human Services and, where required, prominent media outlets.

 

G. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

Your health and billing records are the physical property of Accomplished Health and Wellness. The information in them belongs to you. You have the following rights:

1. Confidential Communications

You may request that we contact you in a specific manner or at a specific location (e.g., home rather than work). Submit your request in writing to the Privacy Officer.

2. Requesting Restrictions

You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment, or health care operations. You also have the right to request that we restrict disclosure of your IIHI to only certain individuals involved in your care or the payment for your care. We are not required to agree to your request; however, if we do agree, we are bound by that agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. To request a restriction, submit your request in writing to the Privacy Officer. Your request must clearly describe:

• The information you wish restricted

• Whether you are requesting to limit our practice's use, disclosure, or both

• To whom you want the limits to apply

3. Inspection and Copies

You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to the Privacy Officer. Our practice may charge a fee for the costs of copying, mailing, labor, and supplies associated with your request.

Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct that review.

4. Amendment

You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to the Privacy Officer with a reason that supports your request.

Our practice may deny your request if you ask us to amend information that is in our opinion:

• Accurate and complete

• Not part of the IIHI kept by or for the practice

• Not part of the IIHI which you would be permitted to inspect and copy

• Not created by our practice, unless the individual or entity that created it is not available to amend the information

5. Accounting of Disclosures

All patients have the right to request an 'accounting of disclosures' — a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment or non-operations purposes. Use of your IIHI as part of routine patient care is not required to be documented in this accounting (for example, a doctor sharing information with a nurse).

To obtain an accounting of disclosures, submit your request in writing to the Privacy Officer. All requests must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge. Our practice may charge you for additional lists within the same 12-month period. We will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

6. Right to a Paper Copy of This Notice

You may request a paper copy of this Notice at any time by contacting the Privacy Officer.

7. Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services. Contact our Privacy Officer at the address above. You will not be penalized for filing a complaint.

8. Right to Authorize Other Uses and Disclosures

We will obtain your written authorization for uses and disclosures not described in this Notice. You may revoke your authorization at any time in writing, after which we will no longer use or disclose your IIHI for those purposes, except where we are required to retain records of your care.

 

Last Updated: May 7, 2026

Accomplished Health and Wellness LLC

A signed acknowledgment is obtained separately at the time of patient intake.