HIPAA ACKNOWLEDGMENT, FINANCIAL RESPONSIBILITY & SERVICE AGREEMENT

Our Commitment to Your Privacy

At Certified Hearts Mobile Phlebotomy & Testing Services, protecting your privacy is one of our highest priorities. We are committed to maintaining the confidentiality of your personal and medical information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and all applicable federal and Indiana privacy laws.

We understand the importance of trust and are dedicated to safeguarding your Protected Health Information (PHI) through secure administrative, technical, and physical safeguards.

What Information We Collect

We may collect information including:

Name
Date of Birth
Address
Phone Number
Email Address
Government-issued Identification (when required)
Insurance Information (if applicable)
Physician Orders
Laboratory Orders
Medical History related to services provided
Test Results
Payment Information
Appointment Information

How We Protect Your Information

Certified Hearts takes every reasonable precaution to safeguard your Protected Health Information.

Our security measures include:

HIPAA-compliant administrative procedures
Secure electronic records
Encrypted communications when appropriate
Password-protected systems
Secure storage of patient information
Limited employee access to medical records
Employee HIPAA privacy training
Secure disposal of confidential documents
Physical safeguards for all patient records

Your HIPAA Rights

Under HIPAA, you have the right to:

Request access to your medical records
Request corrections to inaccurate information
Receive a copy of your records
Request confidential communications
Request restrictions on certain disclosures
Receive an accounting of disclosures
Obtain a copy of this Privacy Policy
File a complaint without fear of retaliation

Website Privacy

Our website may collect limited technical information including:

IP Address
Browser Type
Device Information
Website Usage Statistics
Cookies (if enabled)

This information helps improve website performance and user experience and is not used to identify your medical information.

Communications

We may contact you regarding:

Appointment reminders
Scheduling updates
Laboratory instructions
Billing questions
Follow-up communication
Customer service requests

Whenever possible, communications containing Protected Health Information will be handled securely.

Third-Party Services

Our website may contain links to third-party websites or use third-party scheduling, payment, or laboratory services.

Certified Hearts is not responsible for the privacy practices of third-party websites or providers.

We encourage users to review their privacy policies separately.

Sharing Your Information

We will never sell your personal or medical information.

Your information may only be shared:

With laboratories processing your specimens
With your healthcare provider
With your written authorization
As required by federal or Indiana law
For public health reporting when legally required
For payment and healthcare operations permitted by HIPAA

All third-party partners are expected to maintain appropriate privacy and security safeguards.