Notice of Privacy Practices

Equinox Health Navigation LLC 

2800 E Enterprise Ave STE 333 

Appleton, WI 54913

Phone: 414-395-5270

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

EFFECTIVE DATE: May 4, 2025

This notice describes the privacy practices of Equinox Health Navigation LLC, including its owners, all workforce members, and any business associates who perform services on our behalf that involve the use or disclosure of Protected Health Information (PHI).

We are committed to protecting the privacy of your health information. We create a record of the care and services you receive to provide quality care and comply with legal requirements.

By law, we are required to:

• Maintain the privacy and security of your PHI.
• Provide you with this notice of our legal duties and privacy practices.
• Follow the terms of the notice currently in effect.
• Notify you promptly following a breach of your unsecured PHI.

The following categories describe different ways we may use and disclose your PHI without your written permission. While not every specific use or disclosure is listed, all fall within one of these categories:

• For Treatment: We may use your PHI to provide, coordinate, or manage your health care. For example, we may disclose PHI to another consultant or physician involved in your care.
• For Payment: We may use and disclose PHI so that the services you receive may be billed to and payment collected from you, an insurance company, or a third party.
• For Health Care Operations: We may use PHI for our practice’s internal operations, such as quality assessment, case management, and business planning. This includes sending you appointment reminders or invoices.
• To Avert a Serious Threat to Health or Safety: We may use or disclose PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
• Required By Law: We will disclose PHI when required to do so by federal, state, or local law.
• Law Enforcement, Lawsuits, and Disputes: We may disclose PHI in response to a court or administrative order, or in response to a subpoena, discovery request, or other lawful process, but only if efforts have been made to tell you about the request or to obtain an order protecting the information.
• Public Health Risks & Health Oversight: We may disclose PHI for public health activities (e.g., reporting abuse or neglect) or to health oversight agencies for activities authorized by law, such as audits and investigations.
• Specialized Government Functions: We may release PHI to authorized federal officials for intelligence, national security activities, or for military/veteran purposes.
• Coroners, Medical Examiners, and Workers' Compensation: We may release PHI to a coroner or medical examiner or as authorized by laws relating to workers' compensation.

The following require your specific written authorization:

1. Psychotherapy Notes: Notes we keep separate from your medical record require your authorization for disclosure, except for limited circumstances like our own use in your treatment, our defense in a legal action, or as required by law.
2. Marketing & Sale of PHI: We will not use or disclose your PHI for marketing purposes (including public reviews) or sell your PHI without your written authorization.
3. Fundraising: We do not currently engage in fundraising. If we were to do so, you would be notified of your right to opt out.

• Right to Request Restrictions: You may ask us not to use or share certain PHI for treatment, payment, or operations. We are not required to agree, except if you pay for a service in full out-of-pocket and ask us not to share that info with your health insurer.
• Right to Confidential Communications: You can ask us to contact you in a specific way (e.g., home phone) or at a specific address. We will accommodate all reasonable requests.
• Right to Inspect and Copy: You have the right to see and get a copy of your medical record. In limited circumstances, we may deny your request; if so, you may request a review of the denial.
• Right to Amend: If you feel your PHI is incorrect or incomplete, you may ask us to amend it. We may say "no" if it is already accurate, but we will explain why in writing within 60 days.
• Right to an Accounting of Disclosures: You can request a list of certain disclosures we have made of your PHI for the six years prior to your request.

Wisconsin law (Chapters 51 and 146) generally requires specific, informed consent for the release of mental health, developmental disability, or alcohol and drug abuse records. Where Wisconsin law is more stringent than HIPAA, we will follow the stricter state standard.

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information above or with the U.S. Dept. of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

We reserve the right to change this notice. The new notice will be available upon request, in our office, and on our website.