PRIVACY PRACTICES: Janet L. Borges, MSTCM, L.Ac. LLC, dba Thunderbolt Wellness

This document describes how health and medical information about you may be used and disclosed and how you can obtain access to this information. Please review this carefully.

Thunderbolt Wellness prioritizes your individual privacy. This policy puts you, the individual, in control of how your personal health information (PHI) /medical record is processed and saved.

Protected Health Information refers to information in your health record that could identify you. Your health information consists of: Your answers on printed intake forms & at the initial consultation as well as at each subsequent visit to Thunderbolt Wellness, containing dates, symptoms, exam findings, test results, diagnosis, and treatment notes/plan. We obtain this information as accurately and completely as possible, and is recorded by the practitioner, Janet L. Borges, L.Ac. at the time of each patient visit. This health information is your medical record.

Treatment is when we provide, coordinate, or manage your health care and other services related to your health care.

Payment is when we obtain reimbursement from you for your healthcare services.

Health Care Operations are business related activities such as administrative services, case management, and patient care coordination.

Use applies only to activities within Thunderbolt Wellness’ clinical setting. Disclosure applies to activities outside of Thunderbolt Wellness’ clinical setting.

How your PHI is used: As a tool to assess/continue treatment Identification of an issue/problem/disease/area to be treated Identification of a specific individual to be treated. This improves the outcomes of work rendered as the basis for care and treatment, as a means of communication from Thunderbolt Wellness to another provider (with your written consent), as a means of communication from Thunderbolt Wellness to insurance company upon request, and as a legal document to record the care you received, and the dates care was received. This helps know the health information/record is accurate and assists the patient to make more informed decisions when authorizing disclosure to others. For example: as a means by which you or a 3rd party can verify services billed were provided, as a tool for education of other health care professionals providing your care.

Thunderbolt Wellness protects your privacy by: Taking reasonable precautions to protect your personal medical record/health information from loss, misuse, unauthorized use/access, disclosure, alteration, or destruction. Information is kept only for the purposes for which it was gathered. No credit card numbers, driver’s license numbers, or social security numbers will be stored in written files, electronically, or otherwise.

Thunderbolt Wellness responsibilities to you: Maintain privacy of your medical records and your PHI and your physical privacy at Thunderbolt Wellness. Provide you with notices regarding your legal duties and Thunderbolt Wellness privacy practices with respect of the information we collect and maintain about you. Abide by the terms of this Privacy Practices Notice.

Thunderbolt Wellness reserves the right to: Change our practices, make new provisions for all protected medical records and health information maintained. We reserve the right to change our fees for services with reasonable notice at any time.

Should Thunderbolt Wellness’ information change or we move locations, we will mail notification to the designated address we have on file via USPS, or via electronic mail. We will not disclose any of your medical records/health information that Thunderbolt Wellness maintains without your written authorization.
You have the right to: request your PHI by alternative means and alternative locations (e.g., you may request your bill/records be sent to an alternate address). You have the right to request an amendment of your PHI for as long as the PHI is maintained at Thunderbolt Wellness. We may deny your request. You have the right to request details of your financial payment history at any time in writing for services performed at Thunderbolt Wellness.

Uses and Disclosures Requiring Authorization: Although your health record is the property of Thunderbolt Wellness, this information belongs to you, and we may only use or disclose your PHI for purposes outside of your treatment, payment, and our health care operations when your appropriate authorization is obtained. Authorization is written permission above and beyond the general consent that permits only specific disclosures. In the instance that Thunderbolt Wellness is asked for information for purposes outside of treatment, payment, or healthcare operations, we will obtain written authorization from you before releasing your PHI.

We will also need written authorization before releasing your medical records. You may revoke all such authorization at any time, provided each revocation is in writing by you. You may not revoke any authorization to the extent that Thunderbolt Wellness relied on that authorization, if the authorization was obtained as a condition of obtaining insurance reimbursement coverage, and that the law provides the insurer the right to contest the claim under the policy.

Thunderbolt Wellness may use or disclose your PHI without your consent or authorization in the following scenarios:

Serious Threat to Health or Safety: If Thunderbolt Wellness is engaged in professional duties and you communicate an immediate threat to cause serious bodily injury or death to an identifiable or unidentifiable individual or group of people, and if Thunderbolt Wellness believes you have the intent and ability to carry out that threat immediately or imminently, Thunderbolt Wellness must take steps to protect those third parties by warning the potential victim(s),
parents/guardians of potential victim(s) if under the age of 18, and/or notifying a law enforcement officer.

Child Abuse: If Thunderbolt Wellness has reason to suspect that a child is abused or being neglected, Thunderbolt Wellness is required by law to report to the Virginia Department of Social Services.

Adult/Domestic Abuse: If Thunderbolt Wellness has reason to suspect that an adult is abused, neglected, or exploited Thunderbolt Wellness is required by law to immediately report to the Virginia Department of Welfare and Social Services.

Health Oversight: The Virginia Board of Medicine has the power, when necessary, to subpoena relevant records as the focus of an inquiry.

Judicial & Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis/treatment and the PHI thereof, this PHI is privileged under VA state law, and Thunderbolt Wellness will not release information without the express written authorization of you or your legal representative, or by subpoena (which you have been served/along with notice required by law).

However, IF you move to quash the subpoena, Thunderbolt Wellness is required to place your PHI in a sealed envelope and provide it to the clerk of the court of the appropriate jurisdiction so that the court can determine whether your PHI records should be released. The privilege does not apply when you are being evaluated by a third party or the evaluation is court ordered. In this case, you will be informed in advance.

Worker’s Compensation or Other Third Party Claims: Thunderbolt Wellness does not accept third party claims, including Workers Compensation or Personal Injury cases. If you file a worker’s compensation or personal injury claim, we are required by law & upon request to submit your PHI to you, your employer, the insurer, and the certified rehabilitation provider.

Serious Threat to Health of Safety: If Thunderbolt Wellness is engaged in professional duty and you communicate a specific and/or immediate threat to cause serious bodily injury or death, to an identified or unidentified person, and Thunderbolt Wellness believes you have the intent and ability to carry out that threat immediately or imminently, Thunderbolt Wellness must take steps to protect third parties. These precautions may include warning the potential victim(s), or the parent or guardian of the potential victim(s). Notifying a law enforcement officer.

You have the right to: Request restriction on your medical record/health information. Prohibit disclosure of your medical record/health information. Receive confidential communication by alternate means and at alternative locations. (e.g.: you may request your receipt for services to be sent to an alternate address.) Obtain a copy of this Notice of Privacy Practices for Thunderbolt Wellness upon request. Inspect and/or obtain a copy of your medical record upon written request. Right to request an amendment of PHI for as long as the PHI is maintained in the record. We may deny your request.

Right to obtain a paper copy of this notice from Thunderbolt Wellness, even if you agreed to receive the notice electronically. Obtain an accounting of disclosures on your medical record/health information upon written request. Request a copy of your medical records for another office, upon written request. Include any family member or individual as designated to view or communicate with regarding your health information/medical record upon written request. Revoke your authorization to use or disclose your medical record/health information except to the extent action has already been taken.

Thunderbolt Wellness provides reasonable access to your personal information/health record upon patient request, in writing. There is a copy fee for records sent to insurance companies/attorny’s offices/ 3rd parties as allowed by Virginia law.

If you feel Thunderbolt Wellness is in violation of this Privacy Practices Policy at any time, please contact Janet L. Borges directly in writing at: 8401 Patterson Ave., Suite 103, Richmond, VA. 23229. Or you may also send a written complaint to the Secretary of the U. S. Department of Health and Human Services. You have specific rights under the Privacy Rule. This notice has been updated as of January 1, 2025, and will remain in effect until further notice.

Thunderbolt Wellness reserves the right to change the terms of this privacy notice and to make new provisions for all PHI that we maintain. We will provide you with a record of this revised notice by posting this information at the office of Thunderbolt Wellness, or by written electronic notice to the address provided on file.

janet@thunderboltwellness.com
https://thunderboltwellness.com