HIPAA Notice of Privacy Practices
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.
Our Commitment to Your Privacy
Life Smart Medical Center, PLLC ("we," "us," or "our") is required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this notice of our legal duties and privacy practices, and to notify you in the event of a breach of your unsecured PHI.
We are required to follow the terms of this notice currently in effect. We reserve the right to change the terms of this notice and to make new provisions effective for all PHI we maintain. If we make a material change, we will post the revised notice in our office and on our website.
How We May Use and Disclose Your Health Information
The following categories describe the ways we may use and disclose your health information without your written authorization.
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare. For example, we may share information with another physician we refer you to, or with the pharmacy that fills your prescriptions.
Payment
We may use and disclose your PHI to obtain payment for services we provide to you. This includes billing your insurance company, verifying coverage, and processing claims.
Healthcare Operations
We may use and disclose your PHI for our healthcare operations, including quality assessment, staff training, licensing, and general administrative activities.
Other Permitted or Required Uses
- As required by law — such as reporting to public health authorities for disease prevention or control.
- For health oversight activities — including audits and investigations by government agencies.
- For judicial and administrative proceedings — in response to a court order or subpoena.
- For law enforcement purposes — under limited circumstances required by law.
- To avert a serious threat to health or safety — of you, another person, or the public.
- For workers' compensation — as authorized by applicable law.
- To coroners, medical examiners, and funeral directors — as necessary to carry out their duties.
Uses That Require Your Written Authorization
Other than as described above, we will not use or disclose your health information without your written authorization. Examples include:
- Most uses and disclosures of psychotherapy notes (where applicable)
- Marketing communications
- Sale of your PHI
You may revoke an authorization at any time in writing, except to the extent we have already acted upon it.
Your Rights Regarding Your Health Information
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your medical record and billing records, with limited exceptions. Requests must be made in writing to our office, and we may charge a reasonable, cost-based fee for copies.
Right to Amend
If you believe information in your record is incorrect or incomplete, you may request that we amend it. We may deny your request in certain circumstances, and any denial will be provided in writing with an explanation.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures we have made of your PHI for purposes other than treatment, payment, and healthcare operations, generally within the six years prior to your request.
Right to Request Restrictions
You may request that we restrict how we use or disclose your PHI for treatment, payment, or operations, or to family members involved in your care. We are not required to agree to all requests, but we must comply with a request to restrict disclosure to a health plan if the disclosure is for payment or operations and relates to a service you paid for in full out-of-pocket.
Right to Request Confidential Communications
You may request that we communicate with you about medical matters in a certain way or at a certain location — for example, only by mail or only at your work number. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You have the right to obtain a paper copy of this notice at any time, even if you previously agreed to receive it electronically. Ask any member of our staff for a printed copy.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing — and you may change your mind at any time by letting us know in writing.
Contact Information
If you have questions about this notice, would like to exercise any of the rights described above, or wish to file a complaint, please contact us:
- Life Smart Medical Center, PLLC
- 2176 Fort Street, Suite 2, Lincoln Park, MI 48146
- Phone: (313) 768-5096
- Fax: (877) 409-3290
- Email: info@lifesmartmed.com
This notice was last reviewed and updated on January 1, 2026. A copy of the current notice is always available at this page and posted in our office.