During your treatment by healthcare professionals utilizing the Empower GIA platform, information will be gathered about your medical history and current health condition to provide you with services. This information is known as PHI and includes personal identifying information such as your name, date of birth, contact information such as your full name, email address, phone number, and mailing address, as well as personal health information including your medical conditions and diagnoses, general health, prescriptions, previous treatments, and health insurance information. PHI also includes your username and password, payment information including detailed credit card information, billing, and any other information you provide to Empower GIA.
Your interactions with the healthcare professionals via the Service are not intended to take the place of your relationship with your regular health care practitioners. Neither Empower GIA, nor any of its subsidiaries or affiliates or any third party who may promote the Service or provide a link to the Service, shall be liable for any professional advice obtained from a health care professional via the Service or for any other information obtained on the website. Empower GIA does not endorse any specific tests, physicians, healthcare professionals, medications, products, or procedures that are recommended by healthcare professionals that may use Empower GIA to communicate with you. You acknowledge that your reliance on any healthcare professionals or information provided by the healthcare professionals via the Service is solely at your own risk and you assume full responsibility for all risk associated herewith.
Empower GIA does not make any representations or warranties about the training or skill of any healthcare professionals who provide services via the Service. You will be provided with a list of available healthcare professionals located in the U. S. based solely on the information you, your employer or your plan sponsor provides to Empower GIA. You are ultimately responsible for choosing your healthcare provider.
Telemedicine consent for all users of Empower GIA who book telemedicine/video appointments with independent healthcare professionals on Empower GIA:
- By scheduling telemedicine/video appointments with healthcare professionals utilizing the Empower GIA platform for telemedicine services, I am authorizing the healthcare professionals to provide me with their observations and treatment recommendations regarding my medical condition using telemedicine.
- I understand that an independent healthcare professional wishes to engage with me in a telemedicine consultation using the Empower GIA telemedicine platform.
- I understand that the use of telemedicine involves the electronic communication of my protected health information. I understand that Empower GIA, a subsidiary of Hadera Health which is headquartered in Georgia, is a telehealth and appointment booking platform used by independent healthcare professionals throughout the United States of America.
- I understand that independent healthcare professionals will not perform an in-person physical examination during the telemedicine consultation. They will exclusively rely on the information telecommunicated during the telemedicine consultation.
- I understand how the videoconferencing technology used to provide a telemedicine consultation will not be the same as a direct in-person visit since I will not be in the same room as the independent healthcare professional.
- I understand there are potential risks to this technology, including but not limited to: visit interruptions, loss of medical records from electronic equipment failure, unauthorized access including outside invasion of records by hackers, and technical difficulties including power failure, audio trouble, and/or video trouble. I understand that my independent healthcare professional or I can discontinue the telemedicine consult/visit if it is felt that the videoconferencing connections are not adequate for the visit to continue.
- I understand that physical signs and symptoms that might be detected by a healthcare professional during an in-person consultation/visit may not be detected through a telemedicine visit. I understand that I have the option of seeing another independent healthcare professional for an in-person visit who could evaluate me and provide me with observations and treatment recommendations.
- I understand that my healthcare information may be shared with other individuals for scheduling or billing purposes. These individuals are required to maintain confidentiality of all medical information obtained.
- I understand that I have the following rights as it relates to the telemedicine services provided by independent healthcare professionals utilizing the Empower GIA platform:
- Confidentiality. The laws that protect the confidentiality of medical information apply to telemedicine, and no identifying information or images from the telemedicine interaction will be disclosed to other parties without my consent, except as permitted by law.
- Right to withdraw consent. I have the right to withdraw or withhold my consent to telemedicine at any time and this does not affect my future right to healthcare or treatment.
- Access to information. I have the right to inspect all medical information obtained during my telemedicine consultation and may receive copies of this information if requested.
- I understand that I have the option of seeing another independent healthcare professional for an in-person visit who could evaluate me and provide me with observations and treatment recommendations. By choosing to participate in a telemedicine consultation with independent healthcare professionals on Empower GIA, I understand that physical tests are not able to be conducted or may not be able to be ordered by the telemedicine independent healthcare professional.
- I acknowledge that the observations and recommendations of the independent healthcare professionals on Empower GIA are limited in scope and nature to the specific issues discussed during the telemedicine consult/visit.
By scheduling a telemedicine/video visit with an independent healthcare professional on Empower GIA, I consent to receiving telemedicine services as described above and I certify:
- That I have read this form, had this form read to me, and/or had this form explained to me, and I fully understand the information provided above.
- That I agree with all information contained within this form.
- That I have been given ample opportunity to ask questions.
- That l agree that all my questions have been answered to my satisfaction in a language in which I understand.
- That I consent to receiving the telemedicine services described above.
- Ownership of The Site and Related Materials
All pages within this Site and any material made available for download are the property of Empower GIA, or its licensors or suppliers, as applicable. The Site is protected by United States and international copyright and trademark laws.
- Electronic Communications
When you use any Empower GIA Service, or send e-mails, text messages, and other communications from your desktop or mobile device to us, you are communicating with us electronically. You consent to receive communications from us electronically. You agree that (a) all agreements and consents can be signed electronically and (b) all notices, disclosures, and other communications that healthcare professionals provide to you electronically satisfy any legal requirement that such notices and other communications be in writing.
- Site Access, Security and Restrictions; Passwords
If you create a subscriber account for the Empower GIA Site, you agree to complete the registration process by providing current, complete, and accurate information as required by Empower GIA. You are responsible for all activities that occur under your account. In the event access to the Site or a portion thereof is limited requiring a user ID and password (“Protected Areas”), you agree to access Protected Areas using only your user ID and password as provided to you by Empower GIA. You agree to protect the confidentiality of your user ID and password and not to share or disclose your user ID or password to any third party. You agree that you are fully responsible for all activity occurring under your user ID. Your access to the Site may be revoked by Empower GIA at any time with or without cause.
You may not use any scraper, crawler, spider, robot or other automated means of any kind to access or copy data on the Site, deep-link to any feature or content on the Site, bypass our robot exclusion headers or other measures healthcare professionals may use to prevent or restrict access to the Site.
Violations of system or network security may result in civil or criminal liability. Empower GIA will investigate occurrences that may involve such violations and may involve and cooperate with law enforcement authorities in prosecuting users who are involved in such violations. You agree not to use any device, software or routine to interfere or attempt to interfere with the proper working of this Site or any activity being conducted on this Site.
- No Medical Advice or Services
Healthcare professionals may provide clinical services via the Empower GIA platform to patients that access the Empower GIA platform for telemedicine services or clinic/office services. ALL HEALTHCARE PROFESSIONALS IDENTIFIED OR ACCESSIBLE ON THE SITE ARE INDEPENDENT HEALTHCARE PROFESSIONALS AND ARE NOT EMPLOYED BY OR AFFILIATED WITH Empower GIA.
IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, YOU SHOULD DIAL “911” IMMEDIATELY.
THE CONTENT OF THE SITE AND THE SERVICES, INCLUDING WITHOUT LIMITATION, TEXT, COPY, AUDIO, VIDEO, PHOTOGRAPHS, ILLUSTRATIONS, GRAPHICS AND OTHER VISUALS, IS FOR INFORMATIONAL PURPOSES ONLY AND DOES NOT CONSTITUTE PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, TREATMENT OR RECOMMENDATIONS OF ANY KIND. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR QUALIFIED HEATHCARE PROFESSIONALS WITH ANY QUESTIONS OR CONCERNS YOU MAY HAVE REGARDING YOUR INDIVIDUAL NEEDS AND ANY MEDICAL CONDITIONS. ALL INFORMATION PROVIDED BY Empower GIA OR IN CONNECTION WITH ANY COMMUNICATIONS SUPPORTED BY Empower GIA, INCLUDING BUT NOT LIMITED TO COMMUNICATIONS WITH Empower GIA MEDICAL EXPERTS IS INTENDED TO BE FOR GENERAL INFORMATIONAL PURPOSES ONLY, AND IS IN NO WAY INTENDED TO CREATE A PHYSICIAN – PATIENT RELATIONSHIP AS DEFINED BY STATE AND FEDERAL LAW. THE SITE AND SERVICES ARE NOT A SUBSTITUTE FOR PROFESSIONAL MEDICAL DIAGNOSIS OR TREATMENT. RELIANCE ON ANY INFORMATION APPEARING ON THE SITE, WHETHER PROVIDED BY Empower GIA, ITS CONTENT HEALTHCARE PROFESSIONALS, MEDICAL EXPERTS, CLIENTS, VISITORS TO THE SITE OR OTHERS, IS SOLELY AT YOUR OWN RISK. WHILE Empower GIA FACILITATES YOUR SELECTION OF, COMMUNICATIONS WITH AND OTHER INTERACTIONS WITH PHYSICIANS and other healthcare professionals, Empower GIA DOES NOT PROVIDE MEDICAL SERVICES AND THE DOCTOR-PATIENT RELATIONSHIP IS BETHEALTHCARE PROFESSIONALSEN YOU AND THE HEALTHCARE PROVIDER YOU SELECT. ALL HEALTHCARE PROFESSIONALS IDENTIFIED OR ACCESSIBLE ON THE SITE ARE INDEPENDENT HEALTHCARE PROFESSIONALS AND ARE NOT EMPLOYED BY OR AFFILIATED WITH Empower GIA.
- License and Access
The Contents of the Site, including without limitation the files, documents, text, photographs, images, audio, and video, and any materials accessed through or made available for use or download through this Site (“Content”) may not be copied, distributed, modified, reproduced, published, or used, in whole or in part, except for purposes authorized or approved in writing by Empower GIA. You may not frame or utilize framing techniques to enclose, or deep linking to, any name, trademarks, service marks, logo, Content or other proprietary information (including images, text, page layout, or form) of Empower GIA without our express written consent.
- Accuracy and Integrity of Information
Although Empower GIA attempts to ensure the integrity and accurateness of the Site, it makes no representations, warranties, or guarantees whatsoever as to the correctness or accuracy of the Site and Content thereon. It is possible that the Site could include typographical errors, inaccuracies or other errors, and that unauthorized additions, deletions and alterations could be made to the Site by third parties. If an inaccuracy arises, please inform Empower GIA so that it can be corrected. Information contained on the Site may be changed or updated without notice. Additionally, Empower GIA shall have no responsibility or liability for information or Content posted to the Site from any non-Empower GIA affiliated third party.
- Links to Other Sites
Empower GIA makes no representations whatsoever about any other website that you may access through this Site. When you access a non-Empower GIA site, please understand that it is independent from Empower GIA, and that Empower GIA has no control over the Content on that website. In addition, a link to a non-Empower GIA website does not mean that Empower GIA endorses or accepts any responsibility for the Content, or the use, of the linked site. It is up to you to take precautions to ensure that whatever you select for your use or download is free of such items as viruses, worms, Trojan horses, and other items of a destructive nature. If you decide to access any of the third-party sites linked to this Site, you do this entirely at your own risk.
- User Information
If you submit, upload, post or transmit any health information, medical history, conditions, problems, symptoms, personal information, consent forms, agreements, requests, comments, ideas, suggestions, information, files, videos, images or other materials to us or our Site (“User Information”), you agree not to provide any User Information that (1) is false, inaccurate, defamatory, abusive, libelous, unlawful, obscene, threatening, harassing, fraudulent, pornographic, or harmful, or that could encourage criminal or unethical behavior, (2) violates or infringes the privacy, copyright, trademark, trade dress, trade secrets or intellectual property rights of any person or entity, or (3) contains or transmits a virus or any other harmful component. You agree not to contact other site users through unsolicited e-mail, telephone calls, mailings, or any other method of communication. You represent and warrant to Empower GIA and its Healthcare professionals that you have the legal right and authorization to provide all User Information to Empower GIA and its Healthcare professionals for use as set forth herein and required by Empower GIA and the Healthcare professionals.
This Policy explains how your PHI may be used and shared with others and explains your privacy rights regarding your PHI. Empower GIA is required by law to abide by the terms of this Policy, to make sure that any information that identifies you is kept private, and to provide you this Policy of our legal duties and practices with respect to your PHI. Healthcare professionals are also required to provide you with notification if there is a breach of your PHI. Healthcare professionals utilize measures to help protect your information from any theft, loss, misuse, unauthorized access, unauthorized disclosure, destruction, and alteration. Any data storage system or data transmission over any public network or Internet is not guaranteed to be 100 percent secure.
Uses and Disclosures of Your PHI for Treatment, Payment, and Health Care Operations
Healthcare professionals, while using Empower GIA’s telemedicine platform, may use your PHI to carry out treatment, payment, and health care operations without your written authorization. The following categories provide various examples of the various ways that healthcare professionals may use and disclose your PHI for these purposes
Treatment: Treatment is medical care provided to a patient for an illness or injury and is the provision, management, or coordination of healthcare. Healthcare professionals may use and disclose your PHI to provide you with medical services and treatment. As an example, Healthcare professionals may:
- Use and disclose your PHI to provide and coordinate treatment, medication, and services you receive from healthcare professionals.
- Disclose your PHI to third parties, such as doctors, pharmacies, laboratories, hospitals, insurance companies, government agencies, or other healthcare professionals to assist them in providing you with care or treatment options or to assist with coordination of your medical care.
- Contact you to provide treatment-related services such as appointment reminders.
Sometimes, use and disclosure of your PHI for treatment purposes may be made through a Health Information Exchange or similar system or through shared electronic medical record.
Payment: Payment includes the activities necessary to obtain reimbursement for providing you with medical care. Healthcare professionals may use and disclose your PHI to obtain payment for the services they provide to you or for other payment activities related to the services they provide to you. As an example, Healthcare professionals may:
- Share your PHI with your insurer, health plan, or other third-party payor to determine whether your insurer or third-party payor will reimburse you for the treatment you received by healthcare professionals or pay healthcare professionals directly. This allows healthcare professionals to determine the payment amount that you may owe to the healthcare professionals.
- Share your information with authorized third-party service healthcare professionals and vendors that help us with specific services such as payment processing, billing, customer service, email outreach, business analytics, marketing, data processing, hosting, and performance monitoring. Authorized third-party service professionals and vendors and Service may not use your PHI for purposes other than those related to the services they are providing to healthcare professionals.
- Contact you about a payment or balance due for services you received from healthcare professionals.
- Disclose your PHI to other health plans, healthcare professionals, or other HIPAA-Covered Entities who may need it for their payment actions.
Health Care Operations: Health care operations include the activities necessary for healthcare professionals to run its business operations. Healthcare professionals may use and disclose your PHI to operate our business. As an example, healthcare professionals may:
- Use and disclose your PHI to review treatment, perform quality assessment and performance activities.
- Healthcare professionals may share your information in connection with a substantial business transaction, such as a merger, website or asset sale, consolidation, or bankruptcy.
- Use and disclose your PHI to provide customer services to you such as resolving complaints and coordinating your medical/health care.
- Use and disclosure of your PHI to contact you about health-related products or services such as programs for our patients.
- Disclose your PHI to other HIPAA Covered Entities or their Business Associates that have provided services to you so that they can drive efficiency and quality improvement of their healthcare operations including healthcare services they provide.
- Use or disclose your de-identified PHI data, which all your personally identifiable information has been removed, for business planning, analytics, or other purposes.
- Share your PHI to Corporate affiliates that are subject to this Notice.
Empower GIA and the healthcare professionals may share your PHI for any other purposes disclosed to you at the time your PHI is collected or pursuant to your direction or consent.
Technical data such as the memory state of your mobile device or computer may be collected to address and solve any technical difficulties, such as system crashes while using our Services, and to improve our Services. Your browser settings or device settings may allow you to have control over this technical data collection. By using our Services, you are providing your consent to the collection of this technical data.
Do Not Track, DNT, is a web browser setting that requests that a web application disable its tracking of an individual user. You may choose to turn on the DNT setting in your web browser which then sends Do not Track signal to websites, advertising networks, plug-in healthcare professionals, analytics companies, plug in healthcare professionals, and other web services that you encounter during browsing. There is currently no universally agreed upon standard consensus on how companies you encounter during browsing should interpret DNT signals and so most sites do not change their practices when they receive a DNT signal. Healthcare professionals currently do not act in response to receiving these DNT signals.
If you access third-party organizations and services such as Google, Twitter, of Facebook through our Services for your log-in to our Services or for your ability to share your Services experience information, then healthcare professionals may receive information about you from these other third-party sources. Healthcare professionals may use this third-party data in combination with our first-party data about you, such as your name and email address, to contact you via email, direct mail, or other communication channel. If you engage in public activities on the Site or any third party sites that healthcare professionals provide a link to connect, you must be aware that any information shared by you may be collected, read, or used by other users of these sites. While participating on these sites, use caution in disclosing any personal information and know that healthcare professionals are not responsible for any information you share on these public sites. Information collected by these third-party public sites may not have the same security measures and protection as information you submit to us. Healthcare professionals are not responsible for the protection and security of any information you share on these sites.
Other Uses and Disclosures of Your PHI that Do Not Require Authorization
Healthcare professionals are also allowed or required to share your PHI, without your authorization, in certain instances or when certain conditions have been met as follows:
- Individuals Involved in Your Care or Payment for Your Care: Healthcare professionals may disclose your PHI to a personal representative, friend, or family member who helps pay for your medical care or is involved in your medical care. Healthcare professionals may also make these disclosures after your death as authorized by applicable law, unless doing so is inconsistent with any prior expressed preference. Healthcare professionals may use or disclose your PHI to notify or assist in notifying a family member, personal representative, or any other person responsible for your care regarding your location, status, or general condition. Healthcare professionals may also use or disclose your PHI to disaster relief organizations so that your family or other persons responsible for your care can be notified of your location, general condition, or death. If you are unable to agree or object to the use or disclosure, healthcare professionals may disclose such information as necessary if healthcare professionals determine that it is in your best interest.
- Business Associates: When Healthcare professionals contract with third parties to perform certain services for them, such as billing or consulting, these third-party service healthcare professionals, known as “Business Associates,” may need access to your PHI to perform these services. They are required by law and their agreements with healthcare professionals to protect your PHI in the same way healthcare professionals do.
- Disclosures to Parents or Legal Guardians: If you are a minor (age less than 18 years old), healthcare professionals may release your PHI to your parents or legal guardians when healthcare professionals are permitted or required under state and federal law. Empower GIA does not knowingly permit persons under the age of 18 to create accounts that would grant or allow access to Empower GIA Services.
- Required by Law: Healthcare professionals may disclose your PHI when required by law to do so. This disclosure may include providing your PHI to the Department of Health and Human Services.
- Workers’ Compensation: Healthcare professionals may disclose your PHI as necessary to comply with workers’ compensation laws or other similar programs.
- Law Enforcement: Healthcare professionals may disclose your PHI to law enforcement officials for certain law enforcement purposes. If healthcare professionals are legally obligated to disclose information to a third party about you, Healthcare professionals and Empower GIA will attempt to notify you by sending an email to you using the email address in your records if available unless this would be considered a violation of the law. Examples of law enforcement disclosures:
- Healthcare professionals may use or disclose your PHI to report certain injuries.
- Healthcare professionals may disclose your PHI when healthcare professionals believe the information constitutes evidence of criminal conduct that occurs at our business locations.
- Healthcare professionals may disclose your PHI to law enforcement officials in the case of an administrative request, court orders, subpoenas, warrants, legal process, legal claims, or similar process and to protect and defend the rights, safety, interests, and security of healthcare professionals, our users, affiliates, or the public.
- Public Health Reporting: Healthcare professionals may disclose your PHI to public health agencies as authorized by law. For example, healthcare professionals may report reactions to medications or other products to the U.S. Food and Drug Administration or other authorized entity, and healthcare professionals may use or disclose your PHI to help with product recalls or notify individuals of potential exposure to a communicable disease or risk of spreading a disease or condition.
- Reporting Victims of Abuse or Neglect: Healthcare professionals may disclose your PHI to the appropriate government authority if healthcare professionals believe you have been the victim of abuse, domestic violence, or neglect. This disclosure is only made if you agree with disclosure or when healthcare professionals are required or authorized by law to make this disclosure.
- Health Oversight Activities: Healthcare professionals may disclose your PHI to an oversight agency for oversight activities authorized by law. Oversight activities include investigations, audits, inspections, licensure or disciplinary actions, or administrative, civil, and criminal proceedings, as necessary for oversight of the government programs, health care system, and civil rights laws.
- Research: Under certain circumstances, healthcare professionals may disclose your PHI for research purposes and your separate written authorization for disclosure may be needed.
- To Prevent a Serious Threat to Safety or Safety: If there is a serious threat to your safety and health or the health and safety of another person or the general public, healthcare professionals may use and disclose your PHI in a limited manner to persons who are able to help lessen or prevent the threat.
- Decedents: Healthcare professionals may disclose PHI to coroners, medical directors, medical examiners, or funeral directors so that they can carry out their duties.
- Judicial and Administrative Proceedings: Healthcare professionals may disclose your PHI in response to an administrative or court order, discovery request, subpoena, or other lawful process.
- Specialized Government Functions: In certain instances, Healthcare professionals may use or disclose your PHI to authorized federal officials for the management of national security activities and other specialized government purposes. As an example, if you are a member of the U.S. military or member of a foreign military, Healthcare professionals may disclose your PHI as required by military command authorities, only if certain circumstances are met.
- Organ or Tissue Donation: Consistent with applicable law, Healthcare professionals and Empower GIA may disclose your PHI to organ procurement organizations for the purpose of tissue donation and transplant.
- Correctional Institution: If you are an inmate or become an inmate of a correctional institution, healthcare professionals may disclose your PHI to the correctional institution or its agents to assist them in providing for the safety of the correctional institution, providing you with medical care, protecting your health and safety, or protecting the health and safety of others.
- Affiliated Covered Entity: Healthcare professional entities are part of an affiliated group of entities which is collectively known as Healthcare professionals. This affiliated group of entities treats itself as a single entity under the Health Insurance Portability and Accountability Act of 1996 and the regulations promulgated thereunder (collectively, “HIPAA”), also referred to as an Affiliated Covered Entity, for purposes of using and disclosing your health information. When permitted by HIPAA, Empower GIA and Healthcare professionals may disclose your PHI to other Healthcare professional entities that are part of this Affiliated Covered Entity.
Uses or Disclosures for Purposes that Require Your Authorization
Use and disclosure of your PHI for purposes other than those described above may only be made with your written authorization. Without your authorization, Healthcare professionals and Empower GIA will not use or disclose your PHI for marketing purposes and will not sell your PHI to third parties (except for, in connection with, the transfer of a business to another health care provider required to comply with HIPAA).
Healthcare professionals should obtain your written authorization before using or disclosing your PHI for purposes other than those described in this Notice or otherwise permitted by law. You should be able revoke your authorization at any time by submitting a written notice to your healthcare professional. Your revocation should be effective upon acknowledgment of our receipt. Your revocation will not undo any use or disclosure of your PHI that occurred before you provided your healthcare professional with notification and will not undo any actions taken based upon your previous written authorization.
State laws may be stricter and may prohibit certain uses and disclosures that are identified above. When state law is more protective of your privacy, healthcare professionals should abide by the privacy laws of that state. As an example, some state laws require added protection for medical records related to the treatment of mental health, drug and alcohol treatment, and HIV-related medical information. If you have a question about how Empower GIA complies with your state’s laws, please contact Empower GIA via email at firstname.lastname@example.org. If you have a question about how your healthcare professional complies with your state’s laws, please contact your healthcare professional.
Your Health Information Rights
Obtain a Copy of the Notice: You have the right to obtain a paper copy of our current Policy at any time. You may do so by visiting Empower GIA and printing a copy directly from our website. You may also obtain a copy by contacting Empower GIA via email at email@example.com.
Inspect and Obtain a Copy of Your PHI: With a few exceptions, you have the right to see and obtain a copy of the PHI healthcare professionals maintain about you. You may request access to your PHI electronically. To inspect or obtain a copy of your PHI, submit a written request to your Healthcare professionals or Empower GIA. You may also ask us to provide a copy of your PHI to another person or entity. A reasonable fee may be charged for the expense of fulfilling your request as permitted under HIPAA and/or state law. Healthcare professionals may deny your request to inspect and copy your record in certain limited circumstances. If healthcare professionals deny your request, healthcare professionals should provide you with written notification and should let you know if and how you may request a review of the denial.
Request an Amendment: If you feel that the PHI healthcare professionals maintain about you is incorrect or incomplete, you may request that Healthcare professionals amend it. To request an amendment, submit a written request to the Healthcare professionals directly. You should provide a supporting reason for your request of the amendment. You should be provided with a written explanation if your Healthcare professional does not approve your request for an amendment.
Receive an Accounting of Disclosures: You have the right to request an accounting of disclosures healthcare professionals make of your PHI for purposes other than treatment, payment, or health care operations. Please note that certain other disclosures need not be included in the accounting healthcare professionals provide to you. To obtain an accounting, submit a written request to your Healthcare professionals or Empower GIA. Healthcare professionals should provide one accounting of disclosures per a 12-month period at no cost to you. You may be charged for the cost of any subsequent accountings of disclosure; healthcare professionals should provide you with advance notification of the cost involved at which time you may choose to modify or withdraw your request.
Disclosure Option for California Residents: You have the right to request and obtain a once a year, free of charge, disclosure of specific information for the previous calendar year of any of your specific personal information, if any, that was shared with third parties for their direct marketing purposes. Healthcare professionals should not disclose your personal information to third parties for their direct marketing purposes.
Request a Restriction on Certain Uses and Disclosures: You have the right to request additional restrictions on the use and disclosure of your PHI by sending your written request to your Healthcare professionals. Healthcare professionals are not required to agree to your request except where the disclosure is to a health plan or insurer for purposes of carrying out payment or health care operations, is not otherwise required by law, and the PHI is related to a health care item or service for which you, or a person on your behalf, has paid in full out-of-pocket. Healthcare professionals may accept full payments via credit card for services provided. Healthcare professionals may or may not submit any claims for payment to any health plans.
Request Confidential Communications: You have the right to request that healthcare professionals communicate with you at a specific location or at a specific way. For example, you may request that healthcare professionals contact you only via email of in writing at a specific mailing address. To request confidential communication of your PHI, you must submit a written request to your Healthcare professionals or Empower GIA stating how, when, or where you would like to be contacted by your Healthcare professionals or Empower GIA. Healthcare professionals and Empower GIA should accommodate any reasonable requests.
Request to Opt Out: You have the right to opt out of receiving communications regarding general health, wellness, or treatment options by emailing us at firstname.lastname@example.org and email@example.com. You may or may not include in your request that Empower GIA deletes your personal information.
Notification of a Breach: Empower GIA will notify you if there is a breach of your unsecured PHI that is governed by HIPAA.
Exercise Rights Through a Personal Representative: You may exercise your rights through a personal representative as required or permitted by applicable law. Your personal representative may be required to produce proof of authority to act on your behalf before that individual can be given access to your PHI or allowed to take any action for you on your behalf.
Complaints: If you believe your privacy rights have been violated, you may file a formal complaint with Empower GIA Privacy Office, your Healthcare professionals’ Privacy Office, or with the Secretary of the United States Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized or retaliated against in any way for filing a formal complaint.
Written Requests and Additional Information: you may request additional information about your Healthcare professional’s privacy practices by contacting your Healthcare professional’s Privacy Office. You may request additional information about Empower GIA’s privacy practices by contacting Empower GIA Privacy Office. Information is below:
Empower GIA Privacy Office Contact Information:
Empower GIA c/o Hadera Health
ATTN: Privacy Office
2451 Cumberland Pkwy., Suite 3831
Atlanta, GA 30339
Toll-free telephone: (800) 880-9139
- Claims of Copyright Infringement
Healthcare professionals disclaim any responsibility or liability for copyrighted materials posted on our site. If you believe that your work has been copied in a manner that constitutes copyright infringement, please follow the procedures set forth below.
Empower GIA respects the intellectual property rights of others and expects its users to do the same. In accordance with the Digital Millennium Copyright Act (“DMCA”), healthcare professionals will respond promptly to notices of alleged infringement that are reported to Empower GIA’s Designated Copyright Agent, identified below.
Notices of Alleged Infringement for Content Made Available on the Site
If you are a copyright owner, authorized to act on behalf of one, or authorized to act under any exclusive right under copyright, please report alleged copyright infringements taking place on or through our Site by sending us a notice (“Notice”) complying with the following requirements.
Identify the copyrighted works that you claim have been infringed.
Identify the material or link you claim is infringing (or the subject of infringing activity) and that access to which is to be disabled, including at a minimum, if applicable, the URL of the link shown on the Site where such material may be found.
Provide your mailing address, telephone number, and, if available, email address.
Include both of the following statements in the body of the Notice:
“I hereby state that I have a good faith belief that the disputed use of the copyrighted material is not authorized by the copyright owner, its agent, or the law (e.g., as a fair use).”
“I hereby state that the information in this Notice is accurate and, under penalty of perjury, that I am the owner, or authorized to act on behalf of the owner, of the copyright or of an exclusive right under the copyright that is allegedly infringed.”
Provide your full legal name and your electronic or physical signature.
Deliver this Notice, with all items completed, to firstname.lastname@example.org.
- Disclaimer of Warranties
Empower GIA DOES NOT WARRANT THAT ACCESS TO OR USE OF THE SITE WILL BE UNINTERRUPTED OR ERROR-FREE OR THAT DEFECTS IN THE SITE WILL BE CORRECTED. THIS SITE, INCLUDING ANY CONTENT OR INFORMATION CONTAINED WITHIN IT OR ANY SITE-RELATED SERVICE, IS PROVIDED “AS IS,” WITH ALL FAULTS, WITH NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, QUALITY OF INFORMATION, QUIET ENJOYMENT, AND TITLE/NON-INFRINGEMENT. Empower GIA DOES NOT WARRANT THE ACCURACY, COMPLETENESS OR TIMELINESS OF THE INFORMATION OBTAINED THROUGH THE SITE.
YOU ASSUME TOTAL RESPONSIBILITY AND RISK FOR YOUR USE OF THIS SITE, SITE-RELATED SERVICES, AND LINKED WEBSITES. Empower GIA DOES NOT WARRANT THAT FILES AVAILABLE FOR DOWNLOAD WILL BE FREE OF VIRUSES, WORMS, TROJAN HORSES OR OTHER DESTRUCTIVE PROGRAMMING. YOU ARE RESPONSIBLE FOR IMPLEMENTING PROCEDURES SUFFICIENT TO SATISFY YOUR NEEDS FOR DATA BACK UP AND SECURITY.
- Limitation of Liability Regarding Use of Site
Empower GIA AND ANY THIRD PARTIES MENTIONED ON THIS SITE ARE NEITHER RESPONSIBLE NOR LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, EXEMPLARY, PUNITIVE, OR OTHER DAMAGES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, THOSE RESULTING FROM LOST PROFITS, LOST DATA, OR BUSINESS INTERRUPTION) ARISING OUT OF OR RELATING IN ANY WAY TO THE SITE, SITE-RELATED SERVICES, CONTENT OR INFORMATION CONTAINED WITHIN THE SITE, AND/OR ANY LINKED WEBSITE, WHETHER BASED ON WARRANTY, CONTRACT, TORT, OR ANY OTHER LEGAL THEORY AND WHETHER OR NOT ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. YOUR SOLE REMEDY FOR DISSATISFACTION WITH THE SITE, SITE-RELATED SERVICES, AND/OR LINKED WEBSITES IS TO STOP USING THE SITE AND/OR THOSE SERVICES. TO THE EXTENT ANY ASPECTS OF THE FOREGOING LIMITATIONS OF LIABILITY ARE NOT ENFORCEABLE, THE MAXIMUM LIABILITY OF Empower GIA TO YOU WITH RESPECT TO YOUR USE OF THIS SITE IS $10 (TEN DOLLARS).
- Dispute Resolution.
Empower GIA will try work in good faith to resolve any issue you have with Site, including services ordered or purchased through the Site, if you bring that issue to the attention of our customer service department. However, healthcare professionals realize that there may be rare cases where healthcare professionals may not be able to resolve an issue to a customer’s satisfaction. In the event healthcare professionals cannot resolve a dispute between us, you agree that all matters related to any use or access of the Site, the Services or any other Empower GIA site will be governed by the laws of the State of Georgia, without regard to its conflicts of laws rules. You hereby waive any objections to such jurisdiction or venue. Any claims or controversies arising out of this Agreement, and/or the related use and access of the Site, the Services or any other Empower GIA site, shall be exclusively in the state courts of Georgia, county of Fulton or Cobb.
- Force Majeure
- Right to Modify Revisions; General
Policy Updated: 03/25/2022