Notice Of Privacy Practices

This notice describes how health information may be used and disclosed and how you can get access to this information. Please review it carefully.

Our pledge regarding health information:

We understand that health information is personal. We are committed to protecting health information about you. We create a record of care and services and receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this practice. This tonic will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you and describe certain obligations we have regarding the use and disclosure of your health information.

We are required by law to:

-Make sure that protected health information (“PHI”) that identifies you is kept private.

-Give you this notice of your legal duties and privacy practices with respect to health information

-Follow the terms of the notice that is currently in effect.

-We can change the terms of this Notice, and such changes will apply to information we have about you.

-The new Notice will be available upon request in our office.

How we may use and disclose health information about you:

The following categories describe different ways that we use and disclose health information. For each category of uses or disclosures, we will explain what we mean and try to give you some examples. Not every use or disclosure in a category will be listed; however, all of the ways we are permitted to use and disclose information will fall within one of these categories.

-For Treatment Payment or Health Care Operations: Federal privacy rules and regulations allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment, or health care operations. We may also disclose your protected health information for the treatment activities of any health care provider. This too can be. done without your written authorization. For example, if a health care provider were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the health care provider in diagnosis and treatment of your condition(s).

-Disclosures for treatment purposes are not limited to the minimum necessary standard because other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers, and referrals of a patient for health care from one health care provider to another.

-Lawsuits and Disputes: If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order. We may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain protecting the information requested.

CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

Session Notes: We do keep “Session notes” and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:

-For our use in treating you

-For your use in training or supervising associates to help them improve their clinical skills

-For use in defending ourselves in legal proceedings instituted by you

-For use by the Secretary of Health and Human Services to investigate our compliance with HIPAA

-Required by law and the use or disclosure is limited to the requirements of such low

-Required by law for certain health oversight activities pertaining to the originator of the session notes

-Required to help avert a serious threat to the health and safety of others

Marketing Purposes: As health care providers, we will not use or disclose your PHI for marketing purposes. Sale of PHI: As health care providers, we will not sell your PHI in the regular course of our business.

CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION

Subject to certain limitations in the law, we can use and disclose your PHI without your Authorization for the following reasons:

-When disclosure is required by state or federal law, we can use or disclosure complies with and is limited to the relevant requirements of such law.

-For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

-For health oversight activities, including audits and investigations,

-For judicial and administrative proceedings including responding to a court or administrative order, although our preference is to obtain an Authorization from you before doing so.

-For law enforcement purpose, including reporting crimes occurring on our premises.

-To coroners or medical examiners when such individuals are performing duties authorized by law.

-For research purposes, including studying or comparing the patients who received one from of care versus those who received another form of care for the same condition.

-For specialized government functions, including ensuring the proper execution of military missions, protecting the President of the United States, conducting intelligence or counterintelligence operations, or help to ensure the safety of those working within or housed in correctional institutions.

-For workers compensation purpose. Although our preference is to obtain an Authorization from you, we may provide your PHI in order to comply with workers compensation laws.

-Appointment reminders and health related benefits or services. We may use and disclose your PHI to contact you to remind you that you have appointment with us.

-We may also use and disclose your PHI to tell you about treatment alternatives or other health care services or benefits that we offer.

CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY OBJECT

Disclosure to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in the whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

The Right to Request Limits on Users and Disclosure of Your PHI. You have the right to ask us not to use or disclose certain PHI for treatment, payment, or health care operations purposes.

We are not required to agree to your request, and we may say “no” if we believe it would affect your health care.

The Right to Request Restrictions for Out-of_pocket Expenses Paid for In Full. You have the right to request restriction on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

The Right to Choose How We Send PHI to You. You have the right to ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and we will agree to all reasonable requests.

The Right to See and Get Copies of Your PHI. Other than “session notes” you have the right to get an electronic or parer copy of your summary of care and other information that you have about you. We will provide you with a copy of your record, or a summary of it if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost based fee for doing so.

The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided us with and Authorization. We will respond to your request for an accounting of disclosures within 60 days of receiving your request.

The list we will give you will include disclosures made in the last six years unless you request a shorter time.

We will provide the list to you at no change, but if you make more than one request in the same year, we will charge you a reasonable cost-based fee for additional request.

The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that we correct the existing information and add the missing information.

We may say “no” to your request, but we will tell you why in writing within 60 days of receiving your request.

The Right To Get a Paper or Electronic Copy of this Notice. You have the right to receive both paper copy and a copy by e-mail of this Notice.

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on AUGUST 1, 2019. Updated January 24, 2025

Acknowledgement of Receipt of Privacy Notice

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By signing below, you are acknowledging that you have received a copy of HIPAA Notice or Privacy Practices.