If you believe your privacy rights were violated, you may file a complaint with the Practice or with the U.S. Department of Health and Human Services. Filing a complaint will not affect your care.

The Practice is permitted under federal law to use and disclose protected health information without your written authorization for purposes related to treatment, payment, and health care operations. For treatment purposes, the Practice may use and share protected health information with other professionals involved in your care, such as when your primary care provider requests information about your mental health treatment. For health care operations, the Practice may use and share protected health information to run the business, improve care, and contact you, including sending appointment reminders if you choose. For payment purposes, the Practice may use and share protected health information to bill and obtain payment from health plans or other entities, including sharing information such as treatment or session notes with your insurance carrier or billing service when required to process your claim.

The Practice may also use or disclose protected health information without your authorization or opportunity to object for certain public health and safety purposes, including preventing the spread of disease, assisting with product recalls, reporting adverse reactions to medication, complying with requests from the Secretary of Health and Human Services to investigate or determine compliance with privacy laws, responding to health oversight activities such as audits or investigations, preventing a serious and imminent threat to health or safety, and reporting abuse, neglect, or domestic violence as required by law. The Practice may disclose protected health information as required by federal, state, or local law, in response to court orders, subpoenas, or administrative proceedings, for law enforcement purposes such as locating or identifying an individual or reporting information about a crime victim, and to comply with workers’ compensation laws or support related claims. The Practice may also disclose protected health information for other legally permitted purposes including to coroners or funeral directors performing authorized duties, for organ donation or transplantation, for approved research activities, for individuals who are incarcerated when the information was created or received in the course of providing care, and to business associates that perform services or functions on behalf of the Practice.

Unless you object, the Practice may disclose protected health information to family members, friends, or others involved in your care when the information is directly related to that involvement, or when it is determined to be in your best interest because you are unable to state your preference. The Practice must obtain your written authorization to use or disclose protected health information for certain purposes including marketing activities, the sale of protected health information, and psychotherapy notes. You may revoke your authorization at any time by contacting the Practice in writing. The Practice will not use or share protected health information other than as described in this Notice unless you provide written permission, or you request that your insurance be billed and the insurance carrier or billing service requires protected health information to process your claim.

You have the right to inspect and obtain a copy of your protected health information, request corrections to information you believe is inaccurate or incomplete, request restrictions on certain uses or disclosures of your information, request confidential communications, receive an accounting of certain disclosures, and obtain a paper copy of this Notice at any time. Requests must be submitted in writing to the Practice, and the Practice may deny certain requests as permitted by law.

The Practice is required by law to maintain the privacy and security of protected health information and to comply with the terms of this Notice currently in effect. When more stringent state or federal laws apply, the Practice will follow those laws. The Practice reserves the right to amend this Notice, and any changes will apply to all protected health information maintained by the Practice. If changes are made, you may obtain a revised Notice by requesting a copy from the Practice or by viewing it on the Practice website. The Practice will notify you if protected health information is compromised in a breach.

This Notice is effective on January 1, 2020.