Privacy & HIPAA

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We are required by law to give you this notice of our legal duties and privacy practices with respect to your protected health information.
• We are required by law to notify you following a breach of your unsecured protected health information.
• We must follow the duties and privacy practices described in the notice that is currently in effect, and offer you a copy of it.
• We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by letting us know in writing.

How We Use and Disclose Your Health Information

We typically use or share your health information in the following ways.

Treatment

We may use your health information and share it with other professionals who are treating you. For example, we may share information with your primary care physician or with a therapist who is coordinating your care with us, or send a prescription to your pharmacy.

Payment

We may use and share your health information to bill and get payment from health plans or other entities. For example, we give information about your visit to your health insurance plan so it will pay for your services.

Healthcare Operations

We may use and share your health information to run our practice, improve your care, and contact you when necessary. For example, we may review records to evaluate the quality of care, train staff, or send appointment reminders.

Business Associates

We may share your health information with companies that perform services on our behalf, such as billing, electronic health records, or secure communication services. These business associates must agree in writing to protect your information.

People Involved in Your Care

Unless you object, we may share relevant information with a family member, close friend, or other person you identify who is involved in your care or in paying for your care, or to assist in disaster relief. If you are not able to tell us your preference, for example in an emergency, we may share information if we believe it is in your best interest.

Other Uses and Disclosures Permitted or Required by Law

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes.

• As Required by Law: When federal, state, or local law requires it, including to the U.S. Department of Health and Human Services if it wants to confirm that we are complying with federal privacy law
• Public Health and Safety: To prevent or control disease, report adverse reactions to medications, and help with product recalls
• Abuse, Neglect, or Domestic Violence: To report suspected abuse, neglect, or domestic violence to the appropriate authorities
• Serious Threats: To prevent or lessen a serious and imminent threat to anyone's health or safety
• Health Oversight: To health oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure
• Lawsuits and Legal Actions: In response to a court or administrative order, or in response to a subpoena, as permitted by law
• Law Enforcement: For law enforcement purposes, under specific circumstances permitted by law
• Coroners, Medical Examiners, and Funeral Directors: As needed for them to carry out their duties
• Organ and Tissue Donation: With organ procurement organizations, as permitted by law
• Research: For health research, only under conditions that protect your privacy as required by law
• Workers' Compensation: For workers' compensation claims, as authorized by law
• Specialized Government Functions: For military, national security, and presidential protective services
• Correctional Institutions: If you are an inmate of a correctional institution or in the custody of a law enforcement official

Uses and Disclosures That Require Your Written Authorization

We will not use or share your information in the following ways unless you give us written permission:

• Most uses and disclosures of psychotherapy notes
• Marketing purposes
• Sale of your information
• Any other use or disclosure not described in this notice

You may revoke a written authorization at any time by notifying us in writing. Revoking it will not affect any use or disclosure we already made in reliance on your authorization.

Your Rights

You have the following rights regarding your health information. To exercise any of them, contact our Privacy Officer. Some requests must be made in writing, and we will tell you how.

Access, Inspect, and Get a Copy of Your Records

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Request an Amendment

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say no to your request, but we will tell you why in writing within 60 days.

Request Restrictions

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say no if it would affect your care. If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health insurer for payment or operations. We will say yes unless a law requires us to share that information.

Request Confidential Communications

You can ask us to contact you in a specific way, for example by home or office phone, or to send mail to a different address. We will say yes to all reasonable requests, and we will not ask you why.

Receive an Accounting of Disclosures

You can ask for a list, or accounting, of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all disclosures except those for treatment, payment, and healthcare operations, and certain other disclosures, such as any you asked us to make. We will provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a Paper Copy of This Notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. Ask at our office or call us and we will provide one promptly.

Choose Someone to Act for You

If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will confirm the person has this authority before we take any action.

Changes to This Notice

We reserve the right to change the terms of this notice, and the changes will apply to all information we have about you. If we make a material change, the revised notice will show its new effective date and will be available upon request, in our office, and on this website.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services.

• With Advance Psychiatry & Wellness: Contact our Privacy Officer using the information below.
• With the U.S. Department of Health and Human Services, Office for Civil Rights: Write to 200 Independence Avenue, S.W., Washington, D.C. 20201, call 1-877-696-6775, or visit www.hhs.gov/hipaa/filing-a-complaint.

We will not retaliate against you for filing a complaint.