HIPAA Notice of Privacy Practices

Our Commitment to Your Privacy

We are required by law to maintain the privacy of your Protected Health Information (PHI) and to provide you with this notice of our legal duties and privacy practices. We are obligated to follow the terms of this notice currently in effect.

Protected Health Information (PHI) includes any individually identifiable information relating to your past, present, or future physical or mental health, the provision of healthcare to you, or payment for healthcare.

How We May Use and Disclose PHI

1. Treatment

We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes consultations with other healthcare providers, referrals, and coordination of care.

Example: We may share your medical history with a dermatologist if your treatment plan requires specialized consultation.

2. Payment

We may use and disclose your PHI to bill and collect payment for services provided. This may include disclosures to your insurance company, collection agencies, or other entities involved in payment processing.

Example: We may submit claims to your insurance company that include diagnosis codes and treatment information.

3. Healthcare Operations

We may use and disclose your PHI for healthcare operations, which include quality assessment, training, accreditation, certification, credentialing, and business management activities.

Example: We may review treatment outcomes to improve the quality of care we provide.

Other Uses and Disclosures

In addition to treatment, payment, and healthcare operations, we may use or disclose your PHI in the following situations:

• Appointment Reminders: We may contact you to remind you of scheduled appointments via phone, email, or text message.
• Treatment Alternatives and Health-Related Services: We may inform you about treatment options or health-related products and services that may be beneficial.
• Business Associates: We may disclose PHI to third-party service providers (business associates) who perform services on our behalf, such as billing companies, IT vendors, and appointment scheduling platforms. These entities are required by contract to safeguard your PHI.
• As Required by Law: We may disclose PHI when required by federal, state, or local law.
• Public Health Activities: We may disclose PHI for public health purposes, such as reporting communicable diseases, adverse events, or product defects to health authorities.
• Victims of Abuse, Neglect, or Domestic Violence: We may disclose PHI to appropriate authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence.
• Health Oversight Activities: We may disclose PHI to government agencies authorized to conduct audits, investigations, or inspections of healthcare facilities.
• Legal Proceedings: We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process.
• Law Enforcement: We may disclose PHI to law enforcement officials for purposes such as identifying suspects, locating missing persons, or reporting crimes.
• Coroners, Medical Examiners, and Funeral Directors: We may disclose PHI to coroners or medical examiners for identification purposes or to determine cause of death.
• Serious Threats to Health or Safety: We may use or disclose PHI if we believe it is necessary to prevent or lessen a serious and imminent threat to health or safety.
• Workers' Compensation: We may disclose PHI as authorized by workers' compensation laws.

Uses and Disclosures Requiring Your Authorization

Other than as stated above, we will not use or disclose your PHI without your written authorization. Specific situations requiring authorization include:

• Marketing Communications: We will not use your PHI for marketing purposes without your written consent.
• Sale of PHI: We will not sell your PHI without your authorization.
• Psychotherapy Notes: Most uses and disclosures of psychotherapy notes require your authorization.
• Before and After Photos: We will not use treatment photos for marketing or promotional purposes without your explicit written consent.

You may revoke your authorization at any time in writing, except to the extent that we have already acted based on your authorization.

Your Rights Regarding Your PHI

You have the following rights with respect to your Protected Health Information:

1. Right to Inspect and Copy

You have the right to inspect and obtain a copy of your PHI contained in your medical and billing records. Requests must be made in writing. We may charge a reasonable fee for copying and mailing costs.

2. Right to Amend

If you believe that information in your medical record is incorrect or incomplete, you may request an amendment. Requests must be made in writing and include a reason for the amendment. We may deny your request in certain circumstances.

3. Right to an Accounting of Disclosures

You have the right to request an accounting of certain disclosures of your PHI made by us during the six years prior to your request. This does not include disclosures for treatment, payment, healthcare operations, or disclosures you authorized.

4. Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to your request, except in limited circumstances (e.g., if you pay out-of-pocket in full and request we not disclose to your insurance company).

5. Right to Request Confidential Communications

You have the right to request that we communicate with you in a certain way or at a certain location. For example, you may request that we contact you only at work or via email.

6. Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice of Privacy Practices at any time, even if you have previously agreed to receive it electronically.

7. Right to Be Notified of a Breach

You have the right to be notified if your unsecured PHI is breached and such breach poses a significant risk of harm to you.

How to Exercise Your Rights

To exercise any of the rights described above, please submit a written request to:

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint.

Changes to This Notice

We reserve the right to change the terms of this Notice of Privacy Practices at any time. The revised notice will apply to all PHI we maintain, including information created or received before the changes. We will post the current notice in our office and on our website, with the effective date displayed prominently.

Acknowledgment of Receipt

You will be asked to sign an acknowledgment form confirming that you have received a copy of this Notice of Privacy Practices. If you decline to sign, we may still provide treatment, but we will document your refusal in your medical record.