HIPAA Notice

Summary of Notice of Privacy Practices

The Notice of Privacy Practices (available upon request) contains a detailed description of how our office will protect your health information, your rights as a patient and our common practices in dealing with patient health information. Please refer to that Notice for further information.

Uses and Disclosures of Health Information

We will use and disclose your health information in order to treat you or to assist other health care providers in treating you. We will also use and disclose your health information in order to obtain payment for our services or to allow insurance companies to process insurance claims for services rendered to you by us or other health care providers. Finally, we may disclose your health information for certain limited operational activities such as quality assessment, licensing, accreditation and training of students. We may use and disclose your protected health information to contact you for appointment reminders, billing, or general information related to your care via text message

Uses and Disclosures Based on Your Authorization

Except as stated in more detail in the Notice of Privacy Practices, we will not use or disclose your health information without your written authorization.

Uses and Disclosures Not Requiring Your Authorization

In the following circumstances, we may disclose your health information without your written authorization:

To family members or close friends who are involved in your health care;
For certain limited research purposes;
For purposes of public health and safety;
To Government agencies for purposes of their audits, investigations and other oversight activities;
To government authorities to prevent child abuse or domestic violence;
To the FDA to report product defects or incidents;
To law enforcement authorities to protect public safety or to assist in apprehending criminal offenders;
When required by court orders, search warrants, subpoenas and as otherwise required by the law.

Patient Rights

As our patient, you have the following rights:

To have access to and/or a copy of your health information;
To receive an accounting of certain disclosures we have made of your health information;
To request restrictions as to how your health information is used or disclosed;
To request that we communicate with you in confidence;
To request that we amend your health information;
To receive notice of our privacy practices.

Confidentiality of Substance Use Disorder Patient Records

We may receive your health information related to substance use disorder treatment. The confidentiality of substance use disorder patient records is protected by special federal regulations (commonly called “Part 2”). Unless otherwise permitted by the Part 2 regulations, we may only disclose your substance use disorder treatment records for treatment, payment, and health care operations with your written consent. Upon receipt of your written consent, we may use and disclose your substance use disorder treatment records in the same manner we are permitted to use and disclose your health information as described above. We may disclose your substance use disorder treatment records without your consent to medical personnel in a medical emergency, to public health authorities if those records have been de-identified, or to qualified personnel for research, audit, or program evaluation purposes. We will not use or disclose substance use disorder treatment records or testimony containing information from your records in civil, criminal, administrative, or legislative proceedings against you unless (1) you have consented to such use or disclosure in writing; or (2) a court order has been issued and you have been provided notice and an opportunity to be heard. A court order authorizing use or disclosure of your substance use disorder treatment records must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested Record can be used or disclosed.

If you have a question, concern or complaint regarding our privacy practices, please refer to the Notice of Privacy Practices (available upon request) for the person whom you may contact.