Privacy Policy & HIPAA Notice of Privacy Practices

HIPAA Notice of Privacy Practices for Protected Health Information (PHI)

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Legal Duty

Federal and state law requires us to:

• Maintain the privacy of your Protected Health Information (PHI)
• Provide you with this Notice of our legal duties and privacy practices
• Follow the terms of the Notice currently in effect
• Notify you if we are unable to agree to a requested restriction
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations

How We May Use and Disclose Your Health Information

1. Treatment, Payment, and Health Care Operations (Without Your Authorization)

Treatment: We may use and disclose your PHI to provide, coordinate, or manage your treatment and related services. This includes consultation and referrals to other providers involved in your care.

Example: Sharing your treatment plan with a consulting psychiatrist or coordinating care with your primary care physician.

Payment: We may use and disclose your PHI to obtain payment for treatment services, including billing, claims management, medical necessity reviews, and utilization review.

Example: Submitting claims to Maryland Medicaid or verifying your insurance coverage and benefits.

Health Care Operations: We may use and disclose your PHI for our business operations, including quality assessment, staff training, licensing, accreditation, and business planning.

Example: Conducting internal quality improvement reviews or training clinical staff on evidence-based practices.

2. Other Permitted and Required Uses Without Authorization

We may use or disclose your PHI without your authorization in the following circumstances:

• As Required by Law: When federal, state, or local law mandates disclosure
• Public Health Activities: Reporting communicable diseases, adverse drug reactions, or product recalls
• Health Oversight Activities: Audits, investigations, inspections by licensing boards or health agencies
• Judicial and Administrative Proceedings: In response to court orders or subpoenas
• Law Enforcement: When required by law or court order, or to report crimes on our premises
• Coroners and Medical Examiners: For identification purposes or determining cause of death
• Serious Threat to Health or Safety: To prevent or lessen a serious threat to your health or safety or that of others
• Victims of Abuse, Neglect, or Domestic Violence: As required by Maryland law
• Workers' Compensation: As authorized by workers' compensation laws

3. Uses and Disclosures Requiring Your Authorization

All other uses and disclosures not described above will be made only with your written authorization. You may revoke your authorization at any time by submitting a written request to our Privacy Officer. The revocation will not affect any uses or disclosures already made in reliance on your authorization.

Your Individual Rights Regarding Your Health Information

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your medical and billing records. To request copies, submit a written request to our Privacy Officer. We may charge a reasonable fee for copying, mailing, and supplies. We may deny your request in certain limited circumstances as permitted by law.

Right to Request Amendments

If you believe your PHI is incorrect or incomplete, you may request an amendment. Your request must be in writing and include a reason supporting your request. We may deny your request if we did not create the information, it is not part of our records, or if the information is accurate and complete.

Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures" of your PHI made by us in the six years prior to your request (or shorter period if you specify). The accounting will not include disclosures for treatment, payment, health care operations, or those made with your authorization.

Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request except in one situation: if you pay out-of-pocket in full for a service and request that we not disclose PHI related solely to that service to your health plan for payment or health care operations, we must honor that request.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health matters in a certain way or at a certain location. For example, you may request that we contact you only at work or by mail. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this Notice at any time, even if you previously agreed to receive it electronically. You may obtain a copy from our website, request one from our staff, or contact our Privacy Officer.

Right to Notification of a Breach

You have the right to be notified in the event that we (or a Business Associate) discover a breach of your unsecured PHI.

Changes to This Notice

We reserve the right to change this Notice at any time. Any revised Notice will apply to PHI we already have as well as any PHI we create or receive in the future. We will post the current Notice in our facility and on our website, with the effective date in the top right corner. You may request a copy of the current Notice at any time.

Complaints

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

To file a complaint with us, contact:

Privacy Officer
1114 E 20th Street LLC
1114 E 20th Street, Baltimore, MD 21218
Phone: (443) 320-2706
Email: info@east20thwellness.com

To file a complaint with HHS:

U.S. Department of Health and Human Services
Office for Civil Rights
Online: www.hhs.gov/ocr/privacy/hipaa/complaints/
Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775