Effective from: Sep 01, 2023
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.
The privacy of your medical information is important to us. You may be aware that U.S. government regulators established a privacy rule – Health Insurance Portability and Accountability Act of 1996 “HIPAA” governing protected health information. This notice tells you about how it may be used, and about certain rights that you have.
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.
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’ll notify you in writing within 60 days.
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
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 for the purpose of payment or our operations with your health insurer. We will say “yes” unless the law requires us to share that information.
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with and why. We will include all the disclosures except for those about treatment, payment and health care operations and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee is you ask for another one within 12 months.
If you received this notice electronically, you can ask for a paper copy at any time. We will provide you with a paper copy promptly.
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 make sure that person has the authority and can act for you before we take any action.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share you information when needed to lessen a serious and imminent threat to health and safety.
Unless you give us written permission, we will never share your information for marketing purposes, sale of your information, and most sharing of psychotherapy notes.
We may use your medical information for treatment of you, without further specific notice to you, or written authorization by you. For example, if we refer you to a specialist, we may provide laboratory or test data to that specialist.
We may use your medical information to obtain payment for our services without further specific notice to you, or written authorization by you. For example, we are required to provide your insurance companies with a diagnosis code for your visit and a description of the services rendered so that they can decide the payment.
We may use your medical information for health care operations without specific notice to you, or written authorization by you. For example, our accountants may see your name, dates of treatment and procedure codes during audits of our books.
New York State law provides additional protection for information regarding HIV/AIDS. We will continue to follow New York law with respect to such information.
We may contact you by mail or phone, at your residence, to remind you of appointments or to provided information about treatment alternatives, or ask payment questions. Unless you instruct us otherwise, we may leave a message for you on any answering device or with any person who answers the phone at your residence.
We are required by law to maintain the privacy and security of your protected health information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information. Other uses of disclosures of your medical information will be made only with your written authorization. You may change your mind at any time. Let us know in writing if you change your mind.
We reserve the right to revise this notice and make a new notice effective for all protected health information we maintain. Any revised notice will be posted on our website and in our office, and copies will be available there.
