Notice of Privacy Practices
- 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.
- IT IS OUR LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).
By law, we are required to ensure that your PHI is kept private. The PHI constitutes information created or noted by us that can be used to identify you. It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. We are required to provide you with this Notice of our privacy procedures and to notify you of a breach of your unsecured PHI. This Notice must explain when, why, and how we would use and disclose your PHI. Use of PHI means when we share, apply, utilize, examine, or analyze information within our practice. PHI is disclosed when we release, transfer, give or otherwise reveal it to a third party outside our practice. With some exceptions, we may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, we are always legally required to follow the privacy practices described in this Notice.
Please note that we reserve the right to change the terms of this Notice and our privacy policies at any time. Any changes will apply to PHI already on file with us. Before we make any significant changes to our policies, we will immediately change this Notice and post a new copy of it in our offices and on our website. You may also request a copy of this Notice from us, or you can view a copy of it in our offices or on our website, located at www.altamirarecovery.com.
- HOW WE WILL USE AND DISCLOSE YOUR PHI.
We will use and disclose your PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find the various categories of our uses and disclosures, with some examples.
- Uses and Disclosures Related to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent.
We may use and disclose your PHI without your consent for the following reasons:
- For treatment. We may disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with healthcare services or are otherwise involved in your care. Examples: If a psychiatrist is treating you, we may disclose your PHI to her/him to coordinate your care. We may exchange information with another service provider if you move to that service provider and exchange of information is necessary for continuity of service. We may use PHI to provide appointment reminders.
- For health care operations. We may disclose your PHI, as allowed by state and federal law, to facilitate the efficient and correct operation of our practice. Examples: Quality control – we may use your PHI in the evaluation of the quality of health care services that you have received or to evaluate the performance of the health care professionals who provided you with those services. We may also provide your PHI to our attorneys, accountants, consultants, and others to make sure that we are in compliance with applicable law.
- To obtain payment for treatment. We may use and disclose your PHI to bill and collect payment for the treatment and services we provided you. Example: we might send your PHI to your insurance company or health plan to get payment for the health care services that we have provided to you. We could also provide your PHI to business associates, such as billing companies, claims processing companies, and others that process health care claims for our office.
- Certain Other Uses and Disclosures Do Not Require Your Consent.
We may use and/or disclose your PHI without your consent or authorization for the following reasons:
- When disclosure is required by federal, state, or local law; judicial, board, or administrative proceedings; or, law enforcement. Example: we may make a disclosure to the appropriate officials when a law requires us to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.
- If disclosure is compelled by court order in a proceeding before a court or an administrative agency under its lawful authority.
- If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.
- If disclosure is compelled by the patient or the patient’s representative under state law or corresponding federal statutes or regulations, such as the HIPAA Privacy Rule that requires this Notice.
- To avoid harm. We may provide PHI to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of an individual or the public.
- As required by reporting laws if we suspect abuse, neglect, or domestic violence.
- For public health activities. Example: In the event of your death, if disclosure is permitted or compelled, we may give information about you to a coroner, medical examiner, or funeral director.
- For specific government functions. Example: We may disclose PHI of military personnel and veterans under certain circumstances. We may disclose PHI in the interests of national security, such as protecting the President of the United States or assisting with intelligence operations.
- If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law. Example: When compelled by U.S. Secretary of Health and Human Services to investigate or assess our compliance with HIPAA.
- For research purposes. In certain circumstances, we may provide PHI to conduct medical research.
- For workers’ compensation purposes. We may provide PHI to comply with Workers’ Compensation laws.
- If an arbitrator or arbitration panel compels disclosure, when arbitration is lawfully requested by either party, according to subpoena duces tecum (g., a subpoena for mental health records) or any other provision authorizing disclosure in a proceeding before an arbitrator or arbitration panel.
- If disclosure is otherwise expressly required by law.
- Certain Uses and Disclosures Require You to Have the Opportunity to Object.
- Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or another individual who you indicate is involved in your care or responsible for the payment for your care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.
- Other Uses and Disclosures Require Your Prior Written Authorization.
In any other situation not described in Sections IIIA, IIIB, and IIIC above, we will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures of your PHI by us.
Specifically, we will not make the following types of uses or disclosures without your express written authorization:
- Psychotherapy notes. We will not use or disclose psychotherapy notes except for (i) use by the originator of the notes to carry out treatment, (ii) use or disclosure for our counseling training programs, or (iii) use or disclosure to defend ourselves in a legal action brought by you.
- Marketing. We will not use or disclose your PHI for marketing, except if the communication is in the form of (i) a face-to-face communication made by us to an individual or (ii) a promotional gift of nominal value provided by us.
- Sale of PHI. We will not disclose your PHI in a sale of PHI.
- WHAT RIGHTS YOU HAVE REGARDING YOUR PHI
These are your rights with respect to your PHI:
- The Right to See and Get Copies of Your PHI. In general, you have the right to see your PHI that is in our possession or to get copies of it; however, you must request it in writing. If we do not have your PHI, but we know who does, we will advise you how you can get it. You will receive a response from us within 30 days of receiving your written request. Under certain circumstances, we may feel we must deny your request, but if we do, we will give you, in writing, the reasons for the denial. We will also explain your right to have the denial reviewed. If you ask for copies of your PHI, we may charge you a flat fee up to $6.50 to fulfill each request.
- The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that we limit how we use and disclose your PHI. While we will consider your request, we are not legally bound to agree unless the request is for restriction of disclosure of your PHI to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law and the PHI relates solely to a health care service for which you have already paid in full. If we do agree to your request, we will put those limits in writing and abide by them except in emergency situations. You do not have the right to restrict the uses and disclosures that we are legally required or permitted to make.
- The Right to Choose How we Send Your PHI to You. It is your right to ask that your PHI be sent to you at an alternate address (for example, sending information to your work address rather than your home address) or by an alternate method (for example, via email instead of by regular mail). We are obliged to agree to your request providing that we can give you the PHI, in the format you requested, without undue inconvenience.
- The Right to Get a List of the Disclosures we Have Made. You are entitled to a list of our disclosures of your PHI. We will include all disclosures except for those regarding treatment, payment, and health care operations, and certain other disclosures (such as those to law enforcement or persons involved in your care or those you asked us to make).
We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we give you will include disclosures made in the previous six years unless you indicate a shorter period. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. We will provide the list to you at no cost unless you make more than one request in the same year, in which case we will charge you a reasonable sum based on a set fee for each additional request.
- The Right to Amend Your PHI. If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that we correct the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of our receipt of your request. We may deny your request, in writing, if we find that: the PHI is (a) correct and complete, (b) excluded from your right of access above, (c) not part of our records, or (d) written by someone other than us. Our denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and our denial be attached to any future disclosures of your PHI. If we approve your request, we will make the change(s) to your PHI. Additionally, we will tell you that the changes have been made, and we will advise all others who need to know about the change(s) to your PHI.
- The Right to Getting This Notice by Email. You have the right to get this notice by email. You have the right to obtain a paper copy of it, as well.
- HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
If in your opinion, we may have violated your privacy rights, or if you object to a decision we made about access to your PHI, you are entitled to file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W. Washington, D.C. 20201. If you file a complaint about our privacy practices, we will take no retaliatory action against you.
- PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact us at:
125 Bulkley Ave
Sausalito, CA 94965