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HIPAA Notice of Privacy Practices

Last updated: [DRAFT — pending legal review]

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 Commitment

Brain Centers is required by law to maintain the privacy of your Protected Health Information (PHI), provide this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, and manage your care — for example, among our clinicians involved in your treatment.

Payment

We may use and disclose your PHI to bill and obtain payment for services, including with insurers where applicable.

Health Care Operations

We may use and disclose your PHI for quality improvement, training, and administrative functions necessary to operate our practice.

As Required by Law

We may disclose your PHI when required by federal, state, or local law.

Appointment Reminders & Health-Related Communications

We may contact you about appointments and treatment options.

Uses and Disclosures Requiring Your Authorization

Most uses and disclosures not described above — including marketing, the sale of PHI, and most psychotherapy notes — require your written authorization. You may revoke any authorization you have given us at any time.

Your Health Information Rights

  • Right to inspect and copy your PHI
  • Right to request an amendment to your PHI
  • Right to request an accounting of certain disclosures
  • Right to request restrictions on certain uses and disclosures
  • Right to request confidential communications
  • Right to receive a paper copy of this Notice upon request
  • Right to be notified following a breach of unsecured PHI

Our Responsibilities

We are required to maintain the privacy of your PHI, abide by the terms of this Notice, and notify you following a breach of unsecured PHI.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have, as well as information we receive in the future. We will post the current Notice on our website.

Complaints

You may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.

Contact / Privacy Officer

Privacy Officer, Brain Centers

Email: privacy@brain-centers.com

Phone: (858) 555-0142

4510 Executive Dr, Suite P5, San Diego, CA 92121