
HIPAA NOTICE OF PRIVACY PRACTICES
Your Information. Your Rights. Our Responsibilities.
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
We are required by law to maintain the privacy and security of your protected health information (“PHI”). We will follow the terms of this notice and applicable federal and state privacy laws, including HIPAA. We will notify you following a breach that may have compromised the privacy or security of your information.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use and disclose your PHI without your written authorization for the following purposes:
1. Treatment
We may use and share your information to provide, coordinate, or manage your care.
Example: We may share information with your referring physician or other healthcare providers involved in your care.
2. Payment
We may use and disclose your information to bill and receive payment for services provided to you.
Example: We may submit claims to your health insurance company for eligibility verification, utilization review, and coordination of benefits.
3. Healthcare Operations
We may use and disclose your information to run our business and improve care.
Examples include:
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quality improvement activities
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staff training
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compliance reviews
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business management
OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES
We may also use or disclose your information in the following situations without your authorization:
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As required by law
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Public health activities (such as disease reporting or recalls)
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To prevent or reduce a serious threat to health or safety
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Abuse, neglect, or domestic violence reporting (as required or permitted by law)
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Health oversight activities (audits, investigations, licensing)
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Workers’ compensation claims
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Law enforcement purposes (as required by law)
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Court orders, subpoenas, or legal proceedings
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Organ and tissue donation activities
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Medical examiner or funeral director purposes
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Research (as permitted by law and with appropriate safeguards)
SPECIAL PROTECTION FOR CERTAIN RECORDS (SUBSTANCE USE DISORDER RECORDS)
If we receive records that originate from a substance use disorder treatment program subject to 42 CFR Part 2, we will handle and disclose those records only as permitted by federal law, which may require additional patient consent or a court order.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights:
1. Right to Access Your Records
You may request to inspect or obtain a copy of your health information. We may charge a reasonable cost-based fee.
2. Right to Amend Your Records
You may request corrections to your health information if you believe it is incorrect or incomplete.
3. Right to Request Confidential Communications
You may request that we contact you in a specific way (e.g., phone, email, or mailing address). We will accommodate reasonable requests.
4. Right to Request Restrictions
You may request limits on how we use or disclose your information for treatment, payment, or healthcare operations. We are not required to agree, except where required by law.
5. Right to an Accounting of Disclosures
You may request a list of certain disclosures of your PHI made in the past six years, excluding disclosures for treatment, payment, and healthcare operations.
6. Right to a Copy of This Notice
You may request a paper copy of this Notice at any time.
7. Right to Choose a Representative
If someone has legal authority to act on your behalf (such as a guardian or healthcare power of attorney), we will treat that person as your representative.
8. Right to File a Complaint
If you believe your privacy rights have been violated, you may:
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Contact us using the information below
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File a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights
We will not retaliate against you for filing a complaint.
USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION
We will obtain your written authorization before using or disclosing your PHI for:
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Marketing purposes (when required by law)
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Sale of your health information
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Any other use not described in this Notice
You may revoke a written authorization at any time in writing. The revocation will not affect any use or disclosure already made in reliance on the authorization.
OUR RESPONSIBILITIES
We are required to:
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Maintain the privacy and security of your PHI
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Provide you with this Notice and follow its terms
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Notify you following a breach of unsecured PHI
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Not use or disclose your information other than as described unless permitted or required by law or with your written authorization
CHANGES TO THIS NOTICE
We reserve the right to change this Notice at any time. Any changes will apply to all PHI we maintain. The revised Notice will be available upon request, in our office, and on our website.
CONTACT INFORMATION
Privacy Officer:
Email: Info@therapiesleadingcare.com;
Phone: (205) 440-2992
Effective Date: May 20, 2026
