Notice of Privacy Policies

Effective Date: September 2024

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY BROADENED HORIZONS PSYCHIATRY AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I may share protected health information as necessary to carry out treatment, payment, and healthcare operations as permitted by law. I am required by law to maintain the privacy of your protected health information, provide you with this Notice, and follow the terms currently in effect. State law may provide additional privacy protections beyond those required by the federal Health Insurance Portability and Accountability Act (HIPAA). I reserve the right to revise this Notice. A copy of the current Notice is available upon request.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
Authorization and Consent
Except as outlined below, I will not use or disclose your protected health information for any purpose other than treatment, payment, or healthcare operations unless you have signed a written authorization. You may revoke your authorization in writing at any time. This revocation will apply going forward, except to the extent I have already taken action based on your authorization, or if the authorization was obtained as a condition of obtaining insurance coverage and the insurer has a legal right to contest a claim.

Uses and Disclosures for Treatment
I may use and disclose your protected health information as necessary for your treatment. This includes using information you provide about your symptoms, history, and response to treatment to guide your care, including medications, therapy, and other services.

Uses and Disclosures for Payment
I may use and disclose your protected health information as necessary for payment purposes. This may include sharing information with your insurance company (if applicable) to obtain payment for services provided. I may also use your information to prepare invoices or billing statements.

Uses and Disclosures for Healthcare Operations
I may use and disclose your protected health information as necessary for healthcare operations. These activities may include quality improvement, business management, licensing, and other activities needed to run the practice and improve care.

Individuals Involved in Your Care
I may share limited information with a family member, friend, or other person involved in your care only with your permission, or when required or permitted by law in limited situations, such as an emergency.

Business Associates
Some services are provided through contracts with outside individuals or organizations (such as billing, legal, or administrative services). When necessary, I may share your protected health information with these business associates. I require all business associates to appropriately safeguard your information.

Other Uses and Disclosures
I may use or disclose your protected health information without your authorization when permitted or required by law. These disclosures are limited to what is necessary and permitted by law. This may include situations such as:
When disclosure is required by federal or state law
To protect your safety or the safety of others
In response to a court order, subpoena, or other legal process when permitted or required by law
For public health, licensing, regulatory, or health oversight activities
To medical examiners, coroners, or law enforcement officials when authorized or required by law
Certain categories of health information, including reproductive health information and substance use disorder treatment information when applicable, may receive additional protections under federal or state law. When those protections apply, I will comply with the additional requirements governing the use and disclosure of that information.

DISCLOSURES REQUIRING AUTHORIZATION
Psychotherapy Notes
I must obtain your written authorization before disclosing psychotherapy notes, except in limited circumstances permitted by law, such as to respond to a legal defense, or for regulatory review.

Genetic Information
I must obtain your written authorization before using or disclosing genetic information for most purposes, except as permitted by law.

Marketing
I do not use or disclose your protected health information for marketing purposes. If this were to change, I would obtain your written authorization before using or disclosing your information for marketing, as required by law.

Sale of Protected Health Information
I do not sell your protected health information. If this were ever to change, I would obtain your written authorization before any such use or disclosure, as required by law.

YOUR RIGHTS

Choose How I Contact You
You can ask that I communicate with you in a specific way or at a specific location, and I will accommodate reasonable requests whenever possible. Requests must be made in writing.

Choose Someone to Act for You
If you have given someone medical power of attorney, or if someone is your legal guardian or personal representative, that person may exercise your privacy rights and make choices about your health information to the extent permitted by law.

Get a Copy of Your Records
You can ask to see or receive a copy of your health records. In many cases, you can access your records through the secure client portal.
If you would like records sent to another provider or third party, or would like them provided in a specific format, you may submit a written request. I will respond in accordance with applicable laws. A reasonable fee may apply in certain situations.

Ask Me to Correct Your Records
If you believe information in your records is incorrect or incomplete, you may request a correction in writing. I may deny the request, but I will explain the reason if I do.

Get a List of Disclosures
You have the right to request a list of the times your protected health information has been shared outside of treatment, payment, and healthcare operations. Requests must be made in writing.

Ask Me to Limit What Is Shared
You can ask me not to use or share certain health information. While I am not required to agree, I will consider reasonable requests.
If you pay for a service yourself, you can ask that information related to that service not be shared with your health plan. I will honor that request unless a law requires me to share the information.

Be Notified of a Breach
You will be notified if a breach occurs involving your unsecured protected health information.

Get a Copy of This Notice
You have the right to receive a paper copy of this Notice, even if you agreed to receive it electronically.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with me at 316-202-5600 or with the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
U.S. Department of Health and Human Services Office:
Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints/
Phone: 1-877-696-6775