Notice of Privacy Practices

Your rights

When it comes to your health information, you have the right to:

• Get a copy of your medical record. 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, usually within 30 days of your request (sooner for California patients; see “State laws” below). We may charge a reasonable, cost-based fee.
• Ask us to correct your medical record. If you think health information about you is incorrect or incomplete, you can ask us to correct it. We may say “no,” but we’ll tell you why in writing within 60 days.
• Request confidential communications. You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and we may say “no” if it could affect your care. If you pay for a service or item out-of-pocket in full, you can ask us not to share that information with your health insurer for payment or our operations, and we will say “yes” unless a law requires us to share it.
• Get a list of those with whom we’ve shared information. You can ask for a list (accounting) of the times we’ve shared your health information for six years before the date you ask, who we shared it with, and why. It includes all disclosures except those for treatment, payment, and health care operations, and certain others (such as any you asked us to make). We’ll provide one accounting a year for free but may charge a reasonable, cost-based fee for another within 12 months.
• Get a copy of this notice. You can ask for a paper copy at any time, even if you agreed to receive it electronically. We will provide it promptly.
• Choose someone to act for you. If someone is your legal guardian or has your medical power of attorney, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority before we take any action.
• File a complaint if you feel your rights are violated (see “Complaints” below).

Your choices

For certain health information, you can tell us your choices about what we share. Tell us what you want, and we will follow your instructions. You have the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care or payment for your care.
• Share information in a disaster relief situation.

If you can’t tell us your preference (for example, if you are unconscious), we may share your information if we believe it is in your best interest. We may also share it when needed to lessen a serious and imminent threat to health or safety.

We never share your information for marketing, sell your information, or share most psychotherapy notes unless you give us written permission.

We may contact you for fundraising, but you can tell us not to contact you again. If we have substance use disorder records about you that are subject to 42 CFR Part 2, we will give you clear notice in advance and a choice about whether to receive fundraising communications that use that information.

How we typically use or share your health information

• Treat you. We can use your health information and share it with other professionals who are treating you. Example: Dr. Sonya consults with a specialist about your care.
• Run our practice. We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: we use health information about you to manage your treatment and services.
• Bill for your services. We can use and share your health information to bill and get payment for your care. We do not bill insurance directly. Example: we give you a superbill so you can submit it to your insurance yourself for possible reimbursement.

Other ways we may use or share your health information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes:

• Public health and safety: preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
• Research.
• Complying with the law, including with the U.S. Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
• Organ and tissue donation requests.
• Working with a medical examiner, coroner, or funeral director when an individual dies.
• Workers’ compensation claims, law enforcement purposes, health oversight agencies, and special government functions such as military, national security, and presidential protective services.
• Responding to a court or administrative order or a subpoena.

If we have substance use disorder records about you that are subject to 42 CFR Part 2, we will not use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your written consent or (2) a court order and a subpoena.

For more information, see www.hhs.gov/hipaa/for-individuals.

State laws that may give you more protection

California’s Confidentiality of Medical Information Act (CMIA) and other California, Hawaii, and New Hampshire laws can limit how certain information is shared, such as mental health, HIV test results, and substance use records. When a state law gives your information more protection than federal law, we follow the stricter rule.

Under California law, we will not share your medical information for purposes other than those the law allows unless you give us written authorization, and you can revoke that authorization in writing.

California patients may inspect their records within 5 working days of a written request and receive copies within 15 days.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you do, you may change your mind at any time. Let us know in writing.
• Information we share as allowed by this notice may be shared again by the person or organization that receives it, and may then no longer be protected by federal privacy law.

Complaints

You can complain if you feel we have violated your rights by contacting our Privacy Officer, Sonya Kim, MD, at Drsonya@BestMDHouseCalls.com.

• You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint.

We will not retaliate against you for filing a complaint.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request and on our website.

Privacy Officer

Privacy Officer: Sonya Kim, MD, Drsonya@BestMDHouseCalls.com.

To exercise any of these rights or ask a question about this notice, contact our Privacy Officer, Sonya Kim, MD, at Drsonya@BestMDHouseCalls.com.