Privacy Policy

Notice of Privacy Practices

I. How We May Use and Disclose Your Protected Health Information

The following categories describe different ways that we use and disclose PHI. For each category, we will explain what we mean and provide examples. Not every use or disclosure in a category will be listed.

A. For Treatment We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. This includes the coordination or management of your healthcare with a third party. Example: We may disclose your PHI to another physician or healthcare provider (e.g., a specialist or laboratory) who is involved in your care.

B. For Payment We may use and disclose your PHI to obtain payment for the healthcare services we provide to you. Example: We may disclose your PHI to your health insurance plan so it will pay for your services.

C. For Healthcare Operations We may use and disclose your PHI for our healthcare operations, which are activities necessary to run our practice and ensure that all of our patients receive quality care. Example: We may use PHI to review our treatment and services and to evaluate the performance of our staff in caring for you.

II. Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not covered by this Notice or the laws that apply to us will be made only with your written authorization. Specifically, we will obtain your written authorization for:

Marketing: We will not use or disclose your PHI for marketing purposes without your authorization.

Sale of PHI: We will not sell your PHI without your authorization.

Psychotherapy Notes: Most uses and disclosures of psychotherapy notes require your authorization.

You may revoke this authorization, at any time, in writing, except to the extent that our practice has taken an action in reliance on the use or disclosure indicated in the authorization.

III. Uses and Disclosures Permitted or Required Without Authorization

We may use or disclose your PHI in the following situations without your authorization, as permitted or required by law:

As Required by Law: We will disclose PHI about you when required to do so by federal, state, or local law.

Public Health Activities: For public health purposes, such as controlling disease, injury, or disability.

Health Oversight Activities: To a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.

Judicial and Administrative Proceedings: In response to a court order, administrative order, subpoena, or other lawful process.

Law Enforcement: To law enforcement officials if certain legal conditions are met (e.g., to identify or locate a suspect, fugitive, material witness, or missing person).

To Avert a Serious Threat to Health or Safety: To prevent a serious threat to your health and safety or the health and safety of the public or another person.

Workers’ Compensation: To comply with workers' compensation laws.

Specialized Government Functions: For military, national security, and other specialized government functions.

Breach Notification: We may use or disclose your PHI to provide legally required notices of unauthorized access to or disclosure of your health information.

IV. Your Rights Regarding Your Protected Health Information

You have the following rights regarding PHI we maintain about you:

Right to Inspect and Copy: You have the right to inspect and obtain a copy of PHI that may be used to make decisions about your care. We may charge a reasonable, cost-based fee.

Right to Request an Amendment: If you believe that PHI we have about you is incorrect or incomplete, you may ask us to amend it. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request.

Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we made of your PHI for purposes other than treatment, payment, or healthcare operations.

Right to Request Restrictions: You have the right to request a restriction on our use or disclosure of your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, except for a restriction on a disclosure to a health plan for purposes of carrying out payment or healthcare operations if you have paid for the service out-of-pocket in full.

Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.

Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

V. Our Responsibilities

Bliss Psychiatry is required by law to:

Maintain the privacy and security of your PHI.

Provide you with this notice of our legal duties and privacy practices with respect to your PHI.

Abide by the terms of the notice currently in effect.

Notify you if a breach occurs that may have compromised the privacy or security of your information.

We reserve the right to change our privacy practices and the terms of this notice. If we make a material change, we will post the revised notice in our office and have copies available upon request.

VI. Complaints and Contact Information

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, please contact our Privacy Officer.

Bliss Psychiatry Privacy Officer 515-441-7944

You will not be penalized for filing a complaint.

To file a complaint with the U.S. Department of Health and Human Services, please contact:

U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 1-877-696-6775 www.hhs.gov/ocr/privacy/hipaa/complaints/

If you have any questions about this notice, please contact our Privacy Officer.