Notice of Privacy Practices

We reserve the right to amend this Notice and make revised provisions effective for all PHI we maintain. Copies of revised Notices are available upon request and at www.myclevelandhealthcenter.org.

USES AND DISCLOSURES OF YOUR PHI WITHOUT AUTHORIZATION

We may use or disclose your PHI without your written authorization for the following purposes:

Treatment

To coordinate and provide medical care, we may share your PHI with physicians, nurses, laboratories, pharmacies, and other health professionals involved in your care.

Payment

We may use your PHI to bill insurance companies, verify coverage, and obtain payment for services provided to you.

Healthcare Operations

We may use your PHI for administrative and operational purposes such as quality assessment, licensing, audits, accreditation, and compliance reviews.

Persons Involved in Your Care

We may disclose PHI to individuals involved in your care or payment if you do not object or in cases of emergency or incapacity.

Business Associates

We may disclose PHI to contractors or vendors (e.g., billing services, legal consultants) who are bound by confidentiality agreements and required to safeguard your information.

Public Health and Safety

We may disclose your PHI for public health purposes, including:

• Reporting communicable diseases
• Notifying appropriate authorities of abuse, neglect, or domestic violence
• Preventing or controlling disease or injury

Legal and Governmental Purposes

We may disclose your PHI as required by law, including:

• Court orders, subpoenas, or legal processes
• Health oversight agencies (e.g., licensing boards, audits)
• Law enforcement in limited situations
• National security or military authorities
• Workers' compensation claims

Appointment Reminders and Services

We may contact you with appointment reminders or information about services related to your care. You may request communication via alternative methods or locations.

USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

We will obtain your written authorization before using or disclosing your PHI for any purpose not described above, including:

Psychotherapy Notes

Except as allowed by law (e.g., for treatment or legal defense), we must have your authorization before using or disclosing psychotherapy notes.

Marketing

We must obtain your authorization for most marketing communications unless it involves a face-to-face discussion or a nominal gift.

Sale of PHI

We will not sell your PHI without your specific authorization.

Genetic Information

We will not use or disclose genetic information for underwriting or insurance purposes without your explicit consent, unless permitted by law.

You may revoke any authorization in writing at any time, except to the extent that action has already been taken based on it.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights with respect to your PHI:

Right to Access

You may inspect and request copies of your medical records, including in electronic format. Reasonable copying or mailing fees may apply.

Right to Amend

You may request amendments to your PHI. Requests must be in writing with a justification. We may deny requests under certain conditions.

Right to an Accounting of Disclosures

You may request a list of disclosures made outside of treatment, payment, or operations. The first request in a 12-month period is free.

Right to Request Restrictions

You may request limitations on how we use or disclose your PHI. We are not required to agree, except when you fully pay out-of-pocket for a service and request that the information not be shared with your health plan.

Right to Confidential Communications

You may request communications via specific methods (e.g., only by mail). We will accommodate reasonable requests.

Right to a Paper Copy

You may request a printed copy of this Notice, even if you received it electronically.

Right to Notification of Breach

We will notify you promptly if a breach of your unsecured PHI occurs.

COMPLAINTS

If you believe your rights under HIPAA have been violated, you may file a complaint with:

You may also file a complaint with the U.S. Department of Health and Human Services:

There will be no retaliation for filing a complaint.

CONTACT INFORMATION

For more information about this Notice or your privacy rights, please contact: