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HIPAA Notice of Privacy Practices

Last updated: [DRAFT — pending legal review]

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 Commitment

Brain Centers is required by law to maintain the privacy of your Protected Health Information (PHI), provide this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

Treatment — to provide, coordinate, and manage your care (e.g., among our clinicians).

Payment — to bill and obtain payment for services, including with insurers where applicable.

Health Care Operations — for quality improvement, training, and administrative functions.

As Required by Law — when required by federal, state, or local law.

Appointment Reminders & Health-Related Communications — we may contact you about appointments and treatment options.

Uses and Disclosures Requiring Your Authorization

Most uses and disclosures not described above (e.g., marketing, sale of PHI, most psychotherapy notes) require your written authorization, which you may revoke.

Your Health Information Rights

Right to inspect and copy your health information
Right to request amendment of your records
Right to request an accounting of disclosures
Right to request restrictions on how we use or share your information
Right to request confidential communications
Right to receive a paper copy of this Notice
Right to be notified of a breach of unsecured PHI

Our Responsibilities

We are required to maintain the privacy of PHI, abide by this Notice, and notify you following a breach of unsecured PHI.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have, as well as information we receive in the future.

Complaints

You may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.

Contact / Privacy Officer

Privacy Officer, Brain Centers
privacy@brain-centers.com
(858) 555-0142
4510 Executive Dr, Suite P5, San Diego, CA 92121