NOTICE OF PRIVACY PRACTICES

The collection, use, disclosure, retention and disposal and destruction of Information are governed by the following Privacy Practices. This notice describes how medical information about User may be used and disclosed and how User can get access to this information. Please review it carefully. The Notice of Privacy Practices is incorporated by reference into, and accordingly is part of, the Terms of Use.

Uses and Disclosures

Treatment. User’s PHI may be used by staff members or disclosed to other health care professionals for the purpose of evaluating User’s health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in the User’s electronic medical record to all health professionals who may provide treatment or who may be consulted by staff members.

Payment. User’s PHI may be used to seek payment from User’s health plan (if applicable), from other sources of coverage such as an automobile insurer, or from credit card companies that User may use to pay for services. For example, a health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Health care operations. User’s PHI may be used as necessary to support the day-to-day activities and management of Company. For example, information on the services User received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.

Law enforcement. User’s PHI may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.

Public health reporting. User’s PHI may be disclosed to public health agencies as required by law. For example, Company is required to report certain communicable diseases to the state’s public health department.

Other uses and disclosures require authorization. Disclosure of User PHI or its use for any purpose other than those listed above requires the User’s specific written authorization on a document entitled Release of Information (ROI). If, after User authorizes use or disclosure of information, User no longer wishes that PHI be shared, User may submit a written revocation of the authorization. User’s decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred prior to User’s revocation.

Additional Uses of Information

Appointment reminders. User’s PHI will be used by Authorized Provider(s) and Company administrative staff to send appointment reminders.

Information about treatment. User’s PHI may be used to send information that User may find interesting on the treatment and management of applicable medical condition(s). Company may also send information describing other health-related services that may be interest User.

Individual Rights

User has certain rights under the federal privacy standards. These include:
  • The right of User to request restrictions on the use and disclosure of protected PHI
  • The right of User to receive confidential communications concerning User’s medical condition and treatment
  • The right of User to inspect and copy protected PHI
  • The right of User to amend or submit corrections to PHI
  • The right of User to receive an accounting of how and to whom PHI has been disclosed
  • The right of User to receive a printed copy of this notice

PsychConnect Duties

Company is required by law to maintain the privacy of User’s PHI and to provide User with this notice of privacy practices. Company is also required to abide by the privacy practices that are outlined in this notice.

Right to Revise Privacy Practices

As permitted by law, Company reserves the right to amend or modify its privacy practices. These modifications may be required by changes in federal and state laws and regulations. Upon request, Company will provide User with the most recently revised notice. The revised practices will be applied to all PHI Company maintains.

Requests to Inspect Protected Health Information

Users may generally inspect or copy the PHI that Company maintains. As permitted by federal regulation, Company requires that requests to inspect or copy PHI be submitted in writing. Requests will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

Complaints

User may choose to submit a comment or complaint about Company’s privacy practices and may do so by sending a letter outlining concerns to:

PsychConnect
Attn: Chief Operating Officer
8687 E. Via de Ventura, #310
Scottsdale, AZ 85258

Or, by sending via facsimile to the following number: 480-970-5318

Should User believe Company has violated User’s privacy rights, User should call the matter to the Company’s attention by sending a letter describing the cause of the concern to the same address.

User will not be penalized or otherwise retaliated against for filing a complaint.

How to Get Started

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