THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS IT. PLEASE READ IT CAREFULLY.
1. Our Commitment to Your Privacy
MindFullyMe Wellness (MFMW) recognizes the importance of keeping your health information private. MFMW is dedicated to safeguarding the confidentiality of your personal health information. To provide you with the highest quality care and to comply with legal regulations, we maintain a record of the care and services you receive. This document applies to all records of your care generated by this practice. It outlines how we may use and disclose your health information, as well as your rights regarding your information.
We are required by law to:
Ensure that your protected health information (PHI) remains confidential.
Provide you with this notice of our legal duties and privacy practices concerning your health information.
Abide by the terms outlined in this notice as it is currently in effect.
Please note that we may update this notice. If changes are made, they will apply to all existing information we have on file. The updated notice will be available upon request, in our offices, and on our website.
2. How Your Health Information May Be Used and Disclosed
The following categories explain how we may use or disclose your health information. Examples are provided for clarity, but not every situation will be listed. However, all uses and disclosures will fall into one of these categories.
For Treatment, Payment, or Healthcare Operations: Federal privacy regulations allow healthcare providers to use or disclose your personal health information without your written authorization, when it relates to your treatment, payment, or healthcare operations. For example, if a clinician consults with another healthcare provider regarding your condition, we may share your health information to assist in diagnosing or treating you.
Lawsuits and Legal Disputes: If you are involved in a lawsuit, we may be required to disclose health information in response to a court or administrative order. If there is a subpoena, discovery request, or similar legal process involving your health information, we may disclose your records, but only after reasonable efforts to notify you or seek a protective order.
3. Uses and Disclosures Requiring Your Authorization
Certain uses and disclosures require your explicit consent:
Psychotherapy Notes: We may keep “psychotherapy notes” as defined under HIPAA regulations. These notes are separate from your treatment record and are not used for treatment, payment, or healthcare operations. We will not disclose these notes unless:
It is for our use in your treatment purposes.
It is to aid in training or supervision of mental health professionals.
It is required for defending ourselves, and the practices, in legal proceedings initiated by you.
It is requested by the U.S. Department of Health and Human Services to ensure compliance with HIPAA.
Marketing: We will not use or disclose your personal health information for marketing purposes.
Sale of PHI: We do not sell your personal health information in the course of our business.
4. Uses and Disclosures Not Requiring Your Authorization
We may use or disclose your health information without your consent for the following reasons:
When required by law, as long as the disclosure complies with relevant legal requirements.
To report public health activities, such as suspected abuse, or to prevent serious threats to health or safety.
For health oversight activities, including audits and investigations.
In response to judicial or administrative orders, though we prefer obtaining your authorization first.
For law enforcement purposes, such as reporting crimes occurring on our premises.
To coroners or medical examiners as necessary.
For research purposes, under conditions that protect your privacy.
For specialized government functions, such as military or intelligence operations, or the protection of government officials.
For workers’ compensation purposes, with or without your authorization.
5. Disclosures Requiring an Opportunity for You to Object
Disclosures to Family, Friends, or Others: We may share your health information with family members, friends, or others involved in your care or payment, unless you object. In emergencies, this may happen without prior consent.
6. Your Rights Regarding Your Health Information
You have several rights regarding your personal health information (PHI):
Right to Request Restrictions: You can ask that we not use or disclose certain PHI for treatment, payment, or healthcare operations. We are not required to agree to these requests.
Right to Request Restrictions for Out-of-Pocket Expenses: You can request restrictions on disclosures of your PHI to health plans if you have paid out-of-pocket in full for a service.
Right to Choose How we Contact You: You can request that we contact you in a specific way (e.g., via phone, email, or mail to a different address), and we will comply with reasonable requests.
Right to Access Your PHI: You have the right to review and obtain copies of your medical records, except for psychotherapy notes. We will provide access within 35 days of receiving your written request, and you may be charged a reasonable fee for copying and mailing.
Right to Request a List of Disclosures: You can request a list of disclosures we have made of your PHI, excluding treatment, payment, or healthcare operations disclosures. You can ask for a report covering the last six years.
Right to Request Corrections or Updates: If you believe that any information in your health record is incorrect or incomplete, you have the right to request changes. We will respond within 65 days.
Right to Receive a Paper or Electronic Copy of This Notice: You have the right to request a paper copy of this privacy notice at any time, even if you have agreed to receive it electronically.