Notice of Privacy Practices

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.

Bay Psychiatric Associates collects health information about you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of this medical practice, but the information in the record belongs to you. The law permits us to use or disclose your health information for the following purposes:

We use medical information about you to provide your medical care. We may disclose medical information to our employees and others who are involved in providing the care you need. For example, we may share your medical information with other physicians or health care providers who will provide services that we do not provide, with a pharmacist who needs it to dispense a prescription, or with a laboratory that performs tests. We may also disclose medical information to members of your family or others who can help you when you are sick or injured.

We use and disclose medical information about you to obtain payment for the services we provide. For example, we give your health plan the information it requires before it will pay us. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to you.

We may use and disclose medical information about you to operate this medical practice.

For example, we may use and disclose this information to review and improve the quality of care we provide or to evaluate the competence and qualifications of our professional staff. We may use and disclose this information to obtain authorization from your health plan for services or referrals, and as necessary for medical reviews, legal services, and audits, including fraud and abuse detection and compliance programs, business planning, and management. We may also share your medical information with our “business associates,” such as our billing service, that perform administrative services for us. We have written contracts with each of these business associates requiring them to protect the confidentiality of your medical information.

Although federal law does not protect health information disclosed to someone other than another health care provider, health plan, or health care clearinghouse, California law prohibits all recipients of health care information from redisclosing it except as specifically required or permitted by law.

We may also share your information with other health care providers, health care clearinghouses, or health plans that have a relationship with you when they request this information to help with their quality assessment and improvement activities, training programs, accreditation, certification, or fraud and abuse detection efforts.

We may use and disclose medical information to contact and remind you about appointments. If you are not home, we may leave this information on your answering machine or in a message left with the person answering the phone.

We may use and disclose medical information about you by having you sign in when you arrive at our office. We may also call out your name when we are ready to see you.

We may disclose your health information to notify or assist in notifying a family member, your personal representative, or another person responsible for your care about your location, general condition, or, unless you have instructed us otherwise, in the event of your death.

In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts.

If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communicating with your family and others.

Provided we do not receive payment for making these communications, we may contact you to encourage you to purchase or use products or services related to your treatment, case management, or care coordination, or to recommend other treatments, therapies, health care providers, or settings of care that may be of interest to you.

We may also describe products or services provided by this practice and tell you which health plans we participate in.

We may receive financial compensation to speak with you face-to-face, to provide small promotional gifts, or to cover our cost of reminding you to take or refill your medication or otherwise communicate about a drug or biologic currently prescribed for you, but only if you either:

1. Have a chronic and seriously debilitating or life-threatening condition and the communication is made to educate or advise you about treatment options or to maintain adherence to a prescribed course of treatment; or
2. Are a current health plan enrollee and the communication is limited to the availability of more cost-effective pharmaceuticals.

If we make these communications while you have a chronic and seriously debilitating or life-threatening condition, we will provide notice of:
(1) the fact and source of the remuneration; and
(2) your right to opt out of future remunerated communications by calling the communicator’s toll-free number.

We will not otherwise use or disclose your medical information for marketing purposes or accept payment for other marketing communications without your prior written authorization.

We will not sell your health information without your prior written authorization. The authorization will disclose that we will receive compensation for your health information, and we will stop any future sales of your information to the extent you revoke that authorization.

As required by law, we will use and disclose your health information, limiting our use or disclosure to the relevant requirements of the law.

We may, and are sometimes required by law, to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug

Administration problems with products and reactions to medications; and reporting disease or infection exposure.

When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.

We may, and are sometimes required by law, to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by federal and California law.

We may, and sometimes are required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. Therefore, we may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.

We may, and are sometimes required by law, to disclose your health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order, warrant, grant jury subpoena and other law enforcement purposes.

We may, and are often required by law, to disclose your health information to coroners in connection with their investigations of deaths.

We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.

We may, and are sometimes required by law, to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

We will disclose proof of immunization to a school where the law requires the school to have such information prior to admitting a student if you have agree to the disclosure on behalf of yourself or your dependent.

We may disclose your health information for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.

We may disclose your health information as necessary to comply with workers’ compensation laws. For example, to the extent your care is covered by workers’ compensation, we will make periodic reports to your employer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or workers’ compensation insurance

In the event that this medical practice is sold or merged with another organization, your health information/record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another physician or medical group.

In the case of a breach of unsecured protected health information, we will notify you as required by law. If you have provided us with a current email address, we may use email to communicate information related to the breach. In some circumstances our business associate may provide the notification. We may also provide notification by other methods as appropriate.

We will not use or disclose your psychotherapy notes without your prior written authorization except for the following: (1) your treatment, (2) for training our staff, students and other trainees, (3) to defend ourselves if you sue us or bring some other legal proceeding, (4) if the law requires us to disclose the information to you or the Secretary of HHS or for some other reason, (5) in response to health oversight activities concerning your psychotherapist, (6) to avert a serious threat to health or safety, or (7) to the coroner or medical examiner after you die. To the extent you revoke an authorization to use or disclose your psychotherapy notes, we will stop using or disclosing these notes.

We may disclose your health information to researchers conducting research with respect to which your written authorization is not required as approved by an Institutional Review Board or privacy board, in compliance with governing law.

We may use or disclose your demographic information, the dates that you received treatment, the department of service, your treating physician, outcome information and health insurance status in order to contact you for our fundraising activities. If you do not want to receive these materials, notify the Privacy Officer listed as the top of this Notice of Privacy Practices and we will stop any further fundraising communications. Similarly, you should notify the Privacy Officer if you decide you want to start receiving these solicitations again.

Except as described in this Notice, Bay Psychiatric Associates will not use or disclose health information that identifies you without your written authorization. If you do authorize us to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

Except as described in this Notice of Privacy Practices, this medical practice will not use or disclose health information which identifies you without your written authorization. And, if you do authorize this medical practice to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

You have the right to request restrictions on certain uses and disclosures of your health information, by a written request specifying what information you want to limit and what limitations on our use or disclosure of that information you wish to have imposed. We reserve the right to accept or reject your request, and will notify you of our decision.

You have the right to request that you receive your health information in a specific way or at a specific location. For example, you may ask that we send information to a post office box or to your work address. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.

You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request detailing what information you want access to and whether you want to inspect it or to get a copy of it. We will charge a reasonable fee, as allowed by California law. Further, we may deny your request under limited circumstances. If we deny your request to access your child’s records because we believe allowing access would be reasonably likely to cause substantial harm to your child, you will have the right to appeal our decision. If we deny your request to access your psychotherapy notes, you will have the right to have them transferred to another mental health professional.

You have a right to request that we amend your health information that you believe is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information, and will provide you with information about this medical practice’s denial and how you can disagree with the denial. Further, we may deny your request if we do not have the information, if we did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is.

You also have the right to request that we add to your record a statement up to 250 words concerning any statement or item you believe to be incomplete or incorrect.

You have a right to receive an accounting of disclosures of your health information made by this medical practice, except that this medical practice does not have to account for the disclosures provided to you or pursuant to your written authorization, or as described in paragraphs 1 (treatment), 2 (payment), 3 (health care operations), 4 (notification and communication with family), 13 (specialized government function), and 15 (minors) of Section A of this Notice of Privacy Practices or disclosures for purposes of research or public health which exclude direct patient identifiers, or which are incident to a use or disclosure otherwise permitted or authorized by law, or the disclosures to a health oversight agency or law enforcement official to the extent this medical practice has received notice from that agency or official that providing this accounting would be reasonably likely to impede their activities.

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact our Privacy Officer at the number listed at the top of this Notice of Privacy Practices.

We reserve the right to amend this Notice at any time in the future. Until such amendment is made, we are required by law to comply with this Notice. After an amendment, the revised Notice will apply to all protected health information we maintain, regardless of when it was created or received.
We will post the current Notice in our reception area and on our website, and we will offer you a copy at each appointment.