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**YOUR RIGHTS**

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You have the right to review and obtain a copy, either in paper or electronic form, of certain protected health information (PHI) we hold about you, as long as we still have that information. This includes your medical and billing records, as well as other documents related to your care. Please note that federal law excludes some records from this right, such as psychotherapy notes and information collected for legal proceedings. In limited circumstances, we may deny your request to inspect or copy your PHI, and will provide written notice explaining the reason for the denial and your rights to request a review of our decision. To request access to your medical information, please submit a written request to the Privacy Officer; a reasonable fee may apply for copying records. For inquiries regarding access to your medical records, please contact our Privacy Officer.

 

You have the right to request restrictions on the use or disclosure of your PHI for treatment, payment, or healthcare operations, and to ask that certain parts of your PHI not be shared with family members or friends involved in your care. While we are obligated to honor your requested restrictions, we must comply with limitations on disclosures your insurance plan for services you paid for out of pocket. If we accept a restriction, we cannot use or disclose your PHI in violation of that restriction unless it is necessary for emergency treatment, required by law, or made to the Secretary of the U.S. Department of Health and Human Services for HIPAA compliance assessments. Please submit requests for restrictions in writing to the Privacy Officer, detailing the requested restriction, the PHI involved, and the individuals to whom the restriction should apply.

 

You have the right to request confidential communications from us through alternative means or locations, such as at work instead of home. Please submit your request in writing to the Privacy Officer, specifying your preferred contact method (e.g., alternative address or phone number). We will accommodate reasonable requests and may ask for information on how payment will be handled, but we will require an explanation for your request.

 

You may also have the right to request amendments your PHI. To do so, submit your request in writing to the Privacy Officer, including the reason for your request. In some cases, we may deny your request and will provide the reason for the denial in writing.

 

You have the right to file a statement of disagreement with us, and we may prepare a rebuttal to your statement, providing you with a copy. Please contact our Privacy Officer for any questions regarding amendments to your medical record. You have the right to receive an accounting of certain disclosures of your PHI that we have made for up to six years prior to your request. This right excludes disclosures made for treatment, payment, or healthcare operations purposes, as well as disclosures made to you, to others with your express authorization, to family members or friends involved in your care, and for specific notification purposes (including national security, law enforcement, or correctional facilities). This right is subject to certain exceptions, restrictions, and limitations. Submit requests for an of disclosures in writing to the Privacy Officer. We will provide one accounting per year for free, but may charge a reasonable, cost-based fee for additional requests within a 12-month period.You also have the right to obtain a paper copy of this notice from us. upon request, even if you have agreed to accept this notice electronically. Please contact the Privacy Officer to request a paper copy of this notice. If you have any other questions about our privacy practices or wish to file a complaint, you may do so by contacting Shaunak Parikh, PMHNP-BC. Please mail or email at Parikhmhs@gmail.com

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