Scope
This notice applies to protected health information held or transmitted by Sun Valley Psychiatry. That includes information about your past, present, or future physical or mental health, payment for care, and the care itself — on paper, electronically, or in another form.
Our responsibilities
We are required by law to maintain the privacy of protected health information, to give you this notice, to follow the practices described while it is in effect, and to notify affected people after a breach of unsecured protected health information.
Uses that do not need a separate signature
Treatment
We may share information with clinicians involved in your care, including a specialist we refer you to.
Payment
We may use information for billing, collections, claims, and coverage questions — including sending claims when a payer is involved.
Healthcare operations
Quality review, training, licensing, appointment reminders, and messages about services related to your care.
Business associates
Vendors who help run the practice, under agreements that require them to protect your information.
People you involve
Family, friends, or a legal representative you identify as involved in your care or payment, and disaster-relief notifications when the law allows.
Required by law and public health
Disclosures required by law, public health activities, and reports of abuse, neglect, or domestic violence when we reasonably believe you are a victim and the law allows the report.
Oversight, law enforcement, and courts
Health oversight, law enforcement as HIPAA permits, and court or administrative process when the legal requirements are met.
Safety and specialized functions
Serious and imminent threats, workers’ compensation, coroners and funeral directors, organ donation, research under privacy-board review, military or national-security functions when they apply, and limited or de-identified data sets.
Health information exchanges may also be used so other participants can access information for treatment and other lawful purposes. Not every example in a category will occur.
Other uses
For situations not described in the practice’s notice, we ask for your written authorization first. You may revoke an authorization in writing, except where we have already acted on it.
Your rights, in brief
You may ask to inspect or receive a copy of your record, request an amendment, request restrictions, request confidential communications, and receive an accounting of certain disclosures. You may also request a paper copy of this notice. Some requests can be denied when the law allows, and we will tell you why.
Questions or complaints
Privacy officer: Dr. Ashim Mehta, Chief Legal Officer. Call or text (678) 394-0000. Email info@sunvalleypsychiatry.com. 555 Sun Valley Dr, Unit M1, Roswell (Atlanta), GA 30076. You may also complain to the U.S. Department of Health and Human Services. We will not retaliate for a complaint.
This page restates the practice’s October 18, 2023 notice in shorter form so it is easier to read. It does not narrow your rights under that notice or under HIPAA.