Your trust matters

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

Aday at a Time Therapy Services is committed to protecting the privacy and confidentiality of your health information.

This Notice explains your rights, our responsibilities, and how we may use and disclose your protected health information.

Your Rights

You have the right to:

• Obtain an electronic or paper copy of your health record.
• Ask us to correct health information you believe is incorrect or incomplete.
• Request confidential communication.
• Ask us to limit certain uses or disclosures of your health information.
• Request an accounting of certain disclosures of your health information.
• Obtain a paper copy of this Notice at any time.
• Authorize another person to act on your behalf when permitted by law.
• File a complaint if you believe your privacy rights have been violated.

Get a Copy of Your Health Information

You may ask to inspect or obtain an electronic or paper copy of health information we maintain about you.

We will provide access within the time required by applicable law.

We may charge a reasonable, cost-based fee when permitted by law.

Certain information may be subject to additional restrictions, including psychotherapy notes and information protected by other federal or state confidentiality laws.

Ask Us to Correct Your Health Information

You may ask us to correct health information that you believe is incorrect or incomplete.

We may deny your request under circumstances permitted by law. If we deny your request, we will explain the reason in writing and inform you of any additional rights you may have.

Request Confidential Communications

You may ask us to contact you in a specific way or at a specific location.

For example, you may request that we contact you only at a particular telephone number, email address, or mailing address.

We will accommodate reasonable requests as required by law.

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or health care operations.

We are not required to agree to every request.

However, if you pay for a health care service entirely out-of-pocket, you may ask us not to disclose information about that service to your health plan for payment or health care operations. We will honor that request unless disclosure is required by law.

Get a List of Certain Disclosures

You may request an accounting of certain disclosures of your health information made during the six years before your request.

Accounting will not include disclosures that are excluded from this requirement by law, including many disclosures made for treatment, payment, health care operations, or pursuant to your written authorization.

Get a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Have Someone Act for You

If another person has legal authority to act on your behalf, such as a legal guardian or authorized personal representative, that person may exercise your privacy rights as permitted by law.

We may require documentation establishing that authority.

Your Choices

For certain health information, you may tell us your preferences about what we share.

Depending on the circumstances, you may have choices regarding whether we:

• Share information with family members, friends, or others involved in your care.
• Share information during a disaster-relief situation.
• Contact you for certain communications.

If you are unable to communicate your preference, we may use professional judgment and applicable law to determine whether a disclosure is in your best interest.

Psychotherapy Notes

Psychotherapy notes receive additional protection under federal law.

We generally will not use or disclose psychotherapy notes without your written authorization except when specifically permitted or required by law.

Marketing

We will obtain your written authorization before using or disclosing your protected health information for marketing purposes when authorization is required by law.

Sale of Protected Health Information

We will obtain your written authorization before any disclosure of protected health information that would constitute a sale of protected health information under HIPAA.

Fundraising

If we ever contact you regarding fundraising using protected health information, you will have the right to opt out of receiving future fundraising communications.

How We May Use and Disclose Your Health Information

Federal and state laws allow us to use and disclose your health information without obtaining separate authorization in certain circumstances.

Treatment

We may use and disclose your health information to provide, coordinate, or manage your treatment.

For example, we may share relevant information with another health care professional involved in your care when permitted by law.

Payment

We may use and disclose your health information to obtain payment for services.

Examples include:

• Determining insurance eligibility or benefits.
• Obtaining prior authorization.
• Submitting claims.
• Responding to requests from health plans.
• Conducting other activities necessary to receive payment for services.

Health Care Operations

We may use and disclose your health information to operate and manage our practice.

Examples include:

• Quality assessment and improvement.
• Staff training and supervision.
• Credentialing.
• Compliance activities.
• Auditing.
• Business planning.
• Administrative activities.
• Evaluating the quality and effectiveness of services.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose protected health information without your authorization when permitted or required by law.

Examples may include:

• Public health activities.
• Reporting suspected abuse, neglect, or exploitation.
• Health oversight activities.
• Judicial or administrative proceedings when legally authorized.
• Certain law-enforcement activities.
• Coroners, medical examiners, and funeral directors when applicable.
• Workers' compensation programs.
• Research that satisfies applicable legal requirements.
• Preventing or reducing a serious and imminent threat to health or safety.
• Other disclosures specifically permitted or required by federal or Alaska law.

When the HIPAA minimum-necessary standard applies, we will limit the information used or disclosed to the minimum reasonably necessary to accomplish the intended purpose.

Mental and Behavioral Health Information

Because Aday at a Time Therapy Services provides behavioral and mental health services, some information we maintain may receive additional confidentiality protection under federal or Alaska law.

When another applicable law provides greater privacy protection than HIPAA, we will follow the more protective requirement.

Certain disclosures may nevertheless be permitted or required by law, including circumstances involved:

• Suspected abuse or neglect.
• Protection of vulnerable individuals.
• Serious threats to health or safety.
• Court orders or other legally authorized proceedings.
• Professional licensing or oversight requirements.
• Other legally required disclosures.

Substance Use Disorder Records Protected by Federal Law

Aday at a Time Therapy Services is not a federally assisted substance use disorder treatment program subject to 42 CFR Part 2 solely by virtue of providing behavioral health services.

However, we may receive or maintain information from another provider or program that is specifically protected by federal substance use disorder confidentiality law.

If we receive or maintain records that are protected by 42 CFR Part 2, we will use and disclose those records only as permitted by applicable law.

Additional restrictions may apply to:

• The use or disclosure of Part 2-protected records.
• Use of those records in civil, criminal, administrative, or legislative proceedings.
• Redisclosure of information received from a Part 2 program.
• Patient rights regarding those records.

Nothing in this Notice is intended to characterize Aday at a Time Therapy Services as a Part 2 program.

Our Responsibilities

Aday at a Time Therapy Services is required to:

• Maintain the privacy and security of your protected health information.
• Follow applicable federal and state privacy and confidentiality laws.
• Notify you as required by law if a breach occurs that may compromise the privacy or security of your protected health information.
• Follow the privacy practices described in the Notice currently in effect.
• Provide you with a copy of this Notice upon request.

We will not use or disclose your health information in a manner not described in this Notice unless you provide written authorization or the use or disclosure is otherwise permitted or required by law.

You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance on the authorization.

Filing a Complaint

You have the right to file a complaint if you believe your privacy or confidentiality rights have been violated.

You may contact:

Privacy Officer
Aday at a Time Therapy Services
100 Cushman Street, Suite 308
Fairbanks, Alaska 99701
Phone: 907-318-5686
Email: info@adayatatimetherapyservices.com

You may also file a complaint with the:

U.S. Department of Health and Human Services Office for Civil Rights

Information regarding filing a complaint is available through the U.S. Department of Health and Human Services.

Aday at a Time Therapy Services will not retaliate against you for filing a complaint or exercising your privacy rights.

Changes to This Notice

We may change the terms of this Notice and our privacy practices as permitted by law.

Changes may apply to health information we already maintain as well as information created or received after the change becomes effective.

When this Notice is materially revised, the current version will be made available:

• On our website at adayatatimetherapyservices.com.
• At our office.
• Upon request.

Questions About This Notice

If you have questions about this Notice, your privacy rights, or how your health information is handled, contact:

Privacy Officer
Aday at a Time Therapy Services
100 Cushman Street, Suite 308
Fairbanks, Alaska 99701
Phone: 907-318-5686
Email: info@adayatatimetherapyservices.com