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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.

Our Commitment to Your Privacy

Schott Behavioral Health Group, LLC is committed to maintaining the privacy of your Protected Health Information (PHI). PHI includes information about your health condition, the care you receive, and payment for that care that can identify you. We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, abide by the terms of the Notice currently in effect, and notify you in the event of a breach of your unsecured PHI.

How We May Use and Disclose Your PHI

A. Treatment

We may use and disclose your PHI to provide, coordinate, and manage your child's behavioral health treatment and related services, including disclosures to other treating clinicians, specialists, schools, or physicians when clinically appropriate and authorized.

B. Payment

We may use and disclose your PHI to obtain payment for services, including submitting claims to your insurance company, responding to prior authorization requests, or providing billing information necessary for reimbursement. For private-pay clients, PHI may be used to generate itemized receipts upon request.

C. Healthcare Operations

We may use and disclose your PHI for our healthcare operations, including quality assessment and improvement activities, clinical supervision, staff training and credentialing, compliance activities, and legal and business functions necessary to operate our practice.

D. Disclosures Required or Permitted by Law

We may use or disclose PHI without your authorization in the following circumstances:

E. Business Associates

We may share your PHI with third-party Business Associates who perform services on our behalf, such as billing companies, scheduling platforms, or electronic health records vendors. Our Business Associates are required by contract and by law to protect the privacy and security of your PHI.

F. Telehealth Services

If you receive telehealth services from our practice, we conduct those sessions using HIPAA-compliant platforms. Your PHI transmitted in connection with telehealth services is subject to the same protections described in this Notice.

Uses and Disclosures Requiring Your Authorization

The following uses and disclosures will be made only with your written authorization:

You have the right to revoke an authorization at any time, in writing. Revocation will not apply to uses or disclosures already made in reliance on the authorization.

Your Rights Regarding Your PHI

To exercise any of the following rights, please submit a written request to us at the contact information below.

Right to Access

You have the right to inspect and obtain a copy of your PHI that we maintain in a designated record set. We may charge a reasonable cost-based fee for copies and will respond to your request within 30 days.

Right to Amend

You have the right to request that we amend PHI about you in our records. We will respond within 60 days. We may deny the request if the information was not created by us, is not part of records we maintain, or is accurate and complete.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures of your PHI that we have made in the six years prior to your request, other than disclosures for treatment, payment, healthcare operations, or disclosures you authorized. We will provide this accounting within 60 days.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to your request. However, if you are paying entirely out of pocket and request that we not disclose PHI to your insurance company for that service, we are required by law to honor that request.

Right to Request Confidential Communications

You have the right to request that we communicate with you about PHI by alternative means or at alternative locations, such as a specific phone number or email address. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have received it electronically. Contact us using the information below to request a copy.

Right to Be Notified of a Breach

You have the right to be notified if a breach of your unsecured PHI occurs. We will notify you in accordance with HIPAA Breach Notification Rules without unreasonable delay and in no case later than 60 calendar days after discovery of the breach.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any PHI we receive in the future. We will post the current Notice on our website and make copies available upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W., Washington, D.C. 20201
Toll Free: 1-877-696-6775  ·  www.hhs.gov/ocr/privacy/hipaa/complaints/

Contact Information

For questions about this Notice or to exercise your rights, please contact our Privacy Officer:

Privacy Officer — Schott Behavioral Health Group, LLC
Email: anna@schottbhg.com
Phone: 813-515-0178
Address: Tampa Bay, Florida

This Notice of Privacy Practices is provided in compliance with 45 CFR §164.520. Schott Behavioral Health Group, LLC recommends consulting with qualified HIPAA legal counsel to ensure ongoing compliance with all applicable federal and state requirements.