Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Your Rights:

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

1.  Get an Electronic or Paper Copy of Your Medical Record

  • You can ask to receive an electronic or paper copy of your medical record and other health information we have about you.

  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee as referenced in our Informed Consent.

2.  Ask Us to Correct Your Medical Record

  • You can ask us to correct health information about you that you think is incorrect or incomplete.

  • In the event we decline your correction request, we’ll tell you why, in writing, within 60 days.

3.  Request Confidential Communications

  • You can ask us to contact you in a specific way (e.g., home or office phone) or send mail to a different address.

  • We’ll comply with all reasonable requests regarding communication.

  • You can opt in or out of receiving SMS messages from Bedrock Psychiatry. By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from Bedrock Psychiatry LLC. This includes SMS messages for appointment scheduling, appointment reminders, post-visit instructions, lab notifications, and billing notifications. Message frequency varies. Message and data rates may apply. See privacy policy at https://www.bedrockpsychiatry.com/privacy-policy. Message HELP for technical assistance. Reply STOP to any message to opt out.

4.  Ask Us to Limit What We Use or Share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say decline if it would affect your care.

  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information with your health insurer. We will comply with this request, unless state or federal law requires us to share that information.

  • We will never share substance abuse treatment records without your written permission.

5.  Get a List of Those with Whom We’ve Shared Information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to your request, who we shared it with, and why.

  • We will provide one accounting per year for free but will charge a reasonable, cost- based fee if you request another within 12 months.

6.  Get a Copy of This Privacy Notice

  • You can ask for a paper copy of this notice at any time, even if you’ve agreed to receive it electronically. We will provide you with a paper copy promptly.

7.  Choose Someone to Act for You

  • If you’ve given someone medical power of attorney or if someone is your legal guardian, they can exercise your rights and make choices about your health information.

8.  File a Complaint if You Feel Your Rights Are Violated

  • You can file a complaint with our Privacy Officer or the U.S. Department of Health and Human Services Office for Civil Rights if you believe your rights have been violated.

  • We will not retaliate against you for filing a complaint.

Your Choices:

For certain health information, you can tell us your choices about what we share.

1.  Share Your Information with other Person(s) Involved in Your Care

  • You may request we share information with any named person involved in your care or payment for your care either verbally or by filing a Release of Information. In the event of verbal permission an Release of Information will be required for future interactions.

2.  Share Information in a Disaster Relief Situation

  • We may share your information in a disaster relief situation to help you get the care you need.

3.  Marketing Purposes

  • We will not share your health information for marketing purposes without your written consent.

4.  Sale of Your Information

  • We will never sell your health information.

5.  Most Sharing of Psychotherapy Notes

  • We will not share psychotherapy notes without your written consent, unless required by law.

Our Uses and Disclosures:

We may use and share your health information in the following ways:

1.  Treatment

  • We can use and share your health information for treatment and coordination of your care.

  • Example: A doctor treating you for an injury asks another doctor about your overall health condition.

2.  Run Our Organization

  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.

3.  Bill for Your Services

  • We can use and share your health information to facilitate reimbursement from your health insurance or other entities.

4.  Help with Public Health and Safety Issues

  • We may share your health information for situations like preventing disease, reporting adverse reactions to medications, and reporting suspected abuse.

5.  Do Research

  • We can use or share your information for health research.

6.  Comply with the Law

  • We will share your information if required by state or federal laws.

7.  Respond to Organ and Tissue Donation Requests

  • We can share your information with organ procurement organizations.

8.  Work with a Medical Examiner or Funeral Director

  • We can share your information with a coroner, medical examiner, or funeral director when an individual dies.

9.  Address Workers’ Compensation, Law Enforcement, and Other Government Requests

  • We can use or share health information about you for workers’ compensation, law enforcement, and other government requests.

10.  Respond to Lawsuits and Legal Actions

  • We can share your information in response to a court or administrative order, or subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will notify you promptly if a breach occurs that compromises your information.

  • We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • We will not use or share your information other than as described here unless you tell us in writing we can.

Changes to the Terms of This Notice:

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

For more information, visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

 

 

Effective Date: January 1, 2025

Privacy Officer: Kelsey McClellan, M.D. contact@bedrockpsychiatry.com (501-635-9900)