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JODIE DEIGNAN NURSE PRACTITIONER IN PSYCHIATRY PLLC<\/strong><\/p>\n 180 South Broadway Suite 301A<\/p>\n White Plains, NY 10605<\/p>\n <\/p>\n and<\/p>\n <\/p>\n 13 Steeple Street Suite 202<\/p>\n Mashpee, MA 02649<\/p>\n <\/p>\n 914-216-7550<\/p>\n <\/p>\n Your Information. Your Rights. Our Responsibilities.<\/p>\n 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.<\/p>\n You have the right to:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Get a copy of your paper or electronic medical record<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Correct your paper or electronic medical record<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Request confidential communication<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Ask us to limit the information we share<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Get a list of those with whom we\u2019ve shared your information<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Get a copy of this privacy notice<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Choose someone to act for you<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 File a complaint if you believe your privacy rights have been violated<\/p>\n You have some choices in the way that we use and share information as we:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Tell family and friends about your condition<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Provide disaster relief<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Include you in a hospital directory<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Provide mental health care<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Market our services and sell your information<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Raise funds<\/p>\n We may use and share your information as we:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0Treat you<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Run our organization<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Bill for your services<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Help with public health and safety issues<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Do research<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Comply with the law<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Respond to organ and tissue donation requests<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Work with a medical examiner or funeral director<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Address workers\u2019 compensation, law enforcement, and other government requests<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Respond to lawsuits and legal actions<\/p>\n When it comes to your health information, you have certain rights.<\/strong> This section explains your rights and some of our responsibilities to help you.<\/p>\n Get an electronic or paper copy of your medical record<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 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.<\/p>\n Ask us to correct your medical record<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 We may say \u201cno\u201d to your request, but we\u2019ll tell you why in writing within 60 days.<\/p>\n Request confidential communications<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 We will say \u201cyes\u201d to all reasonable requests.<\/p>\n Ask us to limit what we use or share<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 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 \u201cno\u201d if it would affect your care.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say \u201cyes\u201d unless a law requires us to share that information.<\/p>\n Get a list of those with whom we\u2019ve shared information<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 You can ask for a list (accounting) of the times we\u2019ve shared your health information for six years prior to the date you ask, who we shared it with, and why.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We\u2019ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.<\/p>\n Get a copy of this privacy notice<\/strong><\/p>\n You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.<\/p>\n Choose someone to act for you<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 We will make sure the person has this authority and can act for you before we take any action.<\/p>\n File a complaint if you feel your rights are violated<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 You can complain if you feel we have violated your rights by contacting us using the information on page 1.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov\/ocr\/privacy\/hipaa\/complaints\/.<\/strong><\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 We will not retaliate against you for filing a complaint.<\/p>\n <\/p>\n For certain health information, you can tell us your choices about what we share.<\/strong> If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.<\/p>\n In these cases, you have both the right and choice to tell us to:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Share information with your family, close friends, or others involved in your care<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Share information in a disaster relief situation<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Include your information in a hospital directory<\/p>\n If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.<\/em><\/p>\n In these cases we never share your information unless you give us written permission:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Marketing purposes<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Sale of your information<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Most sharing of psychotherapy notes<\/p>\n <\/p>\n We typically use or share your health information in the following ways.<\/p>\n Treat you<\/strong><\/p>\n We can use your health information and share it with other professionals who are treating you.<\/p>\n Example: A doctor treating you for an injury asks another doctor about your overall health condition.<\/em><\/p>\n <\/p>\n Run our organization<\/strong><\/p>\n We can use and share your health information to run our practice, improve your care, and contact you when necessary.<\/p>\n Example: We use health information about you to manage your treatment and services.<\/em><\/p>\n <\/p>\n Bill for your services<\/strong><\/p>\n We can use and share your health information to bill and get payment from health plans or other entities.<\/p>\n <\/p>\n Example: We give information about you to your health insurance plan so it will pay for your services.<\/em><\/p>\n <\/p>\n We are allowed or required to share your information in other ways \u2013 usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov\/ocr\/privacy\/hipaa\/understanding\/consumers\/index.html<\/a>.<\/p>\n Help with public health and safety issues<\/strong><\/p>\n We can share health information about you for certain situations such as:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Preventing disease<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Helping with product recalls<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Reporting adverse reactions to medications<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Reporting suspected abuse, neglect, or domestic violence<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 Preventing or reducing a serious threat to anyone\u2019s health or safety<\/p>\n Do research<\/strong><\/p>\n We can use or share your information for health research.<\/p>\n Comply with the law<\/strong><\/p>\n We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we\u2019re complying with federal privacy law.<\/p>\n Respond to organ and tissue donation requests<\/strong><\/p>\n We can share health information about you with organ procurement organizations.<\/p>\n Work with a medical examiner or funeral director<\/strong><\/p>\n We can share health information with a coroner, medical examiner, or funeral director when an individual dies.<\/p>\n Address workers\u2019 compensation, law enforcement, and other government requests<\/strong><\/p>\n We can use or share health information about you:<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 For workers\u2019 compensation claims<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 For law enforcement purposes or with a law enforcement official<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 With health oversight agencies for activities authorized by law<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 For special government functions such as military, national security, and presidential protective services<\/p>\n Respond to lawsuits and legal actions<\/strong><\/p>\n We can share health information about you in response to a court or administrative order, or in response to a subpoena.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We are required by law to maintain the privacy and security of your protected health information.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We must follow the duties and privacy practices described in this notice and give you a copy of it.<\/p>\n \u2022\u00a0\u00a0\u00a0\u00a0\u00a0 We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.<\/p>\n For more information see: www.hhs.gov\/ocr\/privacy\/hipaa\/understanding\/consumers\/noticepp.html<\/a>.<\/p>\n <\/p>\n To Request a Copy of Your Records<\/strong><\/p>\n If you wish to obtain a copy of your records, you can make the request directly to Jodie Deignan, by email, PsychNP@jodiedeignan.com<\/a> or by phone, 914-216-7550.<\/p>\n <\/p>\n EFFECTIVE DATE OF THIS NOTICE<\/strong><\/p>\n This notice went into effect on April 15, 2021<\/p>\n <\/p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.14.4″ _module_preset=”default” da_disable_devices=”off|off|off” global_colors_info=”{}” da_is_popup=”off” da_exit_intent=”off” da_has_close=”on” da_alt_close=”off” da_dark_close=”off” da_not_modal=”on” da_is_singular=”off” da_with_loader=”off” da_has_shadow=”on”][et_pb_row _builder_version=”4.14.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.14.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_code _builder_version=”4.14.7″ _module_preset=”default” global_colors_info=”{}”]Your Rights<\/h1>\n
Your Choices<\/h1>\n
Our Uses and Disclosures<\/h1>\n
Your Rights<\/h1>\n
Your Choices<\/h1>\n
Our Uses and Disclosures<\/h1>\n
How do we typically use or share your health information?<\/h2>\n
How else can we use or share your health information?<\/h2>\n
Our Responsibilities<\/h1>\n
Changes to the Terms of this Notice<\/h1>\n
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 web site.<\/h1>\n