HIPAA JOINT PRIVACY NOTICE

THIS JOINT 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.

INTRODUCTION

This Joint Notice is being provided to you on behalf of Double Care ABA and the employees and practitioners that work at the Practice with respect to services provided at the Practice (collectively referred to herein as “We” or “Our”). We understand that your medical information is private and confidential. Further, we are required by law to maintain the privacy of “protected health information.” (or “PHI”) which includes any individually identifiable information that we obtain from you or others that relates to your past, present or future physical or mental health, the health care you have received, or payment for your health care. We will share PHI with one another, as necessary, to carry out treatment, payment or health care operations relating to the services to be rendered at the Practice. As required by law, this notice provides you with information about your rights and our duties and privacy practices with respect to the privacy of PHI. This notice also discusses the uses and disclosures we will make of your PHI. We must comply with the provisions of this Notice as currently in effect, although we reserve the right to change the terms of this Notice from time to time. You can always request a written copy of our most current privacy notice from our compliance officer at the Practice or you can access it on our website at www.doublecareaba.com.​

PERMITTED USES AND DISCLOSURES
We can use or disclose your PHI for purposes of treatment, payment and health care operations, which we describe below with some examples.
OTHER USES AND DISCLOSURES OF PHI
We may also use your PHI in the following ways:
Note: incidental uses and disclosures of PHI sometimes occur and are not considered to be a violation of your rights. Incidental uses and disclosures are by-products of otherwise permitted uses or disclosures which are limited in nature and cannot be reasonably prevented.
SPECIAL SITUATIONS
Subject to the requirements of applicable law, we will make the following uses and disclosures of your PHI:
Note: HIV‑related information, genetic information, alcohol and/or substance abuse records, mental health records and other specially protected health information may enjoy certain special confidentiality protections under applicable state and federal law. Any disclosures of these types of records will be subject to these special protections.
OTHER USES OF YOUR HEALTH INFORMATION
Certain uses and disclosures of PHI will be made only with your written authorization, including uses and/or disclosures: (a) of psychotherapy notes (where appropriate); (b) for marketing; and (c) that constitute a sale of PHI under the Privacy Rule. Other uses and disclosures of PHI not covered by this notice or the laws that apply to us will be made only with your written authorization. You have the right to revoke that authorization at any time, provided that the revocation is in writing, except to the extent that we already have taken action in reliance on your authorization.
YOUR RIGHTS
We may also deny a request for access to PHI under certain circumstances if there is a potential for harm to yourself or others. If we deny a request for access for this purpose, you have the right to have our denial reviewed in accordance with the requirements of applicable law.
COMPLAINTS

If you believe that your privacy rights have been violated, you should immediately contact the Practice Privacy Officer at compliance@doublecareaba.com, or at 646-762-1600 ext. 128. You can also mail your complaint to 1465 51st Street, Brooklyn NY 11219 and write ‘Att: compliance officer’. We will not take action against you for filing a complaint. You also may file a complaint with the Secretary of the U. S. Department of Health and Human Services.

CONTACT PERSON

If you have any questions or would like further information about this notice, please contact the Practice Privacy Officer at compliance@doublecareaba.com, or at 646-762-1600 ext. 128.
This notice is effective as of January 01, 2020

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