Notice of Privacy Practices

Notice of Privacy Practices

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.

Effective Date: 07/10/2024

Our Commitment to Your Privacy

At Baseline Psychiatry, we are committed to protecting the privacy and confidentiality of your medical information. This notice describes the ways in which we may use and disclose your medical information and outlines your rights and our obligations regarding the use and disclosure of that information.

Uses and Disclosures of Medical Information

We may use and disclose your medical information for the following purposes:

1. Treatment: We may use your medical information to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in your care.

2. Payment: We may use and disclose your medical information so that we can bill and collect payment from you, an insurance company, or a third party for the treatment and services you receive.

3. Healthcare Operations: We may use and disclose your medical information for healthcare operations. These uses and disclosures are necessary to run Baseline Psychiatry and ensure that all of our patients receive quality care.

4. Appointment Reminders: We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care.

5. As Required by Law: We will disclose medical information about you when required to do so by federal, state, or local law.

6. To Avert a Serious Threat to Health or Safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Your Rights Regarding Medical Information About You

You have the following rights regarding medical information we maintain about you:

1. Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. This includes medical and billing records but does not include psychotherapy notes.

2. Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.

3. Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you.

4. Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations.

5. Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.

6. Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time.

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice on our website and in our office. The notice will contain the effective date on the first page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with Baseline Psychiatry or with the Secretary of the Department of Health and Human Services. To file a complaint with Baseline Psychiatry, contact our Privacy Officer at:

Baseline Psychiatry Contact Information:

• Phone: (602) 492 - 6358

• Email: contact@baselinepsychiatry.com

All complaints must be submitted in writing. You will not be penalized for filing a complaint.