HIPAA Privacy Statement

Your Information. Your Rights. Our Responsibility.

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

If you have any questions regarding the information on this page you can find our Privacy Officer’s information below. Don’t hesitate to reach out with any questions or concerns.

Privacy Officer: D’Launte Wade, IT Manager
Tech@pgs-nhcare.com
PsychoGeriatric Services
12073 Tech Road, Suite B
Silver Spring, MD 20904
301-592-1315

Your Rights.

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

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and the health information we have about you. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable fee.

Ask us to correct your medical record

You can ask us to correct Personal Health Information (PHI) about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or mail to a different address. We will always say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain Personal Health Information (PHI) for treatment, payment, or our operations. (We are not required to agree to your request, and we may say “no” 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 for the purpose of payment or our operations.

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 the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, patient, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free and will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

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

Choose someone to act for you

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. We will ensure the person has this authority and can act for you before we act.

File a complaint if you feel your rights were violated

You can file a complaint if you feel we have violated your rights by contacting us using the information above. You can file a complaint with the U.S. Department of Health and Human Services for Civil Rights by sending a letter to 200 Independence Avenue, S.W. Washington, DC 20201 or calling 1-877-696-6775 or visiting:

https://www.hhs.gov/hipaa/filing-a-complaint/what-to-expect/index.html

We will not retaliate against you for filing a complaint.

Your Choices.

You can tell us your choices about what we share for certain health information. 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.

You have both the right and choice to tell us to share information with your family, close friends, or other involved in your care for these cases:

Share information in a disaster relief situation.
Include your information in a hospital directory.
Contact you for fundraising efforts.

*If you cannot tell us your preference, for example, if you are unconscious, we may share your information if we believe it is in your best interest. We may share information when needed to lessen serious and imminent threats to health and safety.

In these cases we never share your information unless you give us written permission:

Marketing purposes
Sales information
Most sharing of Psychotherapy notes

In the case of fundraising:

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures.

How do we typically use or share your health information? We typically use or share your health information in the following ways:

To treat you

We can use your Personal Health Information (PHI) and share it with other professionals treating you.

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

To run our organization

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

Example: We use health Personal Health Information (PHI) about you to manage your treatment and services.

To bill for our services

We can use and share your Personal Health Information (PHI) to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will play for your services.

How else can we use or share your information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before sharing your information for these purposes. For more information see:

https://www.hhs.gov/hipaa/for-professionals/special-topics/hipaa-ftc-act/index.html

To help with public health and safety issues

We can share Personal Health Information (PHI) about you for certain situations, such as:

Preventing disease
Helping with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety

To research

We can use or share your information for health research.

To comply with the Law

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 comply with federal privacy laws.

To respond to organ and tissue donation requests

We can share Personal Health Information (PHI) about you with organ procurement organizations.

To work with medical examiner or funeral director

We can share Personal Health Information (PHI) with a coroner, medical examiner, or funeral director when an individual dies.

To address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

For workers’ compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and presidential protective services

To respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or response to a subpoena.

Our Responsibilities

We are required by law to maintain the privacy and security of your Personal Health Information (PHI).
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy.
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.

For more information see: http://www.hhs.gov/ocr/privacy/hippaa/understanding/consumers/noticepp.html

Changes to the Terms of this Notice

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

Privacy Officer: D’Launte Wade, IT Manager, tech@pgs-nhcare.com