Notice of Privacy Practices

This notice applies to the health information maintained by Advanced Psychiatric Services, PLLC, doing business as Brighter NeuroTherapeutics ("Brighter," "we," "us," or "our"), and to the clinicians, employees, and other workforce members acting for this practice. Protected health information includes identifiable information about your health, care, and payment for care, whether spoken, written, or electronic.

Our responsibilities

We are required by law to maintain the privacy of your protected health information, safeguard it as required by law, give you this notice of our legal duties and privacy practices, and follow the notice currently in effect. We must notify you following a breach of your unsecured protected health information as required by law, without unreasonable delay and within the applicable legal deadline.

We limit uses, disclosures, and requests to the minimum necessary when that standard applies. HIPAA has exceptions, including disclosures to or requests by a health care provider for treatment. Any stricter legal protections described in this notice still apply.

How we ordinarily use and share information

Treatment. We may use and share information to provide, coordinate, or manage your care. For example, we may discuss your medications and treatment history with a clinician involved in evaluating you for transcranial magnetic stimulation (TMS). We may contact you about appointments, treatment alternatives, or health-related services.

Payment. We may use and share information to verify coverage, obtain authorization, bill, and collect payment. For example, we may send your insurer information needed to review a claim. If we use an outside collection agency, we will give you prior written notice and limit the information disclosed as required by law.

Health care operations. We may use and share information to manage the practice, improve quality, train personnel, review care, and conduct necessary administrative work. Service providers handling protected information on our behalf must have appropriate agreements and safeguards when required by law.

Other uses and disclosures

The following uses and disclosures are permitted or required only when the conditions of applicable law are met. The additional confidentiality protections below may further limit them. A general permission under HIPAA does not override a stricter law.

People involved in your care. With your agreement, or when you have an opportunity to object and do not, we may share information directly relevant to a family member, friend, or other person's involvement in your care or payment. If you are unavailable or unable to decide, we may make a limited disclosure in your best interests using professional judgment, when law permits. We may also make permitted notifications or disclosures for disaster relief.

Public health and safety. We may share information for legally authorized public health purposes, such as reporting certain diseases, adverse drug reactions, or product problems. We may report suspected abuse, neglect, or domestic violence as law permits or requires. We may disclose information to avert a serious and imminent threat when permitted by law and professional standards.

Oversight and compliance. We may share information with authorized health oversight agencies for audits, investigations, inspections, licensing, or other lawful oversight. We must disclose information to the U.S. Department of Health and Human Services when required to assess our compliance with federal privacy requirements.

Legal proceedings and law enforcement. We may respond to a court or administrative order, subpoena, or other lawful process only if the applicable privacy requirements are satisfied. A subpoena alone does not automatically authorize disclosure. We may make disclosures to law enforcement only in circumstances permitted or required by law. Special limits apply to Part 2 records and other specially protected information.

Other legally authorized purposes. Subject to applicable safeguards, information may be used or shared for workers' compensation; approved research under an authorization or a legally permitted waiver or other exception; organ or tissue donation; coroners, medical examiners, and funeral directors; and authorized military, national security, protective-service, or correctional functions. We may also disclose information when another law requires it, within that law's limits.

When we need your written permission

Most uses and disclosures of separately maintained psychotherapy notes require your written authorization. Marketing and disclosures that constitute a sale of protected health information also require authorization, except for narrow exceptions allowed by law. Other uses or disclosures not described in this notice require your authorization unless the law otherwise permits or requires them.

You may revoke an authorization in writing at any time by contacting our privacy contact. Revocation does not undo actions already taken in reliance on the authorization. Other limited exceptions may apply as provided by law, such as certain insurance-related authorizations. Signing the acknowledgment of this notice is not an authorization to use or disclose your information.

Additional confidentiality protections

Substance-use-disorder records protected by 42 CFR Part 2

Brighter is a general psychiatric practice that may receive records from a substance-use-disorder treatment program. Some of those records are protected by a federal law called 42 CFR Part 2. These protections apply to covered Part 2 records; a reference to substance use in an ordinary psychiatric record does not, by itself, make that record a Part 2 record.

If we receive Part 2 records under a valid consent for treatment, payment, or health care operations, we may use and redisclose them as HIPAA and Part 2 allow, subject to the special restrictions below and any other applicable law. We obtain any consent required for other uses or disclosures unless a legal exception applies.

Proceedings against you. We will not use or disclose Part 2 records, or testimony describing information in those records, in civil, criminal, administrative, or legislative investigations or proceedings against you unless you provide the written consent required by Part 2, or a court issues an order meeting Part 2 requirements. The court-order process must provide notice and an opportunity to be heard to you or the record holder as Part 2 requires. An order authorizing disclosure must be accompanied by a subpoena or similar legal mandate compelling disclosure. A subpoena alone is not enough.

Psychotherapy notes

Psychotherapy notes have a specific meaning under HIPAA: notes by a mental health professional documenting or analyzing counseling conversations that are kept separate from the rest of the medical record. They do not include ordinary progress notes, diagnoses, medication records, treatment plans, symptoms, prognosis, or summaries of progress. Most uses and disclosures require a separate authorization. Limited exceptions include the author's use for treatment, certain training, defense of a legal action brought by you, and disclosures specifically permitted or required by law.

New York protections

New York law gives additional protection to certain information, including HIV-related information, genetic test results, and mental health records covered by special confidentiality laws. Where these laws apply, we obtain the specific consent or authorization required, or confirm that a statutory exception permits disclosure. An ordinary general release may not be sufficient. We follow the law that provides the applicable additional protection or right of access.

Children, adolescents, and personal representatives

A parent or legal guardian generally acts for a minor, subject to state and federal law. Exceptions can apply to care a minor may lawfully consent to, court-directed care, an agreed confidential relationship, or other legally protected care. We apply the governing law to requests for those records; parental access is not automatic in every situation. We verify a representative's legal authority and may decline to treat someone as a representative in circumstances involving abuse, neglect, or endangerment when the law allows.

Fundraising choices

If we conduct fundraising, you may opt out of receiving fundraising communications, and treatment or payment will not depend on your choice. Before using Part 2 records for fundraising communications, we will give you a clear and conspicuous advance opportunity to choose not to receive them.

Your rights concerning your information

Contact our privacy contact to exercise these rights or get help making a request. We may ask for a written request and verify your identity or legal authority as allowed by law. These procedures will not create an unreasonable barrier to exercising your rights.

Inspect and obtain copies

You may inspect or obtain a paper or electronic copy of information in the records we use to make decisions about you, including medical and billing records. Separately maintained psychotherapy notes and information prepared for certain legal proceedings are excluded from the HIPAA access right. Ordinary clinical or progress notes are not automatically excluded. Other denials must have a legal basis. If access is denied, we will explain the reason in writing and any right to review or appeal.

We ordinarily act on an access request within 30 calendar days. HIPAA allows one extension of up to 30 additional days if we give you a written explanation and completion date before the initial deadline. We follow any shorter applicable New York deadline, including the right to an opportunity to inspect records within 10 days of a qualifying written request, subject to the law's exceptions. Copies are provided within the time required by applicable law.

We provide information in the form and format you request if readily producible; otherwise, we agree with you on a readable format. We provide a summary instead of records only if you agree in advance to the summary and any allowed fee.

Any access fee will be reasonable, cost-based, and limited by law. We do not charge for searching for or retrieving your records. For paper copies, New York's 75-cent-per-page ceiling does not allow a charge higher than HIPAA permits. We do not apply a per-page fee to electronic copies. We provide inspection without charge, do not deny access solely because you cannot pay, and provide records without charge when New York law requires this for government-benefit applications, claims, or appeals.

Request a correction

You may ask us in writing to amend information you believe is inaccurate or incomplete and explain why. We generally respond within 60 days. If law permits an extension, we will notify you in writing of the reason and completion date. We may deny a request for reasons allowed by law, such as when the information is accurate and complete. We will explain a denial and how to submit a statement of disagreement for the record.

Request limits on use or disclosure

You may ask us to restrict uses or disclosures for treatment, payment, or operations, or disclosures to people involved in your care. We generally do not have to agree. If we agree, we follow the restriction except as law permits, including needed emergency treatment.

Services paid in full. If you, or someone other than your health plan on your behalf, pay for an item or service out of pocket in full, you may request that we not disclose information about that item or service to your health plan for payment or health care operations. We must honor that request unless disclosure is required by law. Tell us before we submit a claim so we can arrange the restriction.

Request confidential communications

You may ask us to contact you in a particular way or at a different location, such as using a specific telephone number or mailing address. We accommodate reasonable requests. You do not have to explain why you want confidential communications; we may need an alternative contact method and information about handling payment.

Receive an accounting of disclosures

You may request a list of disclosures that HIPAA requires us to account for during a period of up to six years before your request. The list generally excludes disclosures for treatment, payment, or health care operations; disclosures to you or made under your authorization; and other disclosures excluded by law. It identifies the recipients, dates, information disclosed, and purposes as required.

We generally respond within 60 days. If a permitted extension is necessary, we will give you a written explanation and completion date. One accounting in any 12-month period is free. Before charging a reasonable, cost-based fee for an additional accounting in that period, we will tell you the cost and let you withdraw or modify your request.

Obtain a copy of this notice

You may request a paper copy at any time, even if you previously agreed to an electronic copy. We will provide it promptly. The current notice will also be available in our office and on our website.

Have someone act for you

A person with legally valid authority, such as a health care agent or guardian acting within that authority, may exercise your rights. We verify the scope of that authority and follow the limitations described in this notice and applicable law.

Make a complaint without retaliation

If you believe your privacy rights have been violated, you may complain to our privacy contact or directly to the U.S. Department of Health and Human Services Office for Civil Rights (OCR). You do not have to complain to us first. We will not retaliate against you for making a complaint.

Federal complaints. File online or find submission instructions at www.hhs.gov/hipaa/filing-a-complaint/index.html. You may also write to the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, SW, Washington, DC 20201, or call 1-877-696-6775 for assistance. OCR complaints generally must be filed within 180 days of when you knew of the act or omission; OCR may extend this period for good cause.

Changes to this notice

We reserve the right to change our privacy practices and this notice as law permits, and to apply the revised notice to information we already maintain as well as information received later. A revised notice will show its effective date and will be available in our office, on our website, and upon request. We will follow the notice currently in effect.