HIPAA Notice

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.

MedHome is required by law to protect the privacy of your Protected Health Information (PHI) and to provide you with this Notice of our legal duties and privacy practices. We are required to follow the terms of the Notice currently in effect.

1. HOW WE MAY USE AND DISCLOSE YOUR PHI

MedHome may use and disclose your PHI without your authorization for Treatment, Payment, and Health Care Operations (TPO), and other situations permitted or required by law.

2. Uses and Disclosures for Treatment, Payment, and Health Care Operations (TPO)

Purpose	Description and Example
Treatment	We use and disclose your PHI to provide, coordinate, or manage your healthcare. Example: Sharing PHI with your nurse, physician, or lab provider to coordinate care.
Payment	We use and disclose your PHI to bill and receive payment for services provided. Example: Sharing PHI with Medicare, Medicaid, or private insurers to determine coverage or process claims.
Health Care Operations	We use PHI for healthcare operations such as quality assessment, staff performance review, and training. Example: Using PHI internally to improve service quality.

3. Other Permitted Uses and Disclosures

We may also use or disclose your PHI without your authorization in the following situations:

Individuals Involved in Your Care or Payment: Family, friends, or persons you identify, unless you object.
Appointment Reminders & Health-Related Information: To provide reminders or information about alternative treatments or services.
Required by Law: Federal, state, or local laws may require disclosure.
Public Health Activities: Reporting disease, injury, or exposure.
Health Oversight Activities: Compliance audits, inspections, or investigations.
Judicial & Administrative Proceedings: In response to court orders, subpoenas, or legal processes.
Law Enforcement: As required for specific purposes, such as reporting certain injuries or responding to a warrant.
Serious Threat to Health/Safety: To prevent or lessen a serious and imminent threat.
Coroners, Medical Examiners & Funeral Directors: For identifying a deceased person or determining cause of death.

4. USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

For any use or disclosure not covered by this Notice or permitted by law, we must obtain your written authorization. This includes:

Most uses/disclosures of psychotherapy notes
Uses/disclosures for marketing where payment is received
Sale of PHI

You may revoke your authorization at any time in writing, except where actions have already been taken based on it.

5. YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding your PHI. All requests must be submitted in writing to the Privacy Officer.

Your Right	What It Means
Right to Inspect and Copy	You may inspect and obtain a copy of your PHI. Reasonable, cost-based fees may apply.
Right to Amend	You may request correction of PHI you believe is inaccurate or incomplete. If denied, you will receive a written explanation and may submit a statement of disagreement.
Right to Request Restrictions	You may request limits on how we use or share your PHI. We must agree to restrict disclosure to a health plan if you have paid for the service out-of-pocket in full.
Right to Confidential Communications	You may request communications via alternative methods or locations (e.g., mailing to a different address).
Right to an Accounting of Disclosures	You may request a list of certain PHI disclosures made in the last six (6) years, excluding those for TPO.
Right to a Paper Copy	You may request a paper copy of this Notice at any time.
Right to Be Notified of a Breach	You will be notified if your unsecured PHI is compromised in a breach.

6. MEDHOME’S DUTIES AND CONTACT INFORMATION

Our Duties

We are required by law to follow the terms of this Notice.
We may revise this Notice at any time.
Revised Notices apply to all PHI we maintain and will be available upon request and posted on our website.

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with:

MedHome Privacy Officer, or
The U.S. Department of Health and Human Services (HHS)

We will not retaliate against you for filing a complaint.

MedHome Privacy Officer Contact Information

Field	Details
Name/Title:	[Insert Name/Title]
Address:	[Insert MedHome Street Address, City, State, ZIP]
Phone:	[Insert Phone Number]
Email:	[Insert Email Address]