NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this Notice, please contact:

Karen Wachtel, Ph.D. – Privacy Officer

Overview

This Notice of Privacy Practices describes how protected health information about you may be used and disclosed and how you can access this information. I am required by law to maintain the privacy of your protected health information (PHI) and to provide you with this Notice of my legal duties and privacy practices with respect to your PHI. I am required to abide by the terms of this Notice.

Your Protected Health Information

Your “protected health information” (PHI) includes any health information, whether oral, written, or recorded, that is created or received by me, other health care providers, or health plans, and that identifies you or could reasonably be used to identify you.

Uses and Disclosures of Your Protected Health Information

In general, I may not use or disclose your PHI without your written authorization. However, I am permitted by law to use or disclose your PHI without authorization for purposes of treatment, payment, and health care operations, as described below. In all cases, disclosures are limited to the minimum amount of information necessary.

Treatment

Treatment activities include use within my office for the provision, coordination, or management of your health care, as well as contacting you to provide appointment reminders or information related to your treatment.

Payment

Payment activities include disclosures to health plans or plan administrators for purposes such as determining coverage, billing, claims processing, utilization review, and collection of unpaid fees. I may use the services of third-party billing or claims processing companies with whom I have appropriate agreements to protect your PHI.

Health Care Operations

Health care operations include administrative activities such as record keeping, scheduling, billing, and consultation with legal, accounting, or other professional services as necessary to operate the practice.

Unless you request otherwise and I agree, your PHI may be used or disclosed for treatment, payment, and health care operations without your written authorization.

Uses and Disclosures Required by Law

I may use or disclose your PHI when required to do so by law, including for reporting suspected abuse or neglect, responding to court orders or legal processes, health oversight activities, or to protect you or others from serious harm.

Other Uses and Disclosures With Authorization

Any other use or disclosure of your PHI not described above will be made only with your written authorization. You may revoke such authorization at any time in writing, except to the extent that action has already been taken in reliance on it.

Your Rights Regarding Your Protected Health Information

You have the right to:

Request restrictions on certain uses or disclosures of your PHI
Request confidential communications by alternative means or locations
Inspect and obtain a copy of your PHI
Request amendments to your PHI
Receive an accounting of certain disclosures

Requests must be made in writing. I will respond to requests in accordance with applicable law.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with me or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

Changes to This Notice

I reserve the right to revise this Notice at any time. Any revised Notice will apply to all PHI maintained by me and will be made available upon request.

Contact Information

Karen Wachtel, Ph.D.

Privacy Officer

Phone: 646-789-6855

Email: Karen@DrKarenWachtel.com