Notice of Privacy Practices

Shrinkty Medical Services, LLC · Effective date:

What is protected health information?

Protected health information (PHI) is information that identifies you and relates to your past, present, or future physical or mental health, the health care we provide to you, or payment for that care. Examples include your name, contact information, diagnoses, medications, treatment notes, and billing records.

Our legal duties

Shrinkty Medical Services, LLC is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its regulations to maintain the privacy and security of your protected health information, to provide you with this notice of our legal duties and privacy practices, to notify you if a breach occurs that may have compromised the privacy or security of your information, and to follow the terms of the notice currently in effect. We reserve the right to change this notice and to make the revised notice effective for all PHI we maintain. The current notice is available on our website and at our offices.

How we may use and disclose your information without your authorization

Federal law permits us to use and disclose your PHI for the following purposes without your written authorization:

• Treatment. We may use and share your information to provide, coordinate, or manage your care — for example, when your provider consults with another clinician involved in your treatment, or when we send a prescription to your pharmacy.
• Payment. We may use and share your information to bill and collect payment for services — for example, submitting claims to your insurance plan or verifying your coverage.
• Health care operations. We may use and share your information to run our practice — for example, quality improvement, training, licensing, and business planning.
• Business associates. We may share your information with contractors and vendors who perform services for us (such as billing or information technology), under written agreements requiring them to protect your information.
• As required by law. We will disclose your information when federal, state, or local law requires it.
• Public health. We may disclose information to public health authorities for activities such as preventing or controlling disease and reporting adverse reactions to medications.
• Reporting abuse or neglect. We may disclose information to appropriate authorities if we reasonably believe a patient is a victim of abuse, neglect, or domestic violence, as required or permitted by law.
• Health oversight. We may disclose information to health oversight agencies for audits, investigations, inspections, and licensure activities.
• Judicial and administrative proceedings; law enforcement. We may disclose information in response to a court or administrative order, and in certain circumstances in response to a subpoena or other lawful process, or to law enforcement officials as permitted by law.
• Decedents. We may disclose information to coroners, medical examiners, and funeral directors as necessary to carry out their duties.
• Research. We may use or disclose information for research under safeguards approved through a review process designed to protect your privacy.
• Serious threats to health or safety. We may use or disclose information when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
• Specialized government functions. We may disclose information for certain military, national security, and other specialized government functions as permitted by law.
• Workers' compensation. We may disclose information as authorized by workers' compensation laws.
• Appointment reminders. We may contact you to remind you of scheduled appointments and to tell you about treatment options or health-related services that may interest you.

Uses and disclosures that require your written authorization

Uses and disclosures not described in this notice will be made only with your written authorization. This includes most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your information. You may revoke an authorization at any time in writing, except to the extent we have already acted in reliance on it.

Text messaging

Text-messaging originator opt-in data and consent will not be shared with third parties or affiliates for marketing or promotional purposes.

Your rights

You have the following rights regarding your protected health information. To exercise any of these rights, call us at 615-716-8255.

• Right to request restrictions. You may ask us to limit how we use or disclose your information for treatment, payment, or operations. We are not required to agree to every request, but if we do agree, we will honor the restriction except in an emergency.
• Right to inspect and copy. You may inspect and receive a copy of the health information we maintain about you, with limited exceptions. A nominal copying fee may apply.
• Right to request amendment. If you believe information in your record is incorrect or incomplete, you may request that we amend it. We may deny the request in certain circumstances, and we will explain the reason in writing.
• Right to confidential communications. You may ask us to contact you in a specific way or at a specific location — for example, only by phone or only at a certain number. We will accommodate reasonable requests.
• Right to a paper copy of this notice. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your information during the six years before your request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice by calling 615-716-8255 or writing to us at 2462 Old Fort Parkway, Murfreesboro, TN 37128. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Questions

If you have questions about this notice or our privacy practices, contact us at 615-716-8255 or info@shrinkty.com.