Notice of Privacy Practices

Our Commitment to Your Privacy

Mindful Sewa Psychiatry is required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this Notice of our legal duties and privacy practices, and to abide by the terms of the Notice currently in effect. PHI is information that may identify you and that relates to your past, present, or future physical or mental health condition, the healthcare we provide, or payment for that care.

How We May Use and Disclose Your Health Information

For Treatment. We may use and disclose PHI to provide, coordinate, and manage your care — for example, sending a prescription to your pharmacy, consulting with another clinician involved in your care with your consent, or coordinating laboratory monitoring.

For Payment. We may use and disclose PHI to bill and collect payment for services. As a private-pay practice we do not submit claims to insurers; if you request a superbill to seek reimbursement yourself, it may include diagnosis and service codes, and your insurer will receive that information if you submit it.

For Healthcare Operations. We may use PHI for practice operations such as quality improvement, training, compliance, and business management.

Other permitted or required uses. We may use or disclose PHI without your authorization when required or permitted by law, including: when required by federal, state, or local law; for public health activities; to report suspected abuse or neglect; for health oversight activities; in judicial or administrative proceedings; to avert a serious threat to health or safety; for workers' compensation; and to coroners, medical examiners, or funeral directors as permitted by law. Special protections under California law and 42 CFR Part 2 (where applicable) are honored.

Uses requiring your written authorization. Most uses and disclosures of psychotherapy notes, uses for marketing purposes, and any sale of PHI require your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already relied on it.

Your Rights Regarding Your Health Information

• Right to inspect and copy. You may request access to your medical record, with limited exceptions provided by law.
• Right to amend. You may request an amendment to your record if you believe information is incorrect or incomplete.
• Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI.
• Right to request restrictions. You may request restrictions on certain uses and disclosures. We are not required to agree to all requests, but we will honor a request to restrict disclosure to a health plan when you have paid in full out of pocket for the service.
• Right to confidential communications. You may request that we contact you in a specific way or at a specific location.
• Right to a paper copy of this Notice. You may request a paper copy at any time.
• Right to breach notification. We will notify you if a breach occurs that compromises the privacy or security of your PHI.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as information we receive in the future. The current Notice will always be posted on this page.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us at info@mindfulsewa.com or with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Contact

Privacy Contact — Mindful Sewa Psychiatry
Email: info@mindfulsewa.com
Phone: (888) 457-8124