Notice of Privacy Practices


Effective Date: August 3, 2024

Your Information. Your Rights. Our Responsibilities.

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.


Your Rights


  You have the right to:

  1. Get a copy of your paper or electronic medical record: You can ask to see or get a copy of your health information. We will provide a copy or a summary of your health information, usually within 30 days of your request. A reasonable fee may be charged.
  2. Correct your paper or electronic medical record: You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  3. Request confidential communication: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
  4. Ask us to limit what we use or share: You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  5. Get a list of those with whom we’ve shared information: You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  6. Get a copy of this privacy notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
  7. Choose someone to act for you: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care.
  • Share information in a disaster relief situation.
  • Include your information in a hospital directory.

If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

  1. Treat you: We can use your health information and share it with other professionals who are treating you.
  2. Run our organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  3. Bill for your services: We can use and share your health information to bill and get payment from health plans or other entities.

We are also allowed or required to share your information in other ways—usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.


For more information or to file a complaint, contact:
Demetries North
Phone: (202) 656-2744

Email: demetries.north@mysynergypathways.com


or


U.S. Department of Health and Human Services Office for Civil Rights

200 Independence Avenue, S.W.

Washington, D.C., 20201

1-877-696-6775 (toll free)

www.hhs.gov/ocr/privacy/hipaa/complaints/


This Notice of Privacy Practices applies to all individuals seeking services from our practice. Please keep a copy for your records.