HIPAA Notice of Privacy Practices

Uses and disclosures of protected health information

Your protected health information may be used and disclosed by Sullivan Recovery, our staff, and others outside our organization who are involved in your care and treatment for the purpose of providing health care services to you, paying your health care bills, supporting the operation of the organization, and any other use required by law.

Treatment

We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you, or to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

Payment

Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for equipment or supplies coverage may require that your relevant protected health information be disclosed to the health plan to obtain approval for coverage.

Health care operations

We may use or disclose, as needed, your protected health information in order to support the business activities of our organization. These activities include, but are not limited to, quality assessment activities, employee review activities, accreditation activities, and conducting or arranging for other business activities.

For example, we may disclose your protected health information to accrediting agencies as part of an accreditation survey. We may call you by name while you are at our facility. We may use or disclose your protected health information, as necessary, to contact you to check the status of your equipment.

Uses and disclosures that may occur without your authorization

We may use or disclose your protected health information in the following situations without your authorization, as permitted or required by law:

• As required by law
• Public health issues as required by law
• Communicable diseases
• Health oversight
• Abuse or neglect
• Food and Drug Administration requirements
• Legal proceedings
• Law enforcement
• Criminal activity
• Inmates
• Military activity and national security
• Workers' compensation

Required uses and disclosures

Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.

Other permitted uses and disclosures

Other permitted and required uses and disclosures will be made only with your consent, authorization, or opportunity to object, unless required by law.

You may revoke this authorization at any time in writing, except to the extent that your physician or this organization has taken an action in reliance on the use or disclosure indicated in the authorization.

Your rights

Following is a statement of your rights with respect to your protected health information.

• You have the right to inspect and copy your protected health information, subject to certain exceptions under federal law (including psychotherapy notes, information compiled in reasonable anticipation of legal proceedings, and information subject to laws that prohibit access).
• You have the right to request a restriction of your protected health information for treatment, payment, or health care operations, including restrictions on disclosure to family or friends involved in your care. We are not required to agree to a restriction; if we do not agree, you have the right to use another health care professional.
• You have the right to request confidential communications by alternative means or at an alternative location.
• You have the right to obtain a paper copy of this notice from us upon request, even if you have agreed to receive it electronically.
• You may have the right to request an amendment to your protected health information. If we deny your request, you may file a statement of disagreement and we may provide a rebuttal.
• You have the right to receive an accounting of certain disclosures we have made of your protected health information.
• We reserve the right to change the terms of this notice and will inform you by mail of any changes. You may object or withdraw as provided in this notice.

Complaints

You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by notifying our privacy contact. We will not retaliate against you for filing a complaint.

We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information.

Website and contact information

Information you submit through our website contact or insurance verification forms before a treatment relationship is established may not be protected health information under HIPAA, but we treat health-related information you share with us confidentially.

For questions about this notice, contact Sullivan Recovery at 24731 Via San Fernando, Mission Viejo, CA 92692, or email admissions@sullivanrecovery.com.

For more information about HIPAA privacy rights, visit the U.S. Department of Health & Human Services at https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/