HIPAA Notice of Privacy Practices

DRAFT — attorney review required before launch

This page is starter language adapted from common templates. It is not legal advice and must be reviewed and finalized by qualified counsel before ojava health begins providing services.

Effective date: TBD

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.

Our pledge regarding your health information

ojava health and our affiliated licensed clinicians ("we," "us") are committed to protecting your protected health information ("PHI"). We are required by law to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.

How we may use and disclose your health information

For treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care. For example, your provider may share your information with a pharmacy to fill a prescription, or with a laboratory to order tests.

For payment

We may use and disclose your PHI to bill and collect payment for the services we provide. Because we do not bill insurance, this is generally limited to processing your direct payment.

For healthcare operations

We may use and disclose your PHI for activities necessary to run our practice and ensure quality care, such as quality assessment, provider training, and administrative functions.

Other uses and disclosures permitted or required by law

We may use or disclose your PHI without your authorization in limited circumstances permitted by law, including: required reporting to public health authorities, responding to court orders, addressing serious threats to health or safety, and as required for law enforcement purposes.

Uses and disclosures requiring your authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing, and disclosures that constitute a sale of PHI require your written authorization. You may revoke an authorization in writing at any time.

Your rights regarding your health information

Right to inspect and copy. You have the right to inspect and obtain a copy of the PHI we maintain about you, subject to certain limited exceptions.
Right to amend. You may request that we amend PHI you believe 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 how we use or disclose your PHI.
Right to confidential communications. You may request that we communicate with you in a particular way or at a particular location.
Right to a paper copy of this notice. Even if you agreed to receive this notice electronically, you may request a paper copy at any time.
Right to be notified of a breach. We will notify you if a breach of your unsecured PHI occurs.

Changes to this notice

We reserve the right to change this notice and to apply the revised notice to PHI we already have about you, as well as to PHI we receive in the future. The revised notice will be available on our website and upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact below or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Contact

Privacy Officer
ojava health
Email: privacy@ojavahealth.com