Notice of Privacy Practices

This Notice of Privacy Practices ("Notice") applies to Palm Urgent Care & Mental Health ("Palm", "we", "us") and to all of our clinic locations in San Diego County, California. It describes how we may use and disclose your protected health information ("PHI"), the duties we have to protect it, and the rights you have over it under the Health Insurance Portability and Accountability Act (HIPAA) and California law. We are required by law to maintain the privacy of your PHI, to give you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

The following categories describe the ways we may use and disclose PHI. Not every use or disclosure in a category is listed, but all permitted uses and disclosures will fall within one of these categories.

Treatment

We use your PHI to provide, coordinate, and manage your medical and mental health care. For example, our clinicians may share your information with each other, with a laboratory that performs your tests, with a pharmacy that fills your prescription, or with a specialist we refer you to.

Payment

We use and disclose PHI to bill and collect payment for the care we provide. For example, we may send information about your visit to your health plan (including Medi-Cal or Medicare) to obtain payment, confirm your coverage, or respond to a payer's review of a claim.

Health Care Operations

We use and disclose PHI for activities that keep our clinics running and improve the quality of care, such as quality review, staff training and evaluation, licensing, scheduling, and business planning. We may also contact you to remind you of an appointment or to tell you about treatment options or health services that may interest you.

Other Permitted or Required Disclosures

• As required by law. When federal, state, or local law requires disclosure.
• Public health. To public health authorities for disease prevention or control, reporting births and deaths, or reporting reactions to medications.
• Abuse or neglect. To authorities when we reasonably believe a patient is a victim of abuse, neglect, or domestic violence, as required or permitted by law.
• Health oversight. To agencies that oversee the health care system, such as audits, investigations, and licensure activities.
• Legal proceedings. In response to a court or administrative order, or in some cases a subpoena or other lawful process.
• Law enforcement. For limited law enforcement purposes, such as reporting certain wounds or complying with a warrant.
• Serious threat. To prevent a serious and imminent threat to the health or safety of you, another person, or the public.
• Workers' compensation. As authorized by workers' compensation laws for work-related injuries or illness.
• Coroners, medical examiners, funeral directors. As necessary to carry out their duties.
• Business associates. To contractors who perform services for us (for example, billing or IT) under written agreements that require them to safeguard your PHI.

Uses and Disclosures That Require Your Written Authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures of PHI for marketing purposes, and any sale of PHI require your written authorization. We will also obtain your written authorization before any other use or disclosure not described in this Notice. You may revoke an authorization at any time, in writing, except to the extent we have already acted on it. Certain records, including mental health and substance use treatment records, receive additional protection under California law and federal rules and generally will not be disclosed without your specific written permission.

Family, Friends, and Others Involved in Your Care

Unless you object, we may share information relevant to a family member's or friend's involvement in your care or payment for your care, and we may notify a family member or person responsible for your care of your location and general condition. If you are not present or able to agree, we will use professional judgment to decide whether sharing is in your best interest.

Your Rights Over Your Health Information

• Right to inspect and copy. You may inspect and obtain a copy of your medical and billing records, usually within 30 days of a written request. We may charge a reasonable, cost-based fee. If we maintain records electronically, you may request an electronic copy.
• Right to amend. If you believe information in your record is incorrect or incomplete, you may request an amendment in writing, with a reason. We may deny the request in certain cases, and you may respond with a statement of disagreement.
• Right to an accounting of disclosures. You may request a list of certain disclosures we made of your PHI in the six years before your request, other than for treatment, payment, health care operations, and certain other exceptions.
• Right to request restrictions. You may ask us to limit how we use or disclose your PHI. We are not required to agree, except that we must honor a request not to disclose information to your health plan when the disclosure is for payment or operations and you have paid for the service in full out of pocket.
• Right to confidential communications. You may ask that we contact you in a specific way or at a specific location, for example only by mail or only at a certain phone number. We will accommodate reasonable requests.
• Right to a paper copy of this Notice. You may request a paper copy at any time, even if you agreed to receive it electronically. The current Notice is always available at any of our front desks and on this page.
• Right to be notified of a breach. We will notify you if a breach occurs that compromises the privacy or security of your unsecured PHI.

Our Duties

We are required by law to maintain the privacy and security of your PHI, to provide you with this Notice, to notify you following a breach of unsecured PHI, and to abide by the terms of the Notice currently in effect. We reserve the right to change this Notice and to make the revised Notice effective for PHI we already maintain as well as PHI we receive in the future. The current Notice, with its effective date, will be posted at each clinic and on this page.

Complaints and Questions

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

• Privacy Officer, Palm Urgent Care & Mental Health: call (619) 354-6494 or email [email protected].
• U.S. Department of Health and Human Services, Office for Civil Rights: 200 Independence Avenue SW, Washington, DC 20201, or online at hhs.gov/ocr/complaints.

See also our Website Privacy Policy (which covers this website) and our Terms of Service. This Notice covers health information collected in the course of your care at our clinics.