Notice of Privacy Practices (HIPAA)

This Notice describes how medical information about you may be used and disclosed and how you can access that information.

Our Legal Duties

We are required by law to:

• Maintain the privacy of your protected health information (PHI)
• Provide you with this Notice
• Follow the terms of this Notice

Uses and Disclosures of PHI

Treatment

We may use and share PHI to provide, coordinate, or manage your healthcare.

Payment

We may use PHI to bill and collect payment from insurance providers or you directly.

Healthcare Operations

We may use PHI for quality improvement, compliance, training, credentialing, and administrative purposes.

Other Permitted Uses

We may disclose PHI for:

• Public health activities
• Health oversight activities
• Legal proceedings
• Law enforcement purposes
• Preventing serious threats to health or safety

Your Rights Under HIPAA

You have the right to:

• Inspect and obtain copies of your medical records
• Request amendments to your records
• Request restrictions on certain disclosures
• Receive an accounting of disclosures
• Request confidential communications

Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

• The Y Factor Privacy Officer
• U.S. Department of Health and Human Services

You will not be retaliated against for filing a complaint.

Contact Information

Privacy Officer – The Y Factor
Phone: 832-234-9775