HIPAA Notice Of Privacy Practices

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED

AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THE INFORMATION. PLEASE

REVIEW CAREFULLY:

Bear With Me Behavior Solutions PLLC is required by the Health Insurance Portability & Accountability Act of 1996 (HIPAA) to

provide confidentiality for all medical/mental health records and other individually identifiable

health information in my possession. This Notice is to inform you of the uses and disclosures

of confidential information that may be made by Bear With Me Behavior Solutions PLLC, and of your individual

rights and Bear With Me Behavior Solutions LLC's legal duties with respect to confidential information.

Ways in which Bear With Me Behavior Solutions PLLC may use and disclose your protected Health information:

Bear With Me Behavior Solutions PLLC may use and disclose at our discretion your medical records for each of the following

purposes only: treatment, payment and health care operations.

● Treatment means providing, coordinating or managing behavioral health care and related

Services.

● Payment means activities such as obtaining payment for the behavior analytic health care

services we provide to you from your insurance, private-pay, or another third party payer.

● Health care operations include the business aspects of running a practice.

Therapy Notes: Bear With Me Behavior Solutions PLLC uses therapy notes as part of treatment. These notes will not be shared, unless private approval was given or required by law. 

Bear With Me Behavior Solutions PLLC may contact you to provide appointment reminders or other services that may be of interest to you. Bear With Me Behavior Solutions PLLC will disclose your protected health information to any person you identify that is

involved in payment for your care.

Bear With Me Behavior Solutions PLLC  will use and disclose your protected health information when required by federal, state or

local law. There are certain situations in which Bear With Me Behavior Solutions PLLC is required by ethical standards to reveal information obtained during therapy to persons or agencies even if you do not give permission in order to prevent harm to yourself, or others. 

Any other uses and disclosures will be made only with your written authorization. You will be

provided with an authorization form upon request. A separate form will be needed for each

request for release of information. The authorization for release of records is valid until it

expires or is revoked. You may revoke authorization in writing and Bear With Me Behavior Solutions PLLC are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

Your Rights Regarding Protected Health Information: 

You have the right to see and obtain copies of PHI, but requests must be made in writing. Bear With Me Behavior Solutions PLLC will provide that to you within (5) business days. If Bear WIth Me Behavior Solutions PLLC does not have the PHI, but knows who does, we will offer guidance as to how to obtain it. 

You have the rights to place limits on how your PHI is used. You can request limits on your PHI and Bear With Me Behavior Solutions PLLC may take this into consideration, but is not legally required to do so. 

You have the right to choose how PHI information will be sent to you. You have the right to ask for PHI to be sent to an alternate address or via a different method. Bear With Me Behavior Solutions PLLC will honor those requests as long as we are able to do so. 

You have the right to obtain copies of any disclosures

You have the right to amend your PHI. Written requests are required and Bear With Me Behavior Solutions PLLC will contact within (10) business days whether changes will take place. If it is determined that the PHI amendment is not appropriate, you will be notified of the reason. 

You have a right to receive a breach notification. 

You have the right to get a copy of this notice by email, or to ask for a paper copy. Bear With Me Behavior Solutions will get that to you in the most appropriate method, unless otherwise noted. 

How To File A Complaint About Privacy Practices: 

In your opinion, if you believe Bear With Me Behavior Solutions PLLC has violated your privacy rights, or have an objection to a decision regarding your PHI, you are entitled to file a complaint at the following address:  

Office of Civil Rights, Secretary of the Department of Health and Human Services, 200 Independence Ave, S.W Washington DC 20201. IF a complaint is filed, Bear With Me Behavior Solutions will not take any action to retaliate against you. 

If you have any questions regarding this notice or how to file a complaint, please contact Bear With Me Behavior Solutions PLLC directly at 810-328-3532, rsawa@bearwithmebehavior.com

EFFECTIVE DATE OF THIS NOTICE OF PRIVACY PRACTICES. This Notice of Privacy Practice became effective as of January 1st, 2021. Bear With Me Behavior Solutions PLLC will abide by and may change the terms of this Notice at any time. Bear With Me Behavior Solutions PLLC  may, at its discretion, make the new terms effective for all PHI in our possession, including any PHI created or received before the new Notice is issued.