Pivoting Minds Psychiatry 

Privacy Policy 

This notice describes how your medical information may be used and disclosed and how you can access this information. Protecting your health information is our priority. Please review this notice carefully.

Your Rights

1. Access Your Health Records 

– You may request an electronic or paper copy of your medical records and other health
information.
– We will provide the requested information within 30 days, as permitted by law. A
reasonable, cost-based fee may apply.

2. Request Corrections to Your Health Records

– If you believe any health information is incorrect or incomplete, you may request a
correction.
– If we deny your request, we will provide written reasoning within 60 days.

3. Request Confidential Communications

– You may request that we contact you in a specific way (e.g., via phone or mail at a specific
address).
– We will accommodate all reasonable requests.

4. Restrict Information Sharing

– You may request that we not use or share certain health information for treatment,
payment, or operational purposes. While we are not required to agree, we will consider
your request.

– opt-in and Phone numbers for SMS will not be shared with third parties and affiliates for marketing purposes

– If you pay in full for a service or item out-of-pocket, you may request that we do not share
that information with your health insurer unless required by law.

5. Obtain a Record of Disclosures

– You may request a list of entities with whom we have shared your health information,
along with the reasons for each disclosure, within the timeframe and content limits set by
law.

6. Request a Copy of This Notice

– You may request a paper copy of this notice at any time, even if you have agreed to receive
it electronically.

7. Designate a Representative

– If you have assigned medical power of attorney or have a legal guardian, that individual
may exercise your rights and make decisions regarding your health information.
Verification of their authority is required.

8. File a Complaint

– If you feel your privacy rights have been violated, you may file a complaint with Pivoting
Minds Psychiatry or with the U.S. Department of Health and Human Services Office for Civil
Rights. Filing a complaint will not result in retaliation.

Your Choices

You may express your preferences regarding:
– Sharing health information with family, friends, or others involved in your care (with
appropriate documentation).
– Disclosures during disaster relief situations.
If you are unable to communicate your preferences, we may act based on what we believe is
in your best interest or as necessary to prevent a serious threat to your health or safety.
We will never use or share your information for:
– Marketing purposes without written authorization.
– The sale of your information.
– Most disclosures of psychotherapy notes.

How We Use and Share Your Information

Routine Uses

– Treatment: Share information with other professionals involved in your care.
– Operations: Improve your care and ensure efficient practice operations.
– Billing: Submit claims and collect payment for services provided.

Other Permitted Uses

– Public health and safety concerns.
– Research purposes (as permitted by law).
– Workers’ compensation claims.
– Law enforcement requests or as required by law.
– Government functions, such as military operations or national security.
– Responses to lawsuits, court orders, or subpoenas.

Our Responsibilities

– We are required by law to maintain the privacy and security of your Protected Health
Information (PHI).
– We will notify you promptly if a breach occurs that may compromise the privacy or
security of your information.
– We will only use or share your information as described in this notice or with your written
authorization.

SMS Terms And Conditions

If you consent to receive SMS messages, these terms apply:

-Information obtained as part of the SMS consent process will not be shared with third parties
– Purpose: SMS messages may include appointment reminders, provider referrals,
scheduling updates, and medication-related communications.
– Opt-Out: You may opt out of SMS messages at any time by notifying us.
– Fees: There are no fees associated with SMS messaging from Pivoting Minds Psychiatry.
– HIPAA Compliance: SMS communications are conducted through our HIPAA-compliant system, ‘RingCentral’
– Privacy: Your information will not be sold or disclosed; protecting your privacy is our
priority.

A copy of this form is included in all new patient paperwork and will be kept on file for your reference.