Notice of Privacy Practices

Your rights

When it comes to your health information, you have certain rights. This section explains those rights and some of the practice’s responsibilities.

• Get an electronic or paper copy of your medical record and other health information about you, usually within the time required by law. Reasonable, cost-based fees may apply where permitted.
• Ask the practice to correct health information you believe is incorrect or incomplete. A request may be denied in some circumstances, with an explanation provided as required by law.
• Ask the practice to contact you in a specific way or at a different address.
• Ask the practice to limit what is used or shared. The practice is not required to agree to every request, except that a disclosure to a health plan for payment or operations generally must be restricted when you paid the item or service in full out of pocket and the law requires the restriction.
• Get a list of certain disclosures made of your health information, subject to legal exceptions.
• Get a paper copy of this notice and choose someone to act for you when that person has legal authority.
• File a complaint without retaliation if you believe your privacy rights have been violated.

Your choices

• Tell the practice whether to share information with family, close friends, or others involved in your care or payment for care, and whether to share information in a disaster-relief situation.
• If you cannot communicate your preference, the practice may share information when it is believed to be in your best interest and may share information needed to lessen a serious and imminent threat to health or safety.
• Written permission is generally required for most marketing, sale of health information, and most sharing of psychotherapy notes. The practice does not use or share your information for fundraising unless applicable notice and opt-out requirements are met.

How health information may be used and shared

The practice may use or share health information without written permission when permitted or required by law, including for:

• Treatment, care coordination, and communication with other professionals involved in your care.
• Practice operations, such as quality assessment, staff training, credentialing, compliance, and business administration.
• Billing for services and obtaining payment from health plans or other responsible parties.
• Public health and safety activities, reporting suspected abuse or neglect, preventing or reducing a serious threat, health oversight, and other activities authorized by law.
• Organ and tissue donation, medical examiner or funeral director duties, workers’ compensation, certain law-enforcement requests, and other government functions authorized by law.
• Research when legal safeguards and approval requirements are met, responding to lawsuits or legal actions, and complying with other legal requirements.

Substance use disorder records

To the extent the practice maintains records protected by 42 C.F.R. Part 2, those records, or testimony describing their content, generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide written consent or a court order and subpoena meet applicable federal requirements.

Our responsibilities

• The practice is required by law to maintain the privacy and security of protected health information.
• The practice will notify affected individuals as required if a breach may have compromised the privacy or security of their information.
• The practice must follow the duties and privacy practices described in the notice currently in effect and provide a copy on request.
• The terms of this notice may change. A revised notice may apply to health information already held as well as information received in the future. The current notice will be available from the practice and on this website.

Questions and complaints

For questions about this notice, to request a copy, or to raise a privacy concern with Solutions in Pain, call (469) 251-8488 or use the Contact page. You will not be retaliated against for filing a complaint.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting the HHS complaint portal, writing to 200 Independence Avenue SW, Washington, DC 20201, or calling 1-877-696-6775.

HHS Office for Civil Rights complaint information ↗