HIPAA Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective Date: March 2026

This Notice of Privacy Practices (“Notice”) describes how Integrative Psychiatry Optimized may use and disclose your Protected Health Information (PHI) and your rights regarding that information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable New York State law.

This Notice applies to all PHI that we create, receive, or maintain about you while providing psychiatric or psychotherapy services.

Our Legal Duties

We are required by law to:

  • Maintain the privacy and security of your PHI.
  • Provide you with this Notice of our privacy practices.
  • Follow the terms of the Notice currently in effect.
  • Notify you if a breach occurs that may compromise the privacy or security of your PHI.

We may update this Notice periodically. Updated versions will be posted in our office and on our website.

How We May Use and Disclose Your PHI

1. Treatment

We may use and disclose your PHI to provide, coordinate, or manage your mental health care.

Examples:

  • Sharing information with another psychiatrist, therapist, or physician involved in your care.
  • Consulting with a covering provider if your regular clinician is unavailable.

Whenever possible, we will seek your consent before sharing sensitive mental health information.

2. Payment

We may use your PHI to obtain payment for services provided.

  • Verifying insurance coverage.
  • Submitting claims for reimbursement.
  • Responding to insurance questions about services.

If you pay for a service completely out of pocket, you may request that we not disclose information about that service to your health plan.

3. Health Care Operations

We may use PHI for activities necessary to run our practice and maintain quality care.

  • Quality improvement activities
  • Staff training and supervision
  • Practice management and internal operations

When possible, we limit or remove identifying information.

Other Uses and Disclosures Allowed by Law

We may disclose PHI without authorization when permitted or required by law, including:

  • Public Health and Safety: reporting abuse, neglect, or serious threats.
  • Health Oversight: audits, investigations, or licensing reviews.
  • Judicial Proceedings: responding to court orders or subpoenas.
  • Law Enforcement: in limited circumstances permitted by law.
  • Coroners or Medical Examiners: determining cause of death.
  • Workers’ Compensation: complying with workplace injury laws.

When mental health information is disclosed in these circumstances, we follow additional protections required by New York law.

Psychotherapy Notes

Psychotherapy notes are kept separately from the medical record and receive special protection under HIPAA.

We will not use or disclose psychotherapy notes without your written authorization except in limited circumstances permitted by law.

Uses Requiring Your Authorization

We will obtain your written authorization before using or disclosing PHI for:

  • Psychotherapy notes (except limited legal exceptions)
  • Marketing communications involving payment from third parties
  • Sale of PHI
  • Any other uses not described in this Notice

You may revoke authorization at any time in writing.

Your Rights Regarding Your PHI

1. Right to Access

You may inspect or obtain copies of your PHI in our records, with certain legal exceptions.

2. Right to Amend

If you believe information in your record is incorrect or incomplete, you may request an amendment.

3. Right to an Accounting of Disclosures

You may request a list of certain disclosures made during the previous six years.

4. Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your PHI.

5. Right to Confidential Communications

You may request that we communicate with you in a specific way or location to protect your privacy.

6. Right to a Paper Copy

You may request a printed copy of this Notice at any time.

7. Right to Breach Notification

You will be notified if a breach occurs involving your unsecured PHI.

Additional Protections Under New York Law

New York law provides additional privacy protections for mental health records and certain sensitive information such as HIV-related data, genetic information, and substance use disorder records.

When state law provides stronger privacy protections than HIPAA, we follow the stricter standard.

Questions or Complaints

If you believe your privacy rights have been violated, you may contact us or file a complaint. You will not be retaliated against for filing a complaint.

Contact the Practice

Privacy Officer
Integrative Psychiatry Optimized
900 South Ave, Suite #52
Staten Island, NY 10314
Phone: (718) 732-7334

Contact the U.S. Department of Health and Human Services

You may file a complaint with the Office for Civil Rights (OCR):

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