Notice of Privacy Practices

This Notice is provided to you pursuant to the privacy regulations enacted as a result of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). This joint notice of privacy practices describes how your health information may be used and disclosed and how you can get access to your information. This Notice applies to all your health information created or maintained by [Cactus Bloom Studio, LLC] (the “Practice”). PLEASE REVIEW THIS NOTICE CAREFULLY.

  1. Our Commitment to Your Privacy

The Practice is committed to maintaining the privacy of your health information. We are required by law to (i) maintain the privacy of your health information; (ii) provide you with this notice of our legal duties and privacy practices with respect to your health information; (iii) follow the terms of the notice of privacy practices currently in effect; and (iv) notify you if there is a breach of your health information. We must also provide you with the following important information: (a) how we may use and disclose your health information; (b) your privacy rights; and (c) our obligations concerning the use and disclosure of your health information.

This Notice of Privacy Practices is NOT an authorization; rather it describes how we, our Business Associates, and their subcontractors may use and disclose your Protected Health Information to carry out treatment, payment, or healthcare operations, and for other purposes as permitted or required by law. It also describes your rights to access and control your Protected Health Information.

“Protected Health Information” (“PHI”) means information that identifies you individually; including demographic information, and information that relates to your past, present, or future physical or mental health condition and/or related healthcare services.

The terms of this notice apply to all your PHI created or maintained by Practice. We reserve the right to revise or amend this Notice at anytime. Any revision or amendment to this notice will be effective for all of your records that we created or maintained in the past and for any of your records that we may create or maintain in the future. You may request a copy of our most current Notice at any time.

  1. Use and Disclosure of Your Individually Identifiable Health Information (“PHI”)
  2. Treatment. Practice may use or share your PHI to provide health services for you and manage and coordinate your care. For example, PHI may be provided to another health care provider to whom you have been referred to ensure that the provider has the necessary information to diagnose or treat you. All Practice services will be provided via virtual visits (telehealth); accordingly, your information will be shared electronically via a secure transmission to facilitate the virtual visit.
  3. Payment. Practice may use and disclose your PHI in order to bill for services provided and collect payment from you directly, or, as applicable, health plans or other entities.
  4. Health Care Operations. Practice may use and disclose your PHI to run our businesses, improve your care, and contact you when necessary. For example, we may use or disclose your PHI, as necessary, to contact you to remind you of your appointment, and inform you about treatment alternatives or other health related benefits and services that may be of interest to you.
  5. Disclosures to Family or Friends. Practice may disclose your PHI to individuals involved in your care or treatment or responsible for payment of your care or treatment.
  6. Disclosures Required by Law. Practice will use and disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, Practice may disclose your PHI to report a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
  7. Use and Disclosure of Your PHI in Certain Special Circumstance
  8. Public Health Reporting. Practice may disclose and may be required by law to disclose your PHI for certain public health purposes. For example, a disclosure may be made for the purpose of preventing or controlling disease, injury, or disability. dependent.
  9. Health Oversight Activities. Practice may disclose your PHI to a health oversight agency for investigations, inspections, audits, surveys, licensure and disciplinary actions, and in certain civil, administrative, and criminal procedures or actions, or other health oversight activities as authorized by law.
  10. Lawsuits and Disputes. Practice may disclose your PHI in response to a court or administrative order, subpoena, request for discovery, or other legal processes. However, absent a court order, Practice will generally disclose your PHI if you have authorized the disclosure or efforts have been made to inform you of the request or obtain an order protecting the information requested. Your information may also be disclosed if required for our legal defense in the event of a lawsuit.
  11. Law Enforcement. Practice may disclose your PHI if requested by a law enforcement official: (a) regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement; (b) about a death we believe resulted from criminal conduct; (c) regarding criminal conduct on our premises; (d) in response to a warrant, summons, court order, subpoena or similar legal process; (e) to identify/locate a suspect, material witness, fugitive or missing person; or (f) in an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator).