THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Valley Vista Telepsychiatry, PLLC ("we," "us," or "our") is required by federal law to protect the privacy of your health information, give you this notice of our legal duties and privacy practices, and follow the terms of this notice. We reserve the right to change this notice as permitted by law.
Uses & disclosures of your PHI
We may use and disclose your protected health information ("PHI") for the following purposes without your specific written authorization:
Treatment
To provide, coordinate, or manage your psychiatric care — including sharing information with other healthcare providers involved in your treatment (your primary care provider, therapist, pharmacy, laboratory).
Payment
To bill and collect payment for the services we provide — including verifying coverage, submitting claims, and reporting to billing clearinghouses.
Healthcare operations
To run our practice — including quality assessment, training, accreditation, business planning, and administrative functions.
Other permitted disclosures
We may also use or disclose your PHI without your authorization when:
- Required by law (subpoenas, court orders, public health reporting)
- Reporting suspected abuse, neglect, or domestic violence to authorized agencies
- To prevent or lessen a serious and imminent threat to your safety or the safety of others
- For health oversight activities by federal or state agencies (e.g., audits, licensing investigations)
- For workers' compensation, military authorities, or specialized government functions as permitted by law
Disclosures requiring your authorization
We will obtain your written authorization for any other use or disclosure, including:
- Most uses or disclosures of psychotherapy notes
- Uses or disclosures for marketing purposes
- Sales of your PHI
You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
Your rights regarding your PHI
Right to access
You have the right to inspect and obtain a copy of your medical record. Requests must be made in writing to our Privacy Officer. We will respond within 30 days. A reasonable, cost-based fee may apply for copies.
Right to amend
You have the right to request that we amend information you believe is incorrect or incomplete. Requests must be made in writing and include the reason for the amendment. We may deny the request in certain circumstances.
Right to an accounting of disclosures
You have the right to receive a list of certain disclosures we have made of your PHI in the six years prior to your request.
Right to request restrictions
You may request that we restrict certain uses or disclosures of your PHI. We are not required to agree, except where the disclosure is to a health plan for payment or healthcare operations and the PHI pertains solely to a service you paid for in full out of pocket.
Right to confidential communications
You may request that we communicate with you in a specific way (e.g., only by phone, only at a particular address). We will accommodate reasonable requests.
Right to a paper 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.
Right to be notified of a breach
You have the right to be notified following a breach of unsecured protected health information.
Our duties
- We are required by law to maintain the privacy of your PHI.
- We are required to provide you with this notice of our legal duties and privacy practices.
- We are required to abide by the terms of the notice currently in effect.
- We will notify you if a breach occurs that may have compromised the privacy or security of your information.
Filing a complaint
If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer (see below), or directly with the U.S. Department of Health and Human Services, Office for Civil Rights:
200 Independence Avenue SW, Washington, D.C. 20201
Phone: 1-800-368-1019 · TDD: 1-800-537-7697
Web: www.hhs.gov/ocr/privacy/hipaa/complaints
We will not retaliate against you for filing a complaint.
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for PHI we already have about you and any PHI we receive in the future. The current notice will always be available on our website and posted in our virtual practice.
Contact information
Privacy Officer
Valley Vista Telepsychiatry, PLLC
Email: privacy@valleyvistapsychiatry.com
Phone: Available via your patient portal or our contact form
This Notice is provided in accordance with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), the HITECH Act of 2009, and the Omnibus Final Rule of 2013.