Notice of Privacy Practices

Effective Date: March 14, 2025

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.

Manhattan Integrative Psychiatry is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of Protected Health Information ("PHI"), to provide you with this Notice of our legal duties and privacy practices with respect to PHI, and to notify affected individuals following a breach of unsecured PHI. This Notice describes how we may use and disclose your PHI to carry out treatment, payment, or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI.

A. Required Uses and Disclosures:

Under the law, we must make disclosures of your PHI to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with HIPAA.

B. Permitted Uses and Disclosures (Without Your Authorization):

We may use and disclose your PHI without your written authorization for the following purposes:

  • Treatment: We may use and disclose your PHI to provide you with medical treatment or services. For example, we may disclose your PHI to doctors, nurses, technicians, or other personnel involved in your care. We may also share your PHI with other healthcare providers to coordinate your care, such as specialists or therapists.

  • Payment: We may use and disclose your PHI to obtain payment for the services we provide. For example, we may disclose your PHI to your insurance company to obtain prior authorization for treatment or to bill for services rendered.

  • Healthcare Operations: We may use and disclose your PHI for our healthcare operations. These uses and disclosures are necessary to run our practice and make sure that all of our patients receive quality care. For example, we may use your PHI to review our treatment and services and to evaluate the performance of our staff.

  • Appointment Reminders: We may use and disclose your PHI to contact you as a reminder that you have an appointment for treatment or medical care.

  • Treatment Alternatives: We may use and disclose your PHI to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

  • Health-Related Benefits and Services: We may use and disclose your PHI to tell you about health-related benefits or services that may be of interest to you.

  • As Required By Law: We will disclose your PHI when required to do so by federal, state, or local law.

  • Public Health Activities: We may disclose your PHI for public health activities. These activities generally include the following: to prevent or control disease, injury, or disability; to report births and deaths; to report child abuse or neglect; to report reactions to medications or problems with products; to notify people of recalls of products they may be using; to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

  • Health Oversight Activities: We may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

  • Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

  • Law Enforcement: We may release PHI if asked to do so by a law enforcement official: in response to a court order, subpoena, warrant, summons, or similar process; to identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at our facility; and in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.

  • Coroners, Medical Examiners, and Funeral Directors: We may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release PHI to funeral directors as necessary to carry out their duties.

  • National Security and Intelligence Activities: We may release your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

  • Protective Services for the President and Others: We may disclose your PHI to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state or conduct special investigations.

  • Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your PHI to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

  • To Avert a Serious Threat to Health or Safety: We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

C. Uses and Disclosures Requiring Your Written Authorization:

Other uses and disclosures of your PHI that are not described in this Notice will be made only with your written authorization. You may revoke your authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your PHI for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

  • Marketing: We must obtain your written authorization to use or disclose your PHI for marketing purposes, except for face-to-face communications made by us to you and for promotional gifts of nominal value provided by us.

  • Sale of PHI: We must obtain your written authorization for any disclosure of your PHI that constitutes a sale of PHI. We will not sell your PHI without your authorization.

Your Rights Regarding Your PHI:

  • Right to Inspect and Copy: You have the right to inspect and copy your PHI that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. To inspect and copy your PHI, you must submit your request in writing to [Your Contact Information]. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

  • Right to Amend: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to Support@mipnyc.com. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: was not created by us, unless the person or entity that created the information is no longer available to make the amendment; is not part of the PHI kept by or for our practice; is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.

  • Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of your PHI, other than for treatment, payment, healthcare operations, and certain other disclosures (such as any you asked us to make). To request this list or accounting of disclosures, you must submit your request in writing to [Your Contact Information]. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

  • Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request, except in the case where the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment), and the PHI pertains solely to a health care item or service for which you, or a person on your behalf (other than the health plan), has paid us in full. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

  • Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to Support@mipnyc.com. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

  • Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Complaints:

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact us. All complaints must be submitted in writing. You will not be retaliated against for filing a complaint.

Contact Information:
Email: support@mipnyc.com
Phone: (212) 722-2232