Notice of Privacy Practices

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.

At Beyond TSH, we use your Protected Health Information for treatment, obtaining payment, and operational purposes, such as improving the quality of care. We are committed to maintaining your confidentiality and protecting your health information. This notice outlines how your information may be used and disclosed, as well as your rights regarding your Protected Health Information (PHI).

This Notice applies to all information and records related to your care at Beyond TSH, created or received by Bernadette Spencer, NP. It explains the possible uses and disclosures of your PHI and describes your rights and our obligations.

Our Legal Obligations:

• We are required by law to maintain the privacy of our patients’ PHI.
• We must provide you with this detailed notice of our legal duties and privacy practices.
• We are obligated to abide by the terms of this notice, which may change periodically. You will be notified of any material changes.

I. With Your Consent, We May Use and Disclose Your PHI for Treatment, Payment, and Health Care Operations

New York State Law requires us to obtain a signed Consent to use and disclose your PHI for treatment, payment, and operational purposes. Examples include:

• For Treatment: We use your information to manage your care, such as coordinating consultations between healthcare providers.
• For Payment: We use and disclose PHI to obtain payment for healthcare services provided to you. For example, your information may be included in claims to your insurance provider.
• For Health Care Operations: We use PHI to evaluate and improve our services, including staff performance assessments and educational efforts.

II. Other Specific Uses and Disclosures of Your PHI

• Business Associates: We may share your PHI with Business Associates who help us provide services. These associates are required to protect your information.
• Family and Friends: We may disclose your PHI to family members or close friends involved in your care, unless you object.
• Personal Representative: A legal guardian or authorized representative may receive PHI as if they were you.
• Public Health Activities: We may disclose PHI for public health reporting, such as disease outbreaks or other required notifications.
• Health Oversight: We may provide PHI to health oversight agencies conducting audits, inspections, or licensure activities.
• Law Enforcement: We may disclose PHI for certain law enforcement purposes or in response to a legal mandate.
• Judicial Proceedings: PHI may be disclosed in court proceedings if required by law.
• Research: We will obtain written authorization before using your PHI for research.
• To Avert Serious Threats: We may use or disclose PHI to prevent a serious threat to your health or safety, or that of others.
• Workers’ Compensation: We may use or disclose PHI to comply with workers’ compensation laws.

III. Your Authorization is Required for Other Uses of Your PHI

Beyond what is described here or required by law, your written authorization is needed to use or disclose your PHI. You may revoke your authorization at any time by submitting a written request.

• Fundraising: We may contact you for fundraising efforts, but you have the right to opt out of such communications.
• Marketing: In most cases, your written authorization is required for marketing purposes.
• Psychotherapy Notes: Your written authorization is needed to use or disclose psychotherapy notes.

IV. Your Rights Regarding Your PHI

• Right to Access: You have the right to inspect and receive a copy of your PHI, with limited exceptions. You can request records electronically and we will provide them within 30 days.
• Right to Request Restrictions: You may request restrictions on how we use or disclose your PHI for treatment, payment, or operations. While we may not be able to honor all requests, we will comply when legally required.
• Right to Confidential Communications: You may request specific communication methods (e.g., only at a private location).
• Right to Request Amendment: If you believe your PHI is inaccurate, you may request an amendment. If we deny your request, you can submit a written disagreement.
• Right to Breach Notification: We will notify you of any breach of your PHI within 60 days, as required by law.
• Right to Accounting of Disclosures: You can request an accounting of disclosures made, except for treatment, payment, or operations.

V. Complaints

If you believe your privacy rights have been violated, you may file a complaint with Beyond TSH or the Office of Civil Rights in the U.S. Department of Health and Human Services. To file a complaint with us, contact:

Bernadette Spencer, NP
Compliance Officer
Beyond TSH
4027 Sodom Road, Gainesville, NY 14066
[email protected]
716-710-2450

No one will retaliate against you for filing a complaint.

VI. Changes to This Notice

We reserve the right to change this notice at any time. The revised notice will apply to all PHI we maintain and will be provided to you upon request or posted in our office and on our website.

For questions about this notice or more information regarding your privacy rights, please contact:

Bernadette Spencer, NP
Compliance Officer
Beyond TSH
4027 Sodom Road, Gainesville, NY 14066
[email protected]
716-710-2450