HIPAA Notice of Privacy Practices

Our Commitment to Your Privacy

Holistic Solutions LLC 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 Privacy Practices, and to follow the terms of the notice currently in effect.

How We May Use and Disclose Your Health Information

The following describes the ways we may use and disclose your health information. Not every use or disclosure in a category will be listed, but all the ways we are permitted to use and disclose information will fall within one of the categories.

Treatment

We may use and disclose your health information to provide, coordinate, or manage your care and related services. For example, we may share information with physicians, treatment facilities, or other providers involved in your care to ensure continuity and coordination of services.

Healthcare Operations

We may use and disclose your health information for our operational purposes, including quality improvement activities, staff training, licensing, and accreditation. This information is used internally and is not shared externally for operational purposes without your authorization.

As Required by Law

We will disclose health information about you when required to do so by federal, state, or local law, including responses to court orders, subpoenas, or other legal processes.

To Avert a Serious Threat to Health or Safety

We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of another person or the public. Any disclosure would be to someone able to help prevent that threat.

Business Associates

We may share your health information with third-party vendors and business associates that perform services on our behalf, such as billing, record storage, and technology services. These business associates are required by contract and law to protect the confidentiality of your information.

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your health information not covered by this notice or by the laws that apply to us will be made only with your written authorization. This includes, but is not limited to:

• Most uses and disclosures of psychotherapy notes
• Uses and disclosures of PHI for marketing purposes
• Disclosures that constitute a sale of PHI
• Sharing your information with family members, friends, or others you designate

If you authorize us to use or disclose your health information, you may revoke that authorization in writing at any time.

Your Rights Regarding Your Health Information

You have the following rights regarding your health information we maintain:

Right to Inspect and Copy

You have the right to inspect and receive a copy of health information that we use to make decisions about your care. To request access, submit your request in writing to our office. We may charge a reasonable fee for copies.

Right to Amend

If you believe that health information we have about you is incorrect or incomplete, you may request that we correct it. Submit your request in writing, and include the reason. We may deny your request in certain circumstances.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your health information. This right applies to disclosures made for purposes other than treatment, payment, or healthcare operations, and excludes disclosures made with your authorization.

Right to Request Restrictions

You may request restrictions on how we use or disclose your health information for treatment, payment, or operations purposes. We are not required to agree to your request unless you are asking us to restrict disclosure to a health plan for a service you paid for in full out of pocket.

Right to Request Confidential Communications

You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may ask that we only contact you by email or at a specific phone number. We will accommodate all reasonable requests.

Right to a Copy of This Notice

You have the right to a paper copy of this Notice of Privacy Practices at any time, even if you agreed to receive this notice electronically.

Changes to This Notice

We reserve the right to change this notice and to make the revised notice effective for health information we already hold, as well as any information we receive in the future. We will post a current copy of the notice on our website and make copies available at our office.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized for filing a complaint.

Contact Our Privacy Officer

For questions about this notice or to exercise any of your rights, please contact us:

• Privacy Officer: Jack Foley, LMFT
• Email: info@hscasemanagement.com
• Phone: (702) 494-7641
• Address: Los Angeles, CA