HIPAA Notice Of Privacy Practices

Bethesda Mental Health

Effective Date: 01/01/2025

Practice Address:
4101 McEwen Rd
Suite 410
Dallas, TX 75244
United States

This Notice describes how medical and mental health information about you may be used and disclosed and how you can access this information. Please review it carefully.

1. Our Legal Duty Under HIPAA

Bethesda Mental Health is required by law to:

• Maintain the privacy and security of your Protected Health Information (PHI)

• Provide you with this Notice explaining our legal duties and privacy practices

• Follow the terms of this Notice currently in effect

• Notify you promptly in the event of a breach involving your unsecured PHI

Protected Health Information includes any information that identifies you and relates to your mental health condition, treatment, or payment for services.

2. How We May Use and Disclose Your PHI (Without Authorization)

A. Treatment

We may use and share your PHI to provide, coordinate, or manage your mental health care.

Examples:

• Psychiatric evaluations and diagnoses

• Medication management and prescriptions

• Psychotherapy and treatment planning

• Coordination with other healthcare providers involved in your care

B. Payment

We may use and disclose your PHI to bill and receive payment for services provided.

Examples:

• Insurance claims and benefit verification

• Billing statements and collections

• Determining eligibility for coverage

C. Healthcare Operations

We may use your PHI for practice operations to ensure quality care and compliance.

Examples:

• Quality improvement and audits

• Staff training and supervision

• Licensing and accreditation activities

• Legal and regulatory compliance

3. Uses and Disclosures Requiring Your Written Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes such as:

• Sharing information with family members or third parties not involved in your care

• Release of psychotherapy notes (with limited exceptions)

• Marketing or promotional activities

• Any purpose not described in this Notice

You may revoke your authorization at any time in writing, except where we have already relied on it.

4. Special Protection for Psychotherapy Notes

Psychotherapy notes are afforded additional protections under HIPAA.

• They are kept separate from your medical record

• They are not shared without your explicit written authorization, except as required by law

• They are not used for billing or insurance purposes

5. Disclosures Required or Permitted by Law

We may disclose PHI without your authorization in the following circumstances:

A. As Required by Law

Including compliance with federal, state, or local laws, court orders, subpoenas, or legal processes.

B. Public Health and Safety

• Preventing or reducing a serious and imminent threat to your health or safety or that of others

• Reporting suspected abuse, neglect, or domestic violence

• Reporting communicable diseases or adverse medication reactions

C. Health Oversight Activities

For audits, investigations, inspections, and licensure reviews by authorized government agencies.

D. Law Enforcement

Limited disclosures as permitted by law for law enforcement purposes.

6. Your Rights Under HIPAA

You have the right to:

A. Access Your Records

Request to inspect or obtain copies of your medical and billing records.

B. Request Amendments

Ask us to correct or amend information you believe is inaccurate or incomplete.

C. Request Restrictions

Ask us to limit how your PHI is used or disclosed (we are not required to agree in all cases).

D. Confidential Communications

Request communication through alternative means or locations (e.g., phone instead of mail).

E. Accounting of Disclosures

Receive a list of certain disclosures we have made of your PHI.

F. Obtain a Paper Copy

Request a paper copy of this Notice at any time.

7. Data Security Safeguards

Bethesda Mental Health uses administrative, technical, and physical safeguards to protect your PHI, including:

• Secure electronic health record systems

• Password protection and access controls

• Staff HIPAA training and confidentiality agreements

• Secure storage and disposal of paper and electronic records

8. Breach Notification

In the event of a breach involving unsecured PHI, we will:

• Notify affected individuals without unreasonable delay

• Provide details of the breach and mitigation steps

• Comply with all HIPAA Breach Notification Rule requirements

9. Changes to This Notice

We reserve the right to revise this Notice at any time. Changes will apply to all PHI we maintain and will be posted on our website and available upon request.

10. Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Bethesda Mental Health
Privacy Officer
4101 McEwen Rd, Suite 410
Dallas, TX 75244

Or with the U.S. Department of Health and Human Services (HHS). You will not be retaliated against for filing a complaint.

11. Contact Information

For questions about this Notice or your privacy rights, contact:

Bethesda Mental Health
Phone: (817) 753-3216 / (817) 350-4377
Email: hello@bethesdamh.com