SISU Integrated Health Privacy Policy – HIPAA Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU AND YOUR TREATMENT MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
SISU Integrated Health, LLC is required by law to maintain the privacy and confidentiality of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Please also respect the privacy of others you encounter in treatment.
SISU Integrated Health, LLC collects health information about you and stores it in an electronic health record. This is your medical record. The medical record is the property of SISU Integrated Health, LLC, but the information in the medical record belongs to you. The Health Insurance Portability and Accountability Act (HIPAA) requires SISU Integrated Health, LLC to maintain the privacy of your medical record.
HIPAA generally requires that any uses or disclosures of information in your medical record be limited to the minimum necessary to the purposes of the uses or disclosures. HIPAA also provides you certain rights with respect to the information in your medical record which are described below.
Information relating to your treatment at SISU Integrated Health, LLC is protected by federal regulations specific to drug and alcohol treatment, which are known as 42 CFR Part 2. These regulations protect the confidentiality of information relating to the identity, diagnosis, prognosis, or treatment of any patient in a drug or alcohol treatment program. SISU Integrated Health, LLC may not disclose records relating to your treatment without your written consent, except in narrowly limited circumstances. Under 42 CFR Part 2, the terms of a written consent to disclose information must specify the scope and types of information to be disclosed, the parties to whom the information may be disclosed, the purpose of the disclosure and the timeframe of the consent. You may revoke a consent to disclose information relating to drug and alcohol verbally or in writing at any time.
SISU Integrated Health, LLC may ask for your written consent to disclose treatment information for certain purposes, including releasing treatment information to or obtaining information from your other medical providers, obtaining payment from insurance or other payers, contacting your family either for treatment purposes or in the case of a medical or other emergency. SISU Integrated Health, LLC will not disclose your treatment information for these purposes without your consent.
SISU Integrated Health, LLC may disclose treatment information without your written consent under certain narrow circumstances as permitted by 42 CFR Part 2. For treatment purposes, SISU Integrated Health, LLC is permitted to use and disclose treatment information internally and to entities with which it shares administrative control. SISU Integrated Health, LLC is permitted to share treatment information as necessary with qualified service organizations that agree to maintain the confidentiality of the information.
SISU Integrated Health, LLC also may disclose treatment information to outside auditors, regulatory agencies, and evaluators and for certain research purposes. SISU Integrated Health, LLC may disclose treatment information without your written consent when necessary in a life-threatening medical emergency and may disclose to report a crime on the premises or against SISU Integrated Health, LLC personnel. SISU Integrated Health, LLC also may disclose patient information without consent where the state mandates child abuse and neglect reporting; when cause of death is being reported; or when required by a valid court order that contains specific required findings. SISU Integrated Health, LLC may contact you to share information about SISU Integrated Health, LLC treatment services or to send you reminder notices of future appointments for your treatment.
I. Your Health Information Rights
In addition to protecting privacy and confidentiality, HIPAA and 42 CFR Part 2 afford you the following rights with respect to your medical record and drug or alcohol treatment information:
You have the right to a paper copy of this written notice of SISU Integrated Health, LLC’s privacy practices.
You have a right to request a copy of your treatment record or to receive your health information through a reasonable alternative means or at an alternative location. SISU Integrated Health, LLC requires that all such requests be put in writing. A reasonable fee will be charged for copying your health information.
You have a right to request that SISU Integrated Health, LLC amend health information that is incorrect or incomplete. If SISU Integrated Health, LLC determines not to amend the health information, it will provide you with an explanation of the reason for the denial and your rights to disagree with the denial.
You have a right to request restrictions on otherwise permitted uses and disclosures of your health information. SISU Integrated Health, LLC is not obligated to comply with such requests.
You may request that SISU Integrated Health, LLC provide you with a written accounting of all disclosures made by SISU Integrated Health, LLC during a specific time period (not to exceed 6 years). SISU Integrated Health, LLC asks that such requests be made in writing on a form provided by our facility. Please note that an accounting will not apply to any of the following types of disclosures: disclosures made with your written consent for reasons of treatment, payment or health care operations; disclosures made to you or your legal representative, or any other individual involved with your care. You will not be charged for your first accounting request in any 12-month period. However, for any requests that you make thereafter, you will be charged a reasonable, cost-based fee.
II. Changes to this Notice of Privacy Practices
SISU Integrated Health, LLC reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until amendment is made, SISU Integrated Health, LLC is required by law to comply with this Notice. Should our privacy practices change, we will provide all current and future patients with a copy of the revised Notice of Privacy Practices.
Effective April 13, 2024
III. Complaints Regarding Privacy Practices
Complaints about this Notice of Privacy Practices or how SISU Integrated Health, LLC handles your health information should be directed to:
SISU Integrated Health, LLC
228 Saugatuck Ave Unit 2 East
Westport, CT 06880
Phone: (203) 349-5597
Email: rfsilva@sisuintegratedhealth.com
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to one of the following:
Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, SW Room 509F, HHH Building
Washington, DC 20201
You may also address your complaint to one of the regional U.S Department of Health and Human Services Offices for Civil Rights.
Web Privacy Policy
At SISU Integrated Health LLC, we are committed to protecting the privacy and confidentiality of our website visitors and clients. This Privacy Policy outlines how we collect, use, disclose, and safeguard your information when you visit our website or use our services. By accessing or using our website, you consent to the terms of this Privacy Policy.
1. Information We Collect
a. Personal Information: We may collect personal information, such as your name, email address, phone number, and other contact details when you voluntarily provide it to us through our website forms, contact requests, or other interactions.
b. Health Information: If you are a client seeking our services, we may collect health information necessary for treatment, payment, or healthcare operations, as permitted by HIPAA.
c. Website Usage Information: We may automatically collect certain information about your visit to our website, including your IP address, browser type, referring/exit pages, and operating system.
2. Use of Information
a. We use the collected information to provide and improve our services, respond to your inquiries, and communicate with you about our offerings.
b. We may use your health information for treatment, payment, and healthcare operations purposes, as defined by HIPAA, and as necessary to provide you with the requested services.
c. We may use website usage information to analyze trends, administer the site, track users’ movements, and gather broad demographic information for aggregate use.
3. Disclosure of Information
a. We do not sell, trade, or otherwise transfer your personal information to outside parties without your consent, except as described in this Privacy Policy.
b. We may disclose your health information to our business associates who perform functions on our behalf and have agreed to protect the confidentiality of your health information in accordance with HIPAA.
c. We may disclose your information when required by law, such as in response to a subpoena, court order, or government request.
4. Data Security
a. We implement appropriate technical and organizational measures to protect your information from unauthorized access, disclosure, alteration, or destruction.
b. We maintain physical, electronic, and procedural safeguards to protect your health information in compliance with HIPAA.
c. However, please note that no method of transmission over the internet or electronic storage is 100% secure, and we cannot guarantee absolute security.
5. Third-Party Websites
Our website may contain links to third-party websites. We are not responsible for the privacy practices or content of those websites. We encourage you to review the privacy policies of those websites before providing any personal information.
6. Changes to This Privacy Policy
We reserve the right to update or change this Privacy Policy at any time. The most current version of the Privacy Policy will be posted on our website, and the revised date will be indicated at the bottom of this page.
7. Contact Us
If you have any questions or concerns about this Privacy Policy or our privacy practices, please contact us at rfsilva.
This Privacy Policy is effective as of 04/13/2024.