Notice of HIPAA Privacy Practices

Effective Date: July 1, 2024

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 AND REPORT ANY ISSUES, OR CONCERNS, TO: Receptive, Inc. (“ADHD Advisor”) 2810 N. Church Street PMB79505, Wilmington, DE, 19802.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal law requiring that all medical records and other individually identifiable health information used, or disclosed, by us in any form, including whether electronically, via video or teleconference, or orally, are kept properly confidential. HIPAA gives you, the Patient, the right to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse protected health information.
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We have prepared this “Notice of HIPAA Privacy Practices” (Notice) to explain how we maintain the privacy of your health information and how we may use and disclose your health information. We are a Business Associate under HIPAA, and not required by law to maintain or provide this Notice. Nonetheless, we strive to foster confidence between you and us with respect to your protected health information and maintain this Notice as a courtesy to provide information on how we may use your protected health information. We also work closely with your clinicians and practitioners who furnish clinical care to collaboratively and properly maintain your protected health information. We will notify you if we experience a breach of your unsecured protected health information. We will follow the terms of this Notice, and we may amend the Notice if we change any of our privacy policies or practices. We can change the terms of this Notice, and the changes will apply to all information we have about you. The new notice will be available on our website and in the patient portal.

As a business associate to our [independently contracted network of therapists and clinicians (“Clinicians”)], we may use and disclose your medical records for each of the following purposes: treatment, payment, and health care operations:

TREATMENT means providing, coordinating, or managing health care and related services by one or more health care providers, including the Clinicians.

PAYMENT means activities such as obtaining payment or reimbursement for services, billing or collection activities, and utilization review.

HEALTH CARE OPERATIONS include managing your patient portal to facilitate therapeutic consultations with associated Clinicians, as well as conducting quality assessment review and service improvement planning activities, auditing functions, and customer service.

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes, including:

  • Help with public health and safety issues:
  • We can share health information about you for certain situations, such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety
  • Comply with the law:
  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
  • With your Authorization:
  • We will share information about you with those designated by you with your express written authorization. These uses include the use of your psychotherapy notes for treatment, training, or defense in a legal action or proceeding brought by you; Marketing; or the sale of your information.

[Further, we may create and distribute de-identified health information by removing all references to individually identifiable information.]

We may contact you to provide information about our services or other health-related services that may be of interest to you.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You may exercise the following options with respect to your protected health information, by presenting a written request to your Clinician.

You have the right to request from the Clinician restrictions on the ways we use and disclose your health information for treatment, payment, and healthcare operations. You may also request that we limit our disclosures to persons assisting your care. We will consider your request, but are not required to accept it.

You have the right to request from the Clinician that you receive communications containing your protected health information from us by alternative means or at alternative locations. For example, you may ask that we only contact you at home or by mail.

Except under certain circumstances, you may inspect and copy medical, billing, and other records used to make decisions about you. If you ask for copies of this information, we may charge you a nominal fee for copying, packaging, and postage.

If you believe that information in your records is incorrect or incomplete, you have the right to ask your Clinician to correct the existing information or add missing information. Under certain circumstances, we may deny your request, such as when the information is accurate and complete.

You have the right to request from your Clinician a list of certain instances when we have used or disclosed your medical information. If you ask for this information from us more than once every twelve months, charges may apply to cover our costs for administration, archive retrieval, copying, packaging, and postage. Upon request, you have a right to receive a paper copy of this notice. 

You can complain if you feel we have violated your rights by contacting us at (760) 284-5368. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/ privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

This Notice is effective [July 1, 2024]

Receptive Inc. d.b.a ADHDAdvisor.org
(760) 284-5368
legal.privacy@receptive.health