Notice of Privacy Practices for Emerald Psych, LLC

At Emerald Psych, LLC ("we," "our," or "the practice"), we are committed to protecting the privacy and confidentiality of your Protected Health Information (PHI). PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services. This Notice of Privacy Practices describes our legal duties and privacy practices and your rights concerning your PHI, as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Who Will Follow This Notice?

This notice describes the privacy practices of Emerald Psych, LLC and its practitioner, Helder Mendes, PMHNP-BC. Furthermore, Emerald Psych, LLC provides clinical services through third-party platforms, such as Grow Therapy and Headway. In order to provide you with treatment, process payment, and conduct health care operations, we operate as an "organized health care arrangement" with these platforms. This means that Emerald Psych, LLC and our platform partners may share your PHI with each other for these purposes as permitted by HIPAA. All parties within this arrangement agree to abide by the terms of this notice.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information.
• Provide you with this notice of our legal duties and privacy practices with respect to your PHI.
• Abide by the terms of the notice currently in effect.
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We will also comply with any applicable New Jersey laws that provide more stringent protection for your health information.

How We May Use and Disclose Your Protected Health Information (PHI)

The following categories describe different ways that we use and disclose PHI.

1. For Treatment, Payment, and Health Care Operations

We may use and disclose your PHI for treatment, payment, and health care operations without your written authorization.

• For Treatment: We may use your PHI to provide, coordinate, and manage your health care. For example, we may use your PHI to prescribe medication, provide psychotherapy, and coordinate with other health care providers involved in your care.
• For Payment: We may use and disclose your PHI to obtain payment for the services we provide. For example, we may disclose your PHI to your health insurance plan to determine eligibility or coverage and to receive payment for your treatment.
• For Health Care Operations: We may use and disclose your PHI for our business operations. For example, we may use your PHI for quality assessment, compliance reviews, training, and business management.

2. Other Uses and Disclosures Permitted or Required by Law

We may also use or disclose your PHI without your authorization for purposes like public health activities, responding to lawsuits, law enforcement requests, and workers' compensation claims. This also includes sharing information with our contracted Business Associates (like Grow Therapy and Headway), who are legally required to protect your information.

3. Uses and Disclosures Requiring Your Written Authorization

All other uses and disclosures, including for most psychotherapy notes, marketing, or the sale of PHI, will be made only with your written authorization. You can revoke this authorization in writing at any time.

Your Rights Regarding Your PHI

You have the following rights regarding the PHI we maintain about you:

• Right to Inspect and Copy: You can ask to see or get a copy of your health and billing records.
• Right to Amend: You can ask us to correct health information about you that you think is incorrect or incomplete.
• Right to an Accounting of Disclosures: You can ask for a list of the times we've shared your health information for six years prior to your request.
• Right to Request Restrictions: You can ask us not to use or share certain health information for treatment, payment, or our operations.
• Right to Request Confidential Communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• Right to a Paper Copy of This Notice: You can ask for a paper copy of this notice at any time.

Changes to This Notice

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 at https://www.emeraldpsych.net.

Complaints

If you believe your privacy rights have been violated, you can file a complaint with our Privacy Officer or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

• To file a complaint with Emerald Psych, LLC, please contact:
  Helder Mendes, PMHNP-BC, Privacy Officer
  Email: hmendes@emeraldpsych.net
• To file a complaint with the U.S. Department of Health and Human Services:
  Visit: https://www.hhs.gov/hipaa/filing-a-complaint/index.html