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.
This Notice of Privacy Practices describes how Zellig Psychiatry PC may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, and health care operations, and for other purposes permitted or required by law. We are required by law to maintain the privacy and security of your PHI, provide you with this Notice, notify you following a breach of unsecured PHI, and follow the terms of the Notice currently in effect.
The following categories describe the ways we may use and disclose your PHI without your written authorization.
Treatment
We use and disclose your PHI to provide, coordinate, or manage your psychiatric care. For example, we may share your medication list and treatment plan with your primary care physician, with a therapist providing concurrent psychotherapy, or with a laboratory performing testing we have ordered.
Payment
We use and disclose your PHI to obtain payment for the services we provide. For example, we may submit claims to your health insurance company, verify your eligibility and coverage, obtain prior authorization for medications, or follow up on unpaid balances.
Health Care Operations
We use and disclose your PHI to support the business activities of our practice. For example, we may use your PHI to evaluate the quality of care you received, train clinical and administrative staff, conduct internal audits, manage credentialing, or evaluate the performance of our clinicians.
Business Associates
We may share your PHI with third parties that perform services on our behalf — such as our electronic health record vendor, billing service, secure messaging platform, AI-assisted documentation tool, and similar vendors. Each business associate is contractually required to safeguard your PHI and use it only for the purposes we authorize.
Individuals Involved in Your Care
With your verbal agreement, or when you are present and do not object, we may share PHI relevant to your care with family members, friends, or others you have identified as involved in your treatment. In limited circumstances where you are not present or are unable to agree, we may use our professional judgment to share information directly relevant to the person’s involvement in your care.
Appointment Reminders and Health-Related Communications
We may contact you to remind you of appointments, to deliver test results, to communicate about prescriptions, or to provide information about treatment options. These communications may occur by phone, voicemail, text, email, or patient portal, consistent with the communication preferences you have provided to us.
Required by Law
We will disclose your PHI when required to do so by federal, state, or local law.
Public Health Activities
We may disclose PHI for public health activities, including reporting communicable diseases, reporting adverse reactions to medications, and reporting suspected abuse, neglect, or domestic violence as required or permitted by law.
Health Oversight Activities
We may disclose PHI to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, licensure actions, and other oversight activities necessary to monitor the health care system.
Judicial and Administrative Proceedings
We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process, subject to the heightened protections that apply to mental health and substance use disorder records under federal and Pennsylvania law.
Serious Threat to Health or Safety
We may disclose PHI when necessary to prevent a serious and imminent threat to the health or safety of you or others, consistent with Pennsylvania law governing duty to warn and duty to protect.
Mandated Reporting
Our clinicians are mandated reporters under Pennsylvania’s Child Protective Services Law and the Older Adults Protective Services Act. We will report suspected abuse or neglect of a child, older adult, or dependent adult as required by law.
Workers’ Compensation / Coroners / Specialized Government Functions
We may disclose PHI as authorized by workers’ compensation laws, to coroners, medical examiners, and funeral directors as necessary to carry out their duties, and for specialized government functions including military and veterans’ activities and national security activities.
The following uses and disclosures require your specific written authorization, which you may revoke in writing at any time:
To exercise any of these rights, please contact our Privacy Officer using the information at the end of this Notice.
You have the right to inspect and obtain a copy of the PHI we maintain about you, with limited exceptions. Pennsylvania law permits reasonable fees for copies of medical records. Requests must be made in writing.
If you believe information in your record is incorrect or incomplete, you have the right to request that we amend it. Requests must be made in writing and include the reason for the request.
You have the right to request an accounting of certain disclosures of your PHI. This does not include disclosures for treatment, payment, or health care operations.
You have the right to request restrictions on certain uses or disclosures of your PHI. We are required to agree to restrict disclosure to a health plan if you paid in full out of pocket.
You have the right to request that we communicate with you in a specific way or at a specific location. We will accommodate reasonable requests.
You have the right to be notified following a breach of your unsecured PHI, consistent with federal law.
You have the right to obtain a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
We may contact you using the phone numbers, email addresses, and other contact information you have provided to us, for purposes including appointment reminders, billing, care coordination, and other treatment-related matters. Standard messages may include limited identifying information but will not include detailed clinical content unless you have specifically requested otherwise.
If your contact information changes, or if you wish to change how we communicate with you, please notify us promptly.
Pennsylvania law, including Act 65 of 2020 (35 P.S. §§ 10101.1–10101.2), establishes specific rules governing consent to mental health treatment and access to mental health records for patients under age 18. Additional terms apply to minor patients and are described in the Minor Patient Addendum to our Consent to Treatment and Practice Policies.
We reserve the right to change this Notice at any time. Any revised Notice will apply to all PHI we maintain, including PHI created or received before the revision date. The current version of this Notice will be posted in our offices and on our website, and copies will be available on request.
If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the Office for Civil Rights of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
Office for Civil Rights — U.S. Department of Health and Human Services
200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
Privacy Officer: Riley Guinan, PA-C
Email: riley.g@zelligcare.com
Phone: (215) 318-1821
Zellig Psychiatry PC, 172 Stetson Drive, Chalfont, PA 18914
