Notice of Privacy Practices.

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.

Mindful Wellness (MMJ Mindful Wellness, LLC) is an outpatient psychiatric clinic that primarily provides services through telehealth. References to “we,” “our,” or “the practice” in this notice mean Mindful Wellness and the healthcare professionals, employees, contractors, and business associates who support your care.

Your Rights

You have the right to:

• Obtain an electronic or paper copy of your health record.
• Ask us to correct information you believe is incorrect or incomplete.
• Request that we communicate with you in a specific way or at a specific location.
• Ask us to limit how we use or disclose your information.
• Obtain a list of certain disclosures of your information.
• Receive a paper or electronic copy of this notice.
• Choose an authorized person to act on your behalf.
• File a complaint if you believe your privacy rights have been violated.

Accessing your health record

You may ask to review or receive an electronic or paper copy of your medical and mental health records and other protected health information maintained by our practice.

We will generally provide the requested information within 30 days. We may charge a reasonable, cost-based fee when permitted by law. Certain information, including psychotherapy notes maintained separately from the medical record, may be subject to additional limitations.

Requesting a correction

You may ask us to correct health information that you believe is inaccurate or incomplete. We may deny the request in certain circumstances, but we will explain the reason for the denial in writing, generally within 60 days.

Requesting confidential communication

You may ask us to contact you through a particular method or at a particular location. For example, you may request that we contact you only through your cell phone, patient portal, email, or a specific mailing address.

We will accommodate reasonable requests. Please understand that ordinary email and text messaging may carry privacy risks unless a secure communication method is used.

Asking us to limit what we use or disclose

You may ask us not to use or disclose certain information for treatment, payment, or healthcare operations. We are not always required to agree, particularly when the restriction could interfere with your care or when disclosure is required by law.

If you pay for a service entirely out of pocket, you may ask us not to disclose information about that service to your health plan for payment or healthcare operations. We will honor the request unless disclosure is required by law.

If we agree to a restriction, we may still disclose the information when necessary to provide emergency treatment.

Receiving an accounting of disclosures

You may request a list of certain disclosures of your protected health information made during the six years before your request. The list will identify who received the information and why it was disclosed.

The list will not include disclosures made for treatment, payment, or healthcare operations or certain disclosures you authorized or requested. We will provide one accounting in a 12-month period at no charge. A reasonable, cost-based fee may apply to additional requests during the same period.

Receiving a copy of this notice

You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically. An electronic version may also be available through our website or patient portal.

Choosing someone to act for you

If you have authorized another person to act on your behalf, such as a healthcare surrogate, legal guardian, or person holding a valid medical power of attorney, that person may exercise your privacy rights when permitted by law.

We will verify the person’s legal authority before allowing access to your information or taking action on your behalf.

Filing a privacy complaint

If you believe your privacy rights have been violated, you may contact the practice’s privacy contact listed at the beginning of this notice.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:

• Visiting the HHS complaint portal
• Calling 1-877-696-6775
• Writing to: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201

The practice will not retaliate against you or deny treatment because you filed a complaint.

Your Choices

In certain situations, you may tell us how you want your information shared.

You may tell us whether we may:

• Share relevant information with family members, close friends, caregivers, or others involved in your care or payment for your care.
• Communicate with an emergency contact.
• Share information to assist with disaster-relief efforts.

If you cannot communicate your preference, such as during a medical emergency, we may share information when we reasonably believe it is in your best interest. We may also disclose information when necessary to prevent or reduce a serious and imminent threat to your health or safety or the health or safety of another person.

We generally require your written authorization before:

• Using your information for marketing purposes.
• Selling your protected health information.
• Disclosing most psychotherapy notes maintained separately from your medical record.
• Using or disclosing information for purposes not otherwise permitted by law or described in this notice.

The practice does not maintain a hospital directory. We do not sell patient information.

If you provide written authorization, you may revoke it at any time by notifying us in writing. Revocation will not affect information already used or disclosed in reliance on your authorization.

How We May Use and Disclose Your Information

Providing psychiatric treatment

We may use and share your health information to evaluate, diagnose, coordinate, and provide psychiatric care.

Examples include:

• Conducting psychiatric evaluations and medication-management visits.
• Providing care through secure video conferencing or other approved telehealth technology.
• Electronically prescribing medications.
• Reviewing laboratory results and treatment history.
• Coordinating care with your primary care provider, therapist, specialist, pharmacy, hospital, or another treating professional.
• Making referrals for psychotherapy, laboratory testing, TMS, or other services.
• Obtaining information from or reporting information to a prescription drug monitoring program when permitted or required by law.

Operating our practice

We may use and disclose your information to operate the practice, improve the quality of care, and perform administrative functions.

Examples include:

• Scheduling and confirming appointments.
• Sending patient-portal invitations and treatment reminders.
• Contacting you about forms, prescriptions, referrals, or follow-up care.
• Reviewing records for quality assurance and compliance.
• Training staff and healthcare professionals.
• Maintaining and securing our electronic health record.
• Working with technology, billing, legal, accounting, and administrative service providers that are required to protect your information.

Because our services are primarily provided through telehealth, information may be transmitted through approved video, electronic health record, patient-portal, electronic-prescribing, telephone, or other communication systems.

Billing and payment

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

Examples include:

• Verifying insurance eligibility and benefits.
• Obtaining authorization for treatment.
• Submitting claims to your health plan.
• Responding to requests for information related to a claim.
• Determining deductibles, copayments, coinsurance, or other patient responsibility.
• Working with billing companies, clearinghouses, collection services, and other payment-related business associates.

Appointment and treatment communications

We may contact you regarding:

• Upcoming or missed appointments.
• Patient forms or portal access.
• Medication availability and refill requests.
• Laboratory testing.
• Treatment recommendations.
• Referrals and follow-up care.
• Billing balances, copayments, or insurance matters.

Unless you request otherwise, we may leave a limited voicemail or send a brief message asking you to contact the practice. We will limit the health information included in unencrypted email or ordinary text messages whenever reasonably possible.

Public health and safety

We may disclose health information when permitted or required for public-health or safety purposes, including:

• Preventing or controlling disease.
• Reporting adverse medication reactions or product-safety concerns.
• Reporting suspected abuse, neglect, exploitation, or domestic violence.
• Preventing or reducing a serious and imminent threat to a person or the public.
• Complying with public-health reporting requirements.

Health oversight and compliance

We may disclose information to authorized health-oversight agencies for activities such as audits, inspections, licensing, credentialing, investigations, and compliance reviews.

Research

We may use or disclose health information for approved research when required safeguards have been satisfied. When written authorization is required, we will obtain it before using or disclosing your identifiable information.

Compliance with the law

We may use or disclose your health information when state or federal law requires or permits us to do so. This may include responding to the U.S. Department of Health and Human Services when it reviews our compliance with federal privacy requirements.

Workers’ compensation

We may disclose information as permitted or required for workers’ compensation claims or similar programs.

Law-enforcement and government requests

We may disclose information:

• For certain authorized law-enforcement purposes.
• To health-oversight agencies.
• For military, national-security, intelligence, or protective-service functions when authorized by law.
• To correctional institutions or law-enforcement officials responsible for an individual in custody when legally permitted.

Mental health information will receive any additional protection required under applicable federal or state law.

Judicial and administrative proceedings

We may disclose health information in response to a valid court or administrative order. We may also respond to a subpoena, discovery request, or other lawful process when applicable legal requirements and privacy protections have been satisfied.

Medical examiners and funeral directors

We may disclose relevant information to a coroner, medical examiner, or funeral director when authorized by law.

Organ and tissue donation

When applicable, we may disclose health information to organizations involved in organ, eye, or tissue donation and transplantation.

Mental Health and Psychotherapy Information

Mental health records may receive protections beyond those that apply to general medical information. The practice will comply with applicable federal and state laws governing the confidentiality of psychiatric treatment records.

Psychotherapy notes are notes recorded by a mental health professional documenting or analyzing the content of a private counseling session and maintained separately from the medical record. Most uses and disclosures of psychotherapy notes require your written authorization, except when disclosure is otherwise permitted or required by law.

The general medical record may still contain information regarding your diagnosis, medications, symptoms, treatment plan, progress, appointment times, and other information necessary for treatment, payment, and healthcare operations.

Substance Use Disorder Records

If the practice creates, maintains, or receives substance use disorder treatment records that are protected by 42 C.F.R. Part 2, those records may receive additional confidentiality protections.

Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order and subpoena, as required by law.

The specific protections that apply depend on whether the practice or the particular records are subject to 42 C.F.R. Part 2.

Telehealth Privacy

The practice uses telehealth technology to provide outpatient psychiatric services. We take reasonable administrative, technical, and physical measures to protect information created or exchanged during telehealth care.

To help protect your privacy during a video visit, we recommend that you:

• Join the session from a private location whenever possible.
• Use a secure internet connection.
• Avoid public Wi-Fi when possible.
• Use headphones if other people are nearby.
• Tell the provider if another person is present.
• Secure your telephone, computer, email, and patient-portal passwords.

Although we take reasonable safeguards, no electronic communication system can be guaranteed to be completely secure.

Our Responsibilities

The practice is required to:

• Maintain the privacy and security of your protected health information.
• Provide you with this notice describing our legal duties and privacy practices.
• Follow the privacy practices described in the notice currently in effect.
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• Limit uses and disclosures to the minimum necessary when that standard applies.
• Obtain your written authorization before using or disclosing information for purposes not permitted by law or described in this notice.

We may use electronic vendors and other business associates to support telehealth, electronic health records, scheduling, billing, prescriptions, laboratory services, and patient communications. These organizations are required by contract and applicable law to safeguard protected health information.

Changes to This Notice

The practice may change the terms of this notice. Any revised notice may apply to information we already maintain as well as information received in the future.

The current notice will be available upon request and, when applicable, through our website or patient portal. The effective date will appear at the beginning of the notice.

Questions or Requests

For questions about this notice or to exercise your privacy rights, contact:

Privacy Officer
Telephone: (786) 463-0217
Email: hello@mindfulwellnessconsults.com