HIPAA Notice of Privacy Practices

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Our Commitment to Your Privacy

Life Changing Wellness and Treatment Center is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your "Protected Health Information" (PHI), to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your behavioral health care and related services. For example, your therapist may share information with your case manager to coordinate your individualized service plan (ISP).

Payment

We may use and disclose your PHI to bill and collect payment for services rendered. For example, we may submit claims to AHCCCS or other insurers that contain information about your diagnosis and services received.

Healthcare Operations

We may use your PHI for operational purposes such as quality assessment, chart audits, staff training, compliance reviews, and accreditation activities as permitted under A.A.C. R9-10.

Required by Law

We will disclose your PHI when required to do so by federal or Arizona state law, including mandatory reporting obligations under A.R.S. Title 36.

Public Health and Safety

We may disclose PHI to prevent a serious threat to your health or safety or the health or safety of another person or the public, consistent with applicable law.

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your PHI not described above will be made only with your written authorization, including:

• Most disclosures of psychotherapy notes
• Marketing communications
• Sale of your health information
• Substance use disorder records protected under 42 C.F.R. Part 2

You have the right to revoke any authorization at any time in writing.

Your Rights Regarding Your Health Information

• Right to Inspect and Copy: You may request access to your medical and billing records.
• Right to Amend: You may request corrections to your health information.
• Right to an Accounting of Disclosures: You may request a list of disclosures we have made.
• Right to Request Restrictions: You may request restrictions on certain uses of your PHI.
• Right to Confidential Communications: You may request we communicate with you in a specific way or at a specific location.
• Right to a Copy of This Notice: You may request a paper copy of this Notice at any time.
• Right to Breach Notification: You will be notified if your PHI is breached in a manner that compromises its security.

How to Exercise Your Rights

To exercise any of the rights listed above, please submit a written request to our Privacy Officer at the address below. We will respond within 30 days as required by law.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

HHS OCR Complaint Portal: ocrportal.hhs.gov

Changes to This Notice

We reserve the right to change this Notice. We will post the revised Notice in our facility and on our website. The new Notice will apply to all PHI we maintain.

Contact Our Privacy Officer