NOTICE OF PRIVACY PRACTICES

Happy Healthy New York
311 Saint Nicholas Ave, Suite E1
Ridgewood, NY 11385
Phone: 833-427-7969

Effective Date: September 04, 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.

Our Commitment to Your Privacy

Happy Healthy New York Family Health NP PLLC (“HHNY,” “we,” “us,” or “our”) is committed to protecting the privacy of your health information. We are required by law to:

Maintain the privacy and security of your protected health information (“PHI”).
Give you this Notice explaining our legal duties and privacy practices regarding your PHI.
Notify you if a breach occurs that may have compromised the privacy or security of your PHI.
Follow the terms of this Notice currently in effect.

PHI includes information that identifies you and relates to your physical health, mental health, substance use treatment, health care services, or payment for health care services.

How We May Use and Disclose Your Health Information

We may use or disclose your PHI without your written authorization for the following purposes:

Treatment

We may use or share your PHI to provide, coordinate, or manage your care. For example, we may:

Discuss your health information with other clinicians involved in your care.
Send prescriptions to your pharmacy.
Order laboratory tests, review results, or coordinate referrals.
Communicate with hospitals, specialists, therapists, pharmacies, laboratories, or other health care professionals involved in your treatment.

Payment

We may use or disclose your PHI to bill and receive payment for services. For example, we may provide information to your health insurer to verify coverage, obtain authorization, submit claims, or address claim questions.

Health Care Operations

We may use or disclose your PHI to operate and improve our practice. For example, we may use information for quality improvement, training, auditing, compliance, credentialing, practice management, and business planning.

Our quality improvement practices may include conducting and publishing academic research. Your personal health information will be protected and anonymized in these instances.

Appointment Reminders and Health-Related Services

We may contact you to remind you about appointments, follow-up care, treatment options, health-related services, or benefits that may be relevant to your care.

Persons Involved in Your Care

With your permission, upon your request, or when you do not object, we may share health information that is directly relevant to a family member, friend, caregiver, or other person you identify as involved in your care or payment for care. We will share only the information reasonably necessary for that person’s involvement.

We may decline to discuss or disclose information to such individuals when, in our professional judgment, disclosure is not appropriate, is not in your best interest, may create a safety or privacy concern, is inconsistent with your known preferences, or is restricted by applicable law. We may also limit disclosure when we cannot reasonably verify the individual’s identity, role, or authority to receive the information.

Certain individuals, such as a legally authorized personal representative, health care agent, guardian, or parent of a minor, may have rights to access health information under applicable law. Those rights may be limited in certain circumstances, including when state or federal law provides additional confidentiality protections for particular services or records.

As Required or Permitted by Law

We may use or disclose your PHI when required or permitted by law, including for:

Public health activities, such as reporting certain diseases or adverse events.
Health oversight activities, audits, investigations, inspections, licensure, and accreditation.
Workers’ compensation claims.
Judicial or administrative proceedings, such as in response to a court order, subpoena, or other lawful process.
Law enforcement purposes when legally required.
To lessen a serious and imminent threat to the health or safety of you or another person.
Reporting suspected abuse, neglect, or domestic violence, as required or permitted by law.
Coroners, medical examiners, funeral directors, organ procurement organizations, and certain government functions.
Disaster-relief efforts.

Mental Health, Substance Use, and Other Sensitive Information

Your mental health, substance use, HIV-related, reproductive, genetic, and other sensitive health information may receive additional protection under New York or federal law.

If HHNY provides or receives records from a federally assisted substance use disorder treatment program, those records may be protected by federal confidentiality rules, including 42 CFR Part 2. In many circumstances, these records cannot be disclosed without your specific written consent, except as permitted or required by law.

Psychotherapy notes, when maintained separately from the rest of your medical record, generally require your written authorization before disclosure except in limited circumstances allowed by law.

Uses and Disclosures That Require Your Written Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, except when otherwise permitted or required by law.

Your written authorization is generally required for:

Most uses and disclosures of psychotherapy notes.
Most uses and disclosures of PHI for marketing purposes.
The sale of your PHI.
Other disclosures not otherwise allowed by law.

You may revoke an authorization at any time in writing. Your revocation will not affect any use or disclosure already made based on your prior authorization.

Electronic Communications and Telehealth

HHNY provides care in person and through telehealth. We may communicate with you using HIPAA-compliant electronic systems that are encrypted on our end, including:

Email sent through Paubox.
Secure text messaging through iPlum.
Video visits, including Doxy.me or Doximity.
Secure chat or patient communication platforms, including OhMD.
Electronic forms, electronic signatures, patient portals, and other HIPAA-compliant platforms.
HIPAA-compliant artificial intelligence tools that may assist with administrative or clinical functions, such as documentation, when used as part of your care.

Electronic communication can make care more convenient, but no electronic method of communication is entirely free from privacy or security risks. We make reasonable efforts to use secure, HIPAA-compliant systems and safeguards to protect your information.

You may choose whether to communicate with us through email or text message and may withdraw that consent at any time. If you choose to send us information through an unencrypted method, such as standard email or text messaging, you understand that others may potentially access that information.

Email, text messages, and portal messages are not for emergencies. Do not use electronic communication for urgent or life-threatening concerns. If you are experiencing an emergency or feel at immediate risk of harming yourself or someone else, call 911, call or text 988, or go to the nearest emergency department.

During telehealth visits, we may ask you to confirm your identity, your physical location, whether anyone else is present or able to hear the visit, and an emergency contact when clinically appropriate. We do not record telehealth visits unless you provide express consent or recording is otherwise permitted by law.

Your Rights Regarding Your Health Information

You have the following rights regarding your PHI:

Right to Inspect and Obtain a Copy

You have the right to inspect or obtain a paper or electronic copy of your medical record and other health information we maintain about you, with limited exceptions allowed by law. We may charge a reasonable, cost-based fee for copies.

Right to Request an Amendment

If you believe information in your record is incorrect or incomplete, you may ask us to amend it. We may deny your request in certain circumstances, but we will provide a written explanation.

Right to Request Confidential Communications

You have the right to ask us to contact you in a specific way or at a specific location. For example, you may ask us to call only a certain phone number, send mail to a different address, or refrain from leaving detailed voicemail messages. We will accommodate reasonable requests.

Right to Request Restrictions

You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations. We are not required to agree to all requests.

If you pay for a service in full out of pocket and ask us not to share information about that service with your health plan for payment or operations purposes, we will honor that request unless disclosure is required by law.

Right to an Accounting of Disclosures

You may request a list of certain disclosures of your PHI that we have made. This list will not include disclosures made for treatment, payment, health care operations, or certain other disclosures permitted by law.

Right to a Paper Copy of This Notice

You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically.

Right to Choose a Personal Representative

If you have given someone medical power of attorney, if someone is your legal guardian, or if another person is legally authorized to act for you, that person may exercise your rights and make choices about your health information. We will verify that the person has this authority before acting.

Right to File a Complaint

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

To file a complaint with HHNY, contact:

Privacy Officer
Happy Healthy New York
311 Saint Nicholas Ave, Suite E1
Ridgewood, NY 11385
Phone: 833-427-7969
Email: info@happyhealthyny.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights through its online complaint portal or by mail, email, or telephone.

Changes to This Notice

We may change the terms of this Notice at any time. Any revised Notice will apply to all PHI we maintain and will be available upon request, in our office, and through our website or patient intake process, as applicable.

Questions

If you have questions about this Notice or how HHNY protects your health information, please contact the Privacy Officer at the address, phone number, or email listed above.

Patient Bill of Rights

At Happy Healthy New York (“HHNY”), we are committed to compassionate, evidence-based, whole-person care. We respect each patient’s dignity, autonomy, privacy, and right to participate actively in decisions about their health.

This Bill of Rights applies to care provided at our in-person office and through telehealth.

You Have the Right To:

Respectful, Non-Discriminatory Care

Be treated with dignity, courtesy, compassion, and respect.
Receive care free from discrimination based on race, color, ethnicity, national origin, immigration status, religion, sex, sexual orientation, gender identity or expression, age, disability, marital or family status, socioeconomic status, health condition, body size, weight, diagnosis, substance-use history, or any other status protected by applicable law.
Receive care in an environment that is free from harassment, abuse, exploitation, retaliation, or intimidation.
Be addressed by your preferred name and pronouns, when provided.
Receive reasonable accommodations for a disability and meaningful access to language-assistance services, when available and appropriate.

Information and Participation in Your Care

Receive information about your health condition, recommended care, treatment options, expected benefits, material risks, reasonable alternatives, and the likely consequences of declining recommended treatment.
Ask questions and receive answers in language you can understand.
Participate in decisions about your care, including decisions about medications, diagnostic testing, referrals, lifestyle interventions, and other treatment options.
Accept or decline recommended evaluation, treatment, or services to the extent permitted by law, and be informed of potential consequences of declining care.
Request a second opinion or referral to another qualified clinician when appropriate.
Know the name, credentials, and role of the clinician or staff member involved in your care.
Receive care that is individualized to your goals, preferences, values, and clinical needs.
Receive care from clinicians who practice within their training, licensure, and scope of practice.

Privacy and Confidentiality

Have your personal health information kept private and protected as required by applicable federal and New York law.
Receive a copy of HHNY’s Notice of Privacy Practices.
Discuss your health information in a reasonably private setting.
Decide whether HHNY may discuss information with family members, friends, caregivers, or other individuals involved in your care or payment for care, except when disclosure is permitted or required by law.
Request confidential communications, such as communication through a particular phone number, email address, mailing address, or method, when reasonable.
Receive additional protections for sensitive health information, including mental health, substance-use, HIV-related, reproductive, genetic, and other information protected by law.
Know that certain disclosures may be required or permitted by law, including in response to court orders, public-health requirements, suspected abuse or neglect, or serious and imminent safety concerns.

Access to Your Health Information

Inspect or request a copy of your health records, subject to limited exceptions allowed by law.
Request records in paper or electronic format, when readily producible.
Request correction or amendment of information you believe is inaccurate or incomplete in your record.
Request an accounting of certain disclosures of your health information.
Ask questions about how to access, amend, or obtain copies of your medical records.

Telehealth and Electronic Communication

Receive information about whether telehealth is appropriate for your care and choose whether to participate in telehealth when clinically appropriate and legally permitted.
Be informed of the potential benefits, limitations, and privacy considerations of telehealth.
Be informed of the electronic communication methods HHNY uses, which may include encrypted email, secure text messaging, video visits, secure chat, electronic forms, electronic signatures, and other HIPAA-compliant platforms.
Choose whether to communicate with HHNY by email or text message and withdraw that consent at any time.
Request reasonable privacy measures during telehealth visits, including confirmation of who is present and whether you are in a private location.
Know that email, text messages, and portal messages are not monitored continuously and are not appropriate for emergencies.

If you have an emergency or feel at immediate risk of harming yourself or another person, call 911, call or text 988, or go to the nearest emergency department.

Financial Information

Receive understandable information about fees, payment expectations, insurance billing, self-pay charges, and financial policies before or at the time services are provided, when reasonably possible.
Ask questions about a bill or payment responsibility.
Receive an itemized statement of services upon request.
Be informed when a service, treatment, or medication may not be covered by insurance, when known.
Be treated respectfully regardless of insurance status or ability to pay, within the limits of HHNY’s services and policies.

Safe and Appropriate Care with Your Consent

Receive care in a safe setting, whether in person or through telehealth.
Receive clinically appropriate care based on your individual needs and the professional judgment of your clinician.
Be informed of medically appropriate referrals, higher levels of care, or emergency services when your needs cannot safely or appropriately be managed by HHNY.
Have a support person involved in your care when appropriate and when you authorize their involvement.
Refuse to participate in research or educational activities, if offered, without affecting your access to clinical care.

Concerns, Complaints, and Grievances

Express concerns, make a complaint, or file a grievance without fear of retaliation or adverse treatment.
Receive information about how to report concerns regarding your care, privacy, billing, communication, or treatment experience.
Request review of a concern by HHNY’s leadership or designated representative.
File a privacy complaint with HHNY or with the U.S. Department of Health and Human Services, Office for Civil Rights, if you believe your privacy rights have been violated.
Utilize binding arbitration (see the Dispute Resolution and Jury Waiver Agreement signed when establishing care) rather than a lawsuit in court to resolve disputes related to your care—including any financial/billing disputes, injury claims, or malpractice claims. Arbitration is a private process in which a neutral arbitrator, rather than a judge or jury, reviews the dispute and makes a decision. By agreeing to arbitration, you and HHNY have waived the right to have such disputes decided by a judge or jury. Arbitration decisions are generally final and may be reviewed by a court only in limited circumstances.

Your Responsibilities as a Patient

To support a safe and effective care partnership, HHNY asks that you:

Provide accurate and complete information about your health history, medications, allergies, substance use, symptoms, and changes in your condition.
Ask questions when you do not understand your diagnosis, treatment plan, medications, instructions, fees, or clinic policies.
Follow the agreed-upon treatment plan or discuss concerns and alternatives with your clinician.
Treat clinicians, staff, and other patients with respect and refrain from threatening, abusive, discriminatory, harassing, or disruptive behavior.
Attend scheduled appointments or provide timely notice if you need to cancel or reschedule.
Keep your contact information, insurance information, pharmacy, and emergency-contact information current.
Use emergency services, including 911, 988, or the nearest emergency department, for urgent or life-threatening concerns. HHNY does not provide emergency care through email, text, secure messaging, or routine telehealth channels.
Meet financial obligations in accordance with applicable financial policies or communicate promptly if you have questions or concerns about a bill.

Questions or Concerns

If you have questions about your rights, would like to request an accommodation, or wish to submit a concern or grievance, please contact:

Happy Healthy New York
311 Saint Nicholas Ave, Suite E1
Ridgewood, NY 11385
Text: 833HAPPYNY
Fax: (347) 905-4465
Email: info@happyhealthyny.com

HHNY will make reasonable efforts to review and respond to concerns promptly and respectfully.