Notice of Privacy Practices

Our Commitment to Your Privacy

Esperanza Behavioral Health Services PLLC ("Esperanza," "we," "us," or "our") is required by law to maintain the privacy of your Protected Health Information ("PHI") and to provide you with this Notice of our legal duties and privacy practices with respect to your PHI. We are required to abide by the terms of this Notice while it is in effect. This Notice applies to all records of your care generated by Esperanza, whether made by our staff or by an affiliated provider.

How We May Use and Disclose Your Health Information

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

• •Treatment. We may use and disclose your PHI to provide, coordinate, or manage your behavioral health treatment and related services. For example, we may share information with other treatment team members involved in your care.
• •Payment. We may use and disclose your PHI to obtain payment for services, including billing, claims management, and communications with your health insurance plan or other payer.
• •Health Care Operations. We may use and disclose your PHI for internal operations, such as quality assessment, staff training, licensing, compliance activities, and administrative purposes necessary to run our practice.
• •Appointment Reminders and Treatment-Related Communications. We may contact you by phone, mail, email, or text message (SMS) to provide appointment reminders, scheduling information, or other information about treatment options and health-related services, in accordance with your communication preferences and applicable law. See our website Privacy Policy for details on SMS opt-in/opt-out and consent.
• •As Required by Law. We will disclose PHI when required to do so by federal, state, or local law.
• •To Avert a Serious Threat to Health or Safety. We may disclose PHI when necessary to prevent a serious threat to your health or safety, or the health or safety of others, consistent with applicable law.
• •Public Health and Safety Activities, including reporting of abuse, neglect, or domestic violence as required by law.
• •Health Oversight Activities, such as audits, investigations, inspections, or licensure actions.
• •Judicial and Administrative Proceedings, in response to a court order, subpoena, or other lawful process.
• •Law Enforcement Purposes, as required or permitted by law.
• •Coroners, Medical Examiners, and Funeral Directors, as necessary to carry out their duties.
• •Workers' Compensation, as authorized by and to the extent necessary to comply with workers' compensation laws.

Special Protections for Certain Information

Behavioral health, mental health, and substance use disorder treatment records may be subject to additional legal protections beyond general HIPAA requirements (for example, under 42 CFR Part 2 for substance use disorder treatment records, and Arizona law regarding behavioral health records). Where such heightened protections apply, we will obtain your specific written authorization before disclosing this information, except as otherwise permitted or required by law.

Uses and Disclosures Requiring Your Written Authorization

Other than the situations described above, we will not use or disclose your PHI without your written authorization, including for purposes such as:

• •Marketing communications
• •Sale of your PHI
• •Most disclosures of psychotherapy notes
• •Any other use or disclosure not described in this Notice

You may revoke a written authorization at any time, except to the extent we have already relied on it.

Your Rights Regarding Your Health Information

You have the right to:

• •Request Restrictions. Ask us to limit how we use or disclose your PHI. We are not required to agree, except where you paid out of pocket in full for a service and request that we not disclose that information to your health plan.
• •Request Confidential Communications. Ask that we communicate with you in a certain way or at a certain location.
• •Inspect and Copy Your Records. Request access to and a copy of your PHI, with limited exceptions.
• •Request Amendment. Ask us to correct your PHI if you believe it is inaccurate or incomplete.
• •Receive an Accounting of Disclosures. Request a list of certain disclosures of your PHI made by us.
• •Obtain a Paper Copy of This Notice, even if you agreed to receive it electronically.
• •Choose Someone to Act on Your Behalf, such as a personal representative, in accordance with applicable law.
• •File a Complaint if you believe your privacy rights have been violated (see below).

To exercise any of these rights, please contact us using the information at the top of this Notice.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us at the contact information above, 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.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have, as well as PHI we receive in the future. We will post a copy of the current Notice on our website at esperanzabhsaz.org. You may also request a copy at any time.