HIPAA Notice of Privacy Practices

Our Commitment to Your Privacy

Khadija Hamisi, DNP, PMHNP, and Inland Empire Behavioral Group are committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI), provide you with notice of our legal duties and privacy practices, and follow the terms of this notice.

How We May Use and Disclose Your PHI

We may use and disclose your PHI for the following purposes:

• Treatment: To provide, coordinate, or manage your mental health care and related services.
• Payment: To bill and collect payment for the services provided to you.
• Healthcare Operations: For quality assessment, licensing, and business management activities.
• As Required by Law: When required by federal, state, or local law.
• Public Health and Safety: To prevent serious threats to health or safety.

Your Rights

You have the following rights regarding your health information:

• The right to request restrictions on certain uses and disclosures
• The right to receive confidential communications
• The right to inspect and copy your health information
• The right to request amendments to your health information
• The right to receive an accounting of disclosures
• The right to obtain a paper copy of this notice
• The right to file a complaint if you believe your privacy rights have been violated

Psychotherapy Notes

Psychotherapy notes receive special protection under HIPAA. We will not use or disclose psychotherapy notes without your written authorization, except in limited circumstances as permitted by law.

Changes to This Notice

We reserve the right to change this notice and to make the revised notice effective for health information we already have about you as well as any information we receive in the future.

Contact Information

If you have questions about this notice or wish to exercise any of your rights, please contact us:

Complaints

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