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
Arise Treatment Homes LLC understands that your health information is personal. We are committed to protecting your health information and are required by law to:
- Maintain the privacy of your health information
- Provide you with this notice of our legal duties and privacy practices
- Follow the terms of the notice currently in effect
- Notify you if we are unable to agree to a requested restriction
- Notify you in case of a breach of your unsecured health information
How We May Use and Disclose Your Health Information
We may use and disclose your health information for the following purposes:
Treatment: We may use and disclose your health information to provide, coordinate, or manage your health care treatment and related services. This includes consultation with other health care providers regarding your care.
Payment: We may use and disclose your health information to bill and collect payment for the treatment and services we provide to you.
Health Care Operations: We may use and disclose your health information for our health care operations, which include quality assessment, staff evaluation, licensing, and conducting or arranging for other business activities.
As Required by Law: We will disclose your health information when required to do so by federal, state, or local law.
To Avert a Serious Threat: We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Substance Use Disorder Records: Records regarding substance use disorder treatment are protected by federal law (42 CFR Part 2). We cannot disclose this information without your written consent except in limited circumstances permitted by law, such as medical emergencies, court orders with proper findings, or to qualified personnel for treatment purposes.
Other Uses and Disclosures
Other uses and disclosures of your health information not covered by this notice will be made only with your written authorization. You may revoke such authorization in writing at any time, except to the extent that we have already taken action in reliance on the authorization.
Your Rights Regarding Your Health Information
You have the following rights regarding your health information:
Right to Inspect and Copy: You have the right to inspect and obtain a copy of your health information that may be used to make decisions about your care.
Right to Amend: If you believe your health information is incorrect or incomplete, you may request that we amend it.
Right to an Accounting of Disclosures: You have the right to receive a list of certain disclosures we have made of your health information.
Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your health information. We are not required to agree to your request, but if we do, we will comply with it except in emergency situations.
Right to Request Confidential Communications: You have the right to request that we communicate with you about your health information in a certain way or at a certain location.
Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of this notice at any time.
Right to File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this notice and to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice at our facility and on our website. The notice will contain the effective date.
Contact Information
To exercise any of your rights, request additional information, or file a complaint, please contact:
Arise Treatment Homes LLC
DBA Invigorate Behavioral Health
Privacy Officer
553 N Mariposa Ave
Los Angeles, CA 90004
Phone: (949) 678-6047
Email: bjordan@invigoratebh.com
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.