HIPAA Notice of Privacy Practices

Passion Care LLC is committed to protecting the privacy of your health information. This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, and healthcare operations, and for other purposes permitted or required by law. It also describes your rights to access and control your health information. "Protected Health Information" is information about you, including demographic information, that may identify you and relates to your past, present, or future physical or mental health condition, the provision of health care to you, or payment for that care. We are required by law to maintain the privacy of your PHI, to provide you with this Notice of Privacy Practices, and to follow the terms of the Notice currently in effect.

The following categories describe different ways we use and disclose health information. For each category, we will explain what we mean and provide examples. Treatment: We may use or disclose your PHI to provide, coordinate, or manage your health care and any related services. For example, we may share information about your care needs with your assigned caregiver, your physician, or other members of your care team. Payment: We may use and disclose health information about you to obtain payment for services we provide. For example, we may submit information to your insurance company or Medicaid program to receive reimbursement for care provided. Healthcare Operations: We may use and disclose health information about you for our healthcare operations. These uses and disclosures are necessary to run our organization and ensure that all of our clients receive quality care. Examples include quality assessment activities, staff training, licensing activities, and business management. As Required by Law: We will disclose health information about you when required to do so by federal, state, or local law. Public Health Activities: We may disclose health information for public health activities such as reporting certain diseases or conditions to public health authorities. Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Law Enforcement: We may release health information if asked to do so by a law enforcement official under specific circumstances as required by law. Serious Threats to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

You have the following rights regarding health information we maintain about you: Right to Inspect and Copy: You have the right to inspect and obtain a copy of health information that may be used to make decisions about your care. To request access, submit your request in writing to our Privacy Officer. We may charge a reasonable fee for copies. Right to Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we keep the information. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures we have made of your health information, other than disclosures for treatment, payment, and healthcare operations. Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or healthcare operations. We are not required to agree to your request, but if we do, we will comply with it unless the information is needed to provide you emergency treatment. Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice at any time. You may ask us to give you a copy of this Notice at any time, even if you have agreed to receive this Notice electronically.

Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the reasons covered by your written authorization, except where we have already taken action in reliance on your authorization. The following uses and disclosures will be made only with your written authorization: • Most uses and disclosures of psychotherapy notes • Uses and disclosures of PHI for marketing purposes • Disclosures that constitute a sale of PHI

Passion Care LLC is required to: • Maintain the privacy of your protected health information. • Provide you with notice of our legal duties and privacy practices with respect to health information about you. • Notify you if there is a breach of your unsecured protected health information. • Abide by the terms of the Notice currently in effect. 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 on our website. The Notice will contain the effective date on the first page.

If you believe your privacy rights have been violated, you may file a complaint with Passion Care LLC or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer in writing at the address below. You will not be penalized for filing a complaint. Privacy Officer Passion Care LLC 707 Park Avenue NE Atlanta, GA 30326 Phone: 404-287-4426 Email: [email protected] To file a complaint with the U.S. Department of Health and Human Services: Office for Civil Rights U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 Toll Free: 1-877-696-6775 Website: www.hhs.gov/ocr/privacy