HIPAA NOTICE OF LYRA CLINICAL ASSOCIATES P.C. PRIVACY PRACTICES AND CONSENT TO LIMITED DISCLOSURES
Effective date: June 21,2016.
Last Updated: November 2, 2016
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.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides standards for how medical information should be used and disclosed by healthcare providers, health plans, and other covered entities. We have voluntarily elected to provide each of our users with this information and ask each of our users to acknowledge receipt of our Notice of Privacy Practices and Consent to Limited Disclosures, which discloses our practices for personal information gathering and dissemination, and asks for your consent to limited disclosure of your personal information. Please note that by using this website (the "Site") or the services provided by Lyra Clinical Associates P.C., together with any independent contracted affiliates (together ";Lyra", "we", "our" or "us"), you accept the practices described in this Notice and Consent. If you do not agree to this Notice and Consent, please do not use the Site or Lyra's services. IF YOU ARE UNDER 13 YEARS OF AGE, PLEASE DO NOT USE OR ACCESS OUR SITE.
What information do we collect from users and how is it used?
Registration. Before using some of our offerings, we need you to register with the Site and provide your name, email address, a password, and other personal details. We request this information for identification purposes, to communicate with you, and to improve the functioning of certain services, and we may keep this information indefinitely. By providing us with your email address, you consent to receiving information from us by email, including protected health information.
Forms. To fully use our offerings, you may need to fill out forms that ask for or contain personal information such as your name, contact information, health, and other personal information.
Medical Records. In order for us to get you the best care, you may be asked to provide us with your medical records, description of symptoms, a medical history and life-style descriptions.
Correspondence. If you correspond with us via email, we may gather in a file specific to you the information that you submit. We may keep this information indefinitely.
How does Lyra use and disclose protected health information about you that we collect?
Lyra will collect protected health information ("PHI") from you and will use or share it for the following purposes:
Treatment. We can use your PHI and share it with other professionals or programs that are treating you, such as when you are referred to another mental health professional for further treatment. By using our Site, you hereby explicitly consent to the sharing of information like your name, age, gender, problems you seeking help for, including alcohol and substance use, care preferences, and health plan coverage, with potential therapists to ensure a good match.
Business Operations. We can use and share your PHI to run our practice, improve our offerings to clients, improve your care, and contact you when necessary, such as using your PHI to manage your treatment and services, including sharing PHI with our contracted partner, Lyra Health, Inc.
Billing and Payment. We can use and share your PHI to pay providers, bill, and get payment from health plans or other entities. For example, we may submit you PHI to your health insurance plan so that it will pay for your treatment.
You have both the right and the choice to tell us to share your PHI with your family, close friends, or others involved in your care; share your PHI in a disaster relief situation; and whether to contact you for fundraising efforts. If you are not able to tell us your preference, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
We will never share your PHI, unless you give us written permission to, for marketing purposes, for sale of your information, and for any sharing of most psychotherapy notes. You may revoke the authorization to disclose your PHI for these purposes at any time.
Lyra reserves the right to release collected information to law enforcement or other government officials, as we, in our sole and absolute discretion, deem necessary or appropriate. If you use our Site outside of the United States, you consent to the transfer and processing of your information out of your locale, to servers inside the United States and maintained indefinitely.
What are your rights regarding your protected health information?
You have certain rights regarding protected health information that we maintain about you, including rights to:
- Get an electronic or paper copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Contact us at the information below to ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
- Ask us to correct your medical and other records. You can ask us to correct health or other information about you that you think is incorrect or incomplete. Contact us at the information below to ask us how to do this. We may say "no" to your request, but we'll tell you why in writing within 60 days.
- Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say, "yes" to all reasonable requests.
- Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care.
- Get a list of those with whom we've shared information. You can ask for a list (accounting) of the times we've shared your health information for 6 years prior to the date you ask, who we shared it with, and why. We will include all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
- Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
- Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
- File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information below. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877- 696-6775, or visiting here. We will not retaliate against you for filing a complaint.
What are Lyra's responsibilities with my information?
We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: here.
Lyra reserves the right to update this Notice and Consent from time to time. Please visit this page periodically so that you will be apprised of any changes. The policies indicated in this Notice and Consent will remain effective, even if you are no longer using our Site or services.
How to contact us?
If you have questions, or need to reach us for any other reason, you may contact the Chief Privacy Officer at:
Lyra Clinical Associates P.C.
205 Park Road
Burlingame, CA 94010
1) You should be aware that when you are on the Site, you can be directed to other websites that are beyond our control, and Lyra is not responsible for the privacy practices of third parties or the content of linked websites
2) We do not knowingly collect or maintain personally identifiable information from persons under 13 years old, and no part of our Site is directed to persons under 13. If Lyra learns that personally identifiable information of persons less than 13 years old has been collected without verifiable parental consent, then Lyra will take the appropriate steps to delete this information. If you are a parent or guardian and discover that your child under the age of 13 has obtained a Lyra account, then you may alert Lyra at the address below.