THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR PRIVACY COMMITMENT
At Balanced Psychiatry of New York, we are committed to maintaining the confidentiality of your personal health information. This notice is provided in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
OUR DUTIES REGARDING YOUR HEALTH INFORMATION
"Protected Health Information" (PHI) is individually identifiable health information (demographics, health conditions, treatment, or payment history) in any form. We are required by law to:
- Ensure your PHI is kept private.
- Provide you with this notice of our legal duties and privacy practices.
- Follow the terms of the notice currently in effect.
HOW WE MAY USE AND DISCLOSE YOUR PHI
Treatment: To provide, coordinate, or manage your psychiatric care. This includes consultations with other professionals involved in your treatment.
Payment: To bill and collect payment for services. While we are an out-of-network practice, we use PHI to process payments or provide you with superbills for your insurance claims.
Health Care Operations: For internal administrative activities, such as quality assessment, risk management, and clinical supervision.
Business Associates: We share PHI with third-party vendors (e.g., electronic health records, billing services, or AI documentation assistants) who are legally bound to protect your data through signed HIPAA agreements.
Required by Law: We will disclose PHI when required by federal, state, or local laws.
Safety & Public Health: We may disclose PHI to prevent a serious and imminent threat to health or safety, or to report suspected abuse or neglect as required by New York law.
Legal Proceedings: We may disclose PHI in response to a court order, subpoena, or discovery request, typically after notifying you.
YOUR RIGHTS REGARDING YOUR PHI
Right to Inspect and Copy: You have the right to review and obtain copies of your clinical and billing records.
Right to Request Restrictions: You may ask us to limit certain uses or disclosures of your PHI. We are not required to agree but will consider all requests.
Right to Amend: If you believe your record is incorrect or incomplete, you may request an amendment.
Right to an Accounting of Disclosures: You may request a list of certain non-routine disclosures we have made of your PHI.
Right to Confidential Communications: You may request that we communicate with you in a specific way (e.g., home vs. work phone) or at a specific location.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a written complaint with our HIPAA Privacy Officer at 214 E 70th Street, B2, New York, NY 10021, or with the Secretary of the US Department of Health and Human Services. No retaliation will occur for filing a complaint.
Effective Date: January 15, 2018 (Current as of 2026)