This notice describes how medical information about you may be used, disclosed, and safeguarded, and how you can access this information. Please review it carefully.
We hold your personal health information (PHI) in strict confidence. PHI includes records created during the assessment and treatment, such as record of symptoms, examination and test results, diagnoses, treatments, referrals, bills, and payment information. If you need information or want to contact Belle Meade Addiction Medicine & Psychiatry, PLLC, call us at 615-314-2421.
Under federal law we may use and disclose PHI without authorization for treatment, payment and healthcare operations. PHI may also be disclosed in cases of abuse, neglect, or domestic violence to a state or federal agency. We may also disclose PHI to persons involved in your care, such as family members, relatives, or close person friends with your consent.
To exercise any rights described above, submit a request in writing to Belle Meade Addiction Medicine & Psychiatry, PLLC. If you have questions about your rights, call us anytime. If you believe your privacy rights have been violated, then you may file a written complaint by mailing it or delivering it to our office. You may also submit a complaint to the Secretary of Health and Human Services by writing to:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201
You may also submit a complaint by calling 1(800)368-1019 or emailing email@example.com.