Effective Date: February 13, 2025

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.

YOUR RIGHTS

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

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. 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 record

• You can ask us to correct health information about you that you think is incorrect or incomplete. 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.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared your information

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the 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 on page 1.
• 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 www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.

YOUR CHOICES

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, 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.

In these cases we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

[By providing your mobile phone number, you consent to receive SMS/MMS communications from NeurAbilities Healthcare. These messages may include appointment reminders, service updates, and other relevant notifications. You may opt-out at any time by replying with “STOP.”

In the case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again.

OUR USES AND DISCLOSURES

How do we typically use or share your health information?

We typically use or share your health information in the following ways

We do not sell or share your mobile phone contact information or opt-in data with third parties for marketing purposes.

Treat you

• We can use your health information and share it with other professionals who are treating you.
• Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

• We can use and share your health information to run our practice, improve your care, and contact you when necessary.
• Example: We use health information about you to manage your treatment and services.

Bill for your services

• We can use and share your health information to bill and get payment from health plans or other entities.
• Example: We give information about you to your health insurance plan so it will pay for your services.

Help with public health and safety issues

• We can share health information about you for certain situations such as:
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research

• We can use or share your information for health research.

Comply with the law

• We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

• We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

• We can use or share health information about you:
  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

• We can share health information about you in response to a court or administrative order, or in response to a subpoena.

NOTES:

NeurAbilities does not create or manage a hospital directory.

Behavior Health records including ABA PHI and therapy notes will require specific written consents for sharing.

Psychotherapy notes are not generated at the practice.

Our Responsibilities

We may update this Privacy Policy from time to time. Any updates will be posted on our website, and the revised policy will apply to all information previously collected.

• 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.

Mobile Data Policy

SMS Terms and Conditions

Consent to Receive Automated Messages
By providing your mobile phone number, you consent to receive SMS/MMS communications from NeurAbilities Healthcare. These messages may include appointment reminders, service updates, and other relevant notifications. Messages may include but are not limited to appointment confirmations, updates, and important service-related information. Consent to receive automated messages is not a condition of receiving services from NeurAbilities Healthcare.

Frequency of Messages
Message frequency may vary based on your appointments, service updates, and ongoing notifications. You will receive messages relevant to your scheduled services and necessary updates.

Opt-Out and Support Options
You may opt out of receiving text messages at any time by replying with “STOP”. Upon receipt of your opt-out request, you will be unsubscribed and will no longer receive text messages from us. A confirmation message will be sent to confirm your opt-out. Should you wish to re-subscribe, you may text “START” to receive SMS messages again.

For assistance with the messaging service, reply with “HELP” to any SMS message you receive, or contact our customer support team at 856.346.0005.

Wireless Carrier Rates and Services
Message and data rates may apply depending on your carrier. Wireless carriers are not liable for delayed or undelivered messages.

Confidentiality
NeurAbilities Healthcare is committed to safeguarding your personal information. Your mobile number will not be shared or sold to third parties for marketing/promotional purposes

Any data you provide to us is handled in strict compliance with applicable privacy laws. Your mobile number may be shared with service providers who assist in delivering our SMS communications, but they will only use your information for operational purposes related to messaging services.

Your phone number will be handled in accordance with our Privacy Policy. We do not share SMS opt-in consent with any third parties for solicitation purposes.