Notice of Privacy Practice
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 terms of this Notice apply to First Light Recovery. This Notice is intended to inform you about our practices related to your protected health information (PHI). It explains how First Light Recovery may use and disclose your PHI, our obligations related to the use and disclosure of your PHI, and your rights related to any PHI that we have about you.
First Light Recovery is required to maintain the privacy of your health information; provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you; notify you following a breach of unsecured protected health information; and abide by the terms of this Notice.
Below, we have listed some of the reasons why we might use or disclose your PHI with some examples. Not every potential use or disclosure is discussed, but all of the ways that we are allowed to use and disclose information fall into one of the categories below.
Use and Disclosure of Medical Information:
- For Treatment: To provide you with medical treatment or services, we may need to use or disclose information about you to personnel involved in your treatment. For example our physician may need to review your medical history or consult with another healthcare provider before providing treatment.
- For Payment: We may use and disclose your PHI to bill and receive payment for treatment you receive from us. For example, we may share medical information about you with your insurance company to determine your insurance coverage or to receive payment from your insurer for services provided by First Light Recovery.
- For Health Care Operations: We can use and disclose PHI about you for our operations. These uses and disclosures are necessary to run our organization and make sure our clients receive quality care. For example, we may use your PHI to evaluate our staff’s performance in caring for you or to evaluate and improve our programs.
Uses and Disclosures of Medical Information that Do Not Require Your Authorization
We can use or disclose PHI about you without your authorization when there is an emergency, when we are required by law to treat you, or when we are required by law to use or disclose certain information. We may use or disclose your PHI without your authorization in any of the following circumstances:
- When it is required by federal, state, or other law.
- When it is needed for public health activities.
- When disclosing information for the purpose of health oversight activities, such as audits or inspections.
- When disclosing information for judicial and administrative proceedings, such as an order of court.
- When disclosing information for law enforcement purposes
- When we believe in good faith that the disclosure is necessary to avert a serious health or safety threat.
Use of Psychotherapy Notes
First Light Recovery must obtain an authorization from you for any use or disclosure of psychotherapy notes pertaining to your sessions except to carry out the following treatment, payment, or health care operations:
- Your therapist, who wrote the notes, may use them for treatment.
- First Light Recovery may use or disclose what is contained in your psychotherapy notes in our own training programs in which staff or students learn, under supervision, to practice or improve their skills in individual, group, joint, or family counseling.
- First Light Recovery may use psychotherapy notes pertaining to your sessions to defend itself in a legal action or other proceeding brought against our organization by you.
- First Light Recovery may use or disclose psychotherapy notes without written authorization when legally required by law, to investigate First Light Recovery’s compliance, for use of oversight of the therapist who wrote them, to a coroner or medical examiner, or to avert serious threats to health or safety.
Planned Uses or Disclosures:
We may use or disclose your health information for any of the purposes described in this section unless you affirmatively object to or otherwise restrict a particular release.
- We may use or disclose your health information to provide you with information about or recommendations of possible treatment options or alternatives that may interest you.
- We may share information about you with family members and friends who are involved in your care or payment for your care. Whenever possible, we will allow you to tell us who you would like to be involved in your care. However, in emergencies or other situations in which you are unable to tell us who to share information with, we will use our best judgment and share only information that others need to know. We may also share information about you with a public or private agency during a disaster so the agency can help contact your family or friends about your location and tell them how you are doing.
- We may use or disclose your health information to pre-certify you for treatments you may need to seek at other facilities while you are in treatment at First Light Recovery
Other Uses or Disclosures:
First Light Recovery holds your protected health information in strictest confidence. We do not give out, exchange, barter, rent, sell, lend, or disseminate any information about applicants who apply for or clients who actually receive our services that is considered patient confidential, is restricted by law, or has been specifically restricted by a patient/client in a signed HIPAA consent form. Written authorization from you is required for most marketing purposes. There are services provided in our facility through contacts with business associates (Business Associates). Examples include pharmacy services, record storage services, and shredding services. When these services are contracted, we may disclose your PHI to our Business Associate so that they can perform the job we have asked them to do. So that your health information is protected, however, we require the Business Associate to appropriately safeguard your information.
For all other types of uses and disclosures not described in this notice, First Light Recovery will use or disclose clinical information only with a written authorization signed by you that states who may receive the information, what information is to be shared, the purpose of the use or disclosure and an expiration for the authorization. If you provide us written authorization to use or disclose your protected health information, you can change your mind or revoke your authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose the information for the reasons stated in your authorization. We will not, however, be able to take back any disclosures that we made prior to your revocation, and we must retain protected health information that indicates the services we have provided to you.
Your Rights with Respect to Health Information
- Right to obtain a paper copy of this Notice of Privacy Practices upon request
- Right to Inspect and Copy Your Health Information: You have the right to inspect and copy your health information with certain exceptions. We ask that you make such a request in writing, sign it, date it, and send it to the Compliance Officer at the address listed below. We can provide you with a form to assist you with this written request. If you request copies of information, we may charge a reasonable fee to cover copying, mailing, and other costs and supplies associated with your request.
- Right to Request Information in Certain Form and Location: You have the right to request health information in a certain form or at a specific location. For instance, you can request that we not fax or email you. You can request that we not contact you at work or that we only send PHI to a Post Office Box. You may request an electronic copy of your health record if maintained in that format. We ask that you make such a request in writing, sign it, date it, and send it to the Compliance Officer at the address listed below. We can provide you with a form to assist you with this written request. You do not need to tell us the reason for your request. Your request must specify how or where you wish to be contacted. You will also be required to tell us what address to send bills to for payment. We will accept all reasonable requests. However, if we are unable to contact you using the requested ways or locations, we may contact you using any information we have.
- Right to Request Amendment to Your Health Information: You have a right to request that your health information be amended if you believe that it is incorrect or incomplete. You must provide the reason that you want the amendment added to your health information. This request must be in writing, signed, and dated. We can provide you with a form to assist you with this written request. Please send your request to the Compliance Coordinator at the address below.
- Right to Request Restrictions: You have the right to ask that we limit our use or sharing of information about you for treatment, payment, or health care operations. You also have the right to ask us to limit the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a surgery you had. We reserve the right to accept or reject most requests. Generally, we will not accept restrictions for treatment, payment, or health care operations. We will notify you if we do not agree to your request. If we do agree, our agreement must be in writing, and we will comply with the restriction unless the information is needed to provide emergency treatment for you. You do, however, have the right to restrict certain disclosures of protected health information to a health plan if you pay for health care items or First Light Recovery out of pocket in full; we must comply with such a request. If we agree to restrict our use or sharing of your information we are allowed to end the restriction if we tell you, unless you have paid for items or services in full out of pocket. If we end the restriction, it will only affect medical information that was created or received after we notify you.
Your request to restrict the use and sharing of your medical information must be in writing, signed, and dated. We can provide you with a form to assist you with this written request; you may also download it from our website. Please send it to the Compliance Coordinator at the address below. Your request must tell us: 1) what information you want to limit, 2) whether you want to limit our use, disclosure, or both, and 3) to whom you want the limits to apply.
Right to Receive an Accounting of Disclosures: You have the right to request a list of when your medical information was shared without your written consent in the six years or less prior to the date on which we receive the request. This list will not include uses or disclosures:
- to carry out treatment, payment, or health care operations
- to you or your personal representative
- to your family members or friends who are involved in your care
- as required or permitted by law as described above
- as part of a limited data set with direct identifiers removed.
Any request for this list must be made in writing to the Compliance Coordinator at the address listed below. We can provide you with a form to assist you with this written request; you may also download it from our website. Your request must state the time period for which you want the list. The time period may not be longer than six years; it may be shorter. The first list you request within a 12-month period will be free. We will charge you a fee for additional requests in that same period.
Right to Breach Notification: You have the right to be notified following a breach of your unsecured protected health information.
Changes to This Notice
Federal law gives all patients a right to a paper copy of this Notice. We have the right to change this Notice at any time. Any change could apply to medical information we already have about you as well as any information we receive in the future. Should our information practices change, we will provide a copy of the current Notice of Privacy Practices to you when you come in for your next visit.
How to Ask a Question or Report a Complaint
If you have questions about this Notice or want to talk about a problem without filing a formal complaint, please contact the Compliance Officer at 888-963-8921. If you believe your privacy rights have been violated, you may file a written complaint with us. Please send it to the Compliance Officer at First Light Recovery, 32122 Camino Capistrano, #210, San Juan Capistrano, CA 92675, Attn: Privacy Issues. You may also file a complaint with the Secretary of the Department of Health and Human Services by contacting the Office for Civil Rights, 200 Independence Avenue, S.W., Washington D.C. 20201. You will not be treated differently for filing a complaint.
This privacy statement describes how firstlightrecovery.com collects and uses your personal information.
Collection and Use of Personal Information back to top
Your data is used for purposes that you expect it to be used for such as fulfilling your order or providing services you requested. This may include providing you personalized content, features to enable you to interact with others, securing your data, and communicating about, improving, or troubleshooting the products or services being provided.
We collect the following personal information from you
- Contact Information such as name, email address, mailing address, phone number
- Billing Information such as credit card number, and billing address
As is true of most Websites, we automatically gather information about your computer such as your IP address, browser type, referring/exit pages, and operating system.
We use this information to
- Fulfill your order
- Send you an order confirmation
- Send you requested product or service information
- Send product updates or warranty information
- Respond to customer service requests
- Administer your account
- Respond to your questions and concerns
Marketing CommunicationsYou may choose to stop receiving our newsletter or marketing emails by following the unsubscribe instructions included in these emails or you can unsubscribe by sending an email to firstname.lastname@example.org.
Disclosure to Third Parties back to top
We will share your personal information with third parties only in the ways that are described in this privacy statement. We do not sell your personal information to third parties.
We may provide your personal information to companies that provide services to help us with our business activities such as shipping your order or offering customer service. These companies are authorized to use your personal information only as necessary to provide these services to us.
We may also disclose your personal information
- as required by law such as to comply with a subpoena, or similar legal process
- when we believe in good faith that disclosure is necessary to protect our rights, protect your safety or the safety of others, investigate fraud, or respond to a government request,
- if Example-site.com is involved in a merger, acquisition, or sale of all or a portion of its assets, you will be notified via email and/or a prominent notice on our Website of any change in ownership or uses of your personal information, as well as any choices you may have regarding your personal information,
- to any other third party with your prior consent to do so.
Tracking Technologies back to top
Web beaconsOur Web pages contain electronic images known as Web beacons (sometimes called single-pixel gifs) and are used along with cookies to compile aggregated statistics to analyze how our site is used and may be used in some of our emails to let us know which emails and links have been opened by recipients. This allows us to gauge the effectiveness of our customer communications and marketing campaigns. Our Web pages may also contain electronic images known as Web beacons (sometimes called single-pixel gifs) that are set by our third party partners. Web beacons are used along with cookies enabling our partners to compile aggregated statistics to analyze how our site is used.
We use a third party to gather information about how you and others use our Website. For example, we will know how many users access a specific page and which links they clicked on. We use this aggregated information to understand and optimize how our site is used.
Links to Other Web SitesOur Site includes links to other Websites whose privacy practices may differ from those of Example-site.com. If you submit personal information to any of those sites, your information is governed by their privacy statements. We encourage you to carefully read the privacy statement of any Website you visit.
Ad ServingThis site allows third parties like ad networks to serve advertisements. Some ads include tracking technologies which aggregate information about your behavior on this and other site.
Interest-based ads are selected for you according to your interests as determined by companies such as ad networks and data aggregators. These companies collect information about your online activity and use it to show you ads tailored to your interests.
Set Your Advertising Preferences-If you would like to opt-out of their use of your browsing activity to serve you interest-based ads visit the Trusted Ads Preference Manager.
Security back to top
The security of your personal information is important to us. We follow generally accepted industry standards to protect the personal information submitted to us, both during transmission and once we receive it. No method of transmission over the Internet, or method of electronic storage, is 100% secure, however. Therefore, we cannot guarantee its absolute security. If you have any questions about security on our Website, you can contact us at email@example.com
Other Information back to top
Correcting and Updating Your Personal InformationTo review and update your personal information to ensure it is accurate, contact us at firstname.lastname@example.org.
Notification of Privacy Statement ChangesWe may update this privacy statement to reflect changes to our information practices. If we make any material changes we will notify you by email (sent to the e-mail address specified in your account) or by means of a notice on this Site prior to the change becoming effective. We encourage you to periodically review this page for the latest information on our privacy practices.