HIPAA Notice of Privacy Practices.

1. Our duties

Aesura Health LLC ("Aesura") is required by law to maintain the privacy of your Protected Health Information ("PHI"), to provide you with this notice of our legal duties and privacy practices regarding PHI, and to abide by the terms of this notice currently in effect. We reserve the right to change this notice; revised notices will be posted at our office and on this page.

2. How we may use and disclose your PHI without your authorization

Treatment

We use and share your PHI to provide, coordinate, or manage your healthcare — including consulting with other physicians, laboratories, pharmacies, and specialists involved in your care.

Payment

We use and share your PHI to obtain payment for services — including verifying coverage, billing, and collection activities.

Healthcare operations

We use and share your PHI to run our practice — quality improvement, training, licensing, accreditation, and business management.

Other permitted uses

• Appointment reminders and information about treatment alternatives or health-related benefits.
• Public health activities, including reporting communicable disease, adverse events, or product recalls.
• Required by law, including court orders, subpoenas, and law-enforcement requests.
• Health oversight by government agencies such as licensing boards.
• To avert a serious threat to health or safety.
• Workers' compensation claims.
• Coroners, medical examiners, and funeral directors as required.
• Organ and tissue donation coordination.
• Research, only when an Institutional Review Board has approved a privacy waiver or you have authorized it.
• Military, national security, and inmate situations as permitted by law.

3. Uses and disclosures requiring your written authorization

The following always require your written authorization, which you may revoke in writing at any time:

• Most uses and disclosures of psychotherapy notes.
• Uses and disclosures for marketing purposes.
• Sale of your PHI.
• Photographs or video used for marketing, social media, or training, unless separately authorized.
• Most other uses not described in this notice.

4. Your rights

• Right to inspect and copy. You may request access to your medical and billing records. We may charge a reasonable, cost-based fee.
• Right to amend. You may request that we correct PHI you believe is incorrect or incomplete. We may deny the request in limited circumstances.
• Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your PHI.
• Right to request restrictions. You may ask us to limit how we use or share your PHI for treatment, payment, or operations. We are not required to agree, except for disclosures to a health plan when you have paid in full out-of-pocket.
• Right to confidential communications. You may request that we contact you at a specific address or by a specific method.
• Right to a paper copy of this notice, even if you have agreed to receive it electronically.
• Right to be notified of a breach of unsecured PHI.
• Right to choose someone to act for you. A personal representative or person with legal authority may exercise your rights.

5. How to file a complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Aesura Privacy Officer
390 Hackensack Ave, Hackensack, NJ 07601
info@aesura.com · (201) 983-2582

U.S. Department of Health and Human Services, Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
1-877-696-6775 · www.hhs.gov/ocr/

6. Acknowledgement

At your first visit you will be asked to acknowledge receipt of this notice. If you decline or are unable to acknowledge, we will document the attempt as required by law.