This Notice describes how medical information about you may be used and disclosed, and how you can access that information.

As a solo provider offering telehealth services, I am committed to maintaining the privacy and security of your protected health information (PHI)
in compliance with the Health Insurance Portability and Accountability Act (HIPAA).

Commitment to Privacy

• Telehealth interactions are conducted using secure, HIPAA-compliant technology.
• By using telehealth, you consent to the electronic transmission of health information for treatment.
• While safeguards are in place, electronic transmission may carry some risk.

Your PHI may be used or disclosed without authorization for the following:

• Treatment: Sharing information with other healthcare providers as needed.
• Payment: Billing insurance or processing patient payments.
• Health Care Operations: Quality improvement, compliance, and accreditation.
• Caregiver Involvement: With permission or in your best interest, information may be shared with those assisting with your care.
• Business Associates: Contractors who perform services under confidentiality agreements.
• Appointments & Services: Appointment reminders and communications about benefits or services.
• Required by Law: PHI may be disclosed when mandated, such as for public health, legal proceedings, or national security.

• Psychotherapy Notes: Most uses require authorization, except in limited legal or treatment contexts.
• Genetic Information: Authorization required unless allowed by law.
• Marketing: Consent required except for face-to-face or small promotional items.
• Sale of Information: Authorization required, with limited exceptions such as public health, research, or legal obligations.

• Access: Request copies (paper or electronic) with reasonable fees for reproduction and mailing.
• Amendments: Submit written requests to correct information, including rationale.
• Accounting of Disclosures: Request a history of certain non-routine disclosures.
• Restrictions: Request limitations on disclosure—particularly when paying out of pocket in full.
• Breach Notification: You will be notified of any breach involving your PHI.
• Paper Copy: Request a hard copy of this notice at any time.

If you believe your privacy rights have been violated, you may file a complaint with:

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Avenue SW
Washington, DC 20201
Phone: (800) 368-1019
TDD: (800) 537-7697
Fax: (202) 619-3818
Online: Submit a complaint online

There will be no retaliation for filing a complaint.

You may also contact:
Recovery TeleCare LLC
724 Bielenberg Drive #83
Woodbury, MN 55125

Secure messaging through the EHR portal is encouraged.