Notice of Privacy Practices

Grace Health, PLLC 153 Main Street, Suite 15, Manchester, CT 06042 · (860) 730-4718 Original effective date: February 1, 2016 · Revised: July 14, 2026

 

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 Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires all medical records and other individually identifiable health information we use or disclose — whether electronically, on paper, or orally — to be kept properly confidential. HIPAA gives you, the patient, significant rights to understand and control how your health information is used, and it imposes penalties on covered entities that misuse your personal information. As required by HIPAA, this notice explains how we must maintain the privacy of your health information and how we may use and disclose it.

How we may use and disclose your health information

We may use and disclose your medical records for treatment, payment, and health care operations:

 

Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. Examples include a physical examination or coordinating your care with a specialist or a pharmacy.

 

Payment means activities such as obtaining reimbursement for services, confirming coverage, billing and collection, and utilization review. An example would be sending a bill for your visit to your insurance company for payment.

 

Health care operations include the business aspects of running our practice, such as quality assessment and improvement activities, auditing functions, cost management analysis, and customer service. An example would be an internal quality assessment.

 

We may also create and distribute de-identified health information by removing all references to individually identifiable information.

 

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may interest you.

 

Uses and disclosures permitted or required by law. In limited circumstances, we may use or disclose your health information without your authorization, including:

 

• When required by federal, state, or local law

• For public health activities, such as reporting communicable diseases or adverse reactions to medications

• To report suspected abuse, neglect, or domestic violence as required by law

• For health oversight activities such as audits and inspections

• In response to a court order, subpoena, or other lawful process

• To law enforcement in limited circumstances defined by law

• To avert a serious threat to health or safety

• For workers' compensation purposes

• To a coroner, medical examiner, or funeral director, as permitted by law

 

Uses requiring your written authorization. We will not use or disclose your health information for the following purposes without your signed, written authorization: most uses and disclosures of psychotherapy notes; marketing purposes; and any sale of your health information. Any other uses and disclosures not described in this notice will also be made only with your written authorization. You may revoke an authorization at any time, in writing, and we are required to honor that request, except to the extent we have already taken action relying on your authorization.

 

Family and others involved in your care. With your permission — or, if you are unavailable, using our professional judgment — we may share relevant information with a family member or other person involved in your care or in payment for your care. You may ask us not to.

Your rights regarding your health information

You may exercise any of these rights by presenting a written request to our Privacy Officer:

 

• The right to request restrictions on certain uses and disclosures of your protected health information, including disclosures to family members, other relatives, close personal friends, or any other person you identify. We are not required to agree to every requested restriction; however, we must agree if you ask us not to disclose information to your health plan about a service you have paid for in full, out of pocket. If we agree to a restriction, we must abide by it unless you agree in writing to remove it.

• The right to request confidential communications — to receive your health information from us by alternative means or at alternative locations (for example, calling only your cell phone). We will accommodate all reasonable requests.

• The right to inspect and copy your protected health information. You may also access much of your record at any time through the patient portal.

• The right to amend your protected health information if you believe it is incorrect or incomplete. We may deny the request in certain cases, and if so, we will explain why in writing.

• The right to receive an accounting of disclosures of your protected health information made in the six years prior to your request.

• The right to obtain a paper copy of this notice from us upon request, even if you agreed to receive it electronically.

• The right to be notified of a breach. We will notify you promptly if a breach occurs that may have compromised the privacy or security of your unsecured health information.

• The right to choose someone to act for you. A person with medical power of attorney or legal guardianship may exercise your rights on your behalf.

Our responsibilities

We are required by law to maintain the privacy of your protected health information, to provide you with notice of our legal duties and privacy practices, to notify you promptly if a breach may have compromised your information, and to abide by the terms of the Notice of Privacy Practices currently in effect.

Changes to this notice

We reserve the right to change the terms of this notice and to make the new provisions effective for all protected health information we maintain. We will post the current notice in our office and on our website, and you may request a written copy of any revised notice from our office at any time.

Questions or complaints

If you feel your privacy protections have been violated, you have the right to file a written complaint with our office or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will never retaliate against you for filing a complaint.

 

Privacy Officer Grace Health, PLLC 153 Main Street, Suite 15, Manchester, CT 06042 · (860) 730-4718 · info@gracehealthct.com

 

U.S. Department of Health & Human Services, Office for Civil Rights 200 Independence Avenue SW, Washington, DC 20201 1-877-696-6775 · www.hhs.gov/ocr/privacy/hipaa/complaints

Acknowledgment

We will ask you to sign an acknowledgment that you received this notice at your first visit. Signing is not required to receive care.