Notice of Privacy Practices

Treatment

We may use your PHI to provide, coordinate, or manage your psychiatric care. This includes sharing relevant information with other healthcare providers involved in your care, such as your therapist, primary care provider, or referring clinician, to ensure safe and coordinated treatment.

Payment

We may use your PHI to process payment for the services we provide. This includes collecting payment at the time of service and generating superbills for patients who choose to seek reimbursement through their own out-of-network insurance benefits. We do not submit claims directly to insurance companies or health plans.

Healthcare Operations

We may use your PHI for activities that support the operation of our practice and the quality of your care. Examples include quality assessment, staff training, compliance activities, and business planning.

Other Uses and Disclosures Permitted or Required Without Authorization

We may also use or disclose your PHI without your authorization in limited circumstances, including:

• As required by law: When federal, state, or local law requires disclosure.
• Public health activities: To prevent or control disease, injury, or disability as required by public health authorities.
• Victims of abuse or neglect: To report suspected abuse, neglect, or domestic violence to appropriate government authorities as required by law.
• Health oversight activities: To a health oversight agency for activities authorized by law, such as audits, investigations, or inspections.
• Judicial and administrative proceedings: In response to a court order or, in some cases, a subpoena or discovery request.
• Law enforcement: Under limited circumstances, such as in response to a court order or warrant, or to report certain types of wounds or injuries.
• To avert a serious threat to health or safety: When necessary to prevent a serious and imminent threat to your health or safety or the health or safety of others.
• Workers' compensation: As authorized by workers' compensation laws.
• Coroners, medical examiners, and funeral directors: To identify a deceased person, determine cause of death, or carry out their duties under the law.
• Organ and tissue donation: To organizations that handle organ procurement or transplantation, if applicable.
• Military and veterans: If you are a member of the armed forces, as required by military command authorities.
• National security and intelligence: To authorized federal officials for intelligence, counterintelligence, or national security activities.
• Inmates: To a correctional institution or law enforcement official having lawful custody, under specific circumstances.
• HHS investigations: To the U.S. Department of Health and Human Services when it is investigating our compliance with federal privacy law.

Uses and Disclosures Requiring Your Written Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes not described in this notice. Common situations requiring authorization include:

• Marketing communications
• Sale of your PHI
• Most uses of psychotherapy notes (if maintained separately from your medical record)
• Other uses and disclosures not described in this notice

You may revoke your authorization in writing at any time, except to the extent that we have already acted in reliance on it.

Right to Access Your Records

You have the right to inspect and obtain copies of your PHI maintained in our records. Submit your request in writing via the patient portal, email, or letter. We will respond within 15 business days, consistent with Washington State law (RCW 70.02), which provides a shorter timeline than the 30-day federal standard.

You may request records in a specific format, including electronic format. We will provide records in the format you request if it is readily producible.

Under Washington State law, your first copy of records is provided at no charge. For subsequent requests, we may charge a reasonable, cost-based fee for labor, supplies, and postage.

We may deny your request in limited circumstances (for example, if the information consists of psychotherapy notes maintained separately from your medical record). If we deny your request, we will provide a written explanation and instructions for requesting a review of the denial.

Right to Request an Amendment

If you believe your PHI is inaccurate or incomplete, you have the right to request an amendment. Submit your request in writing, including the reason you believe the information should be changed.

We will act on your request within 60 days. We may deny your request if the information was not created by our practice, is not part of your designated record set, or is accurate and complete. If we deny your request, we will provide a written explanation and inform you of your right to submit a written statement of disagreement, which will be included in your record.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your PHI during the six years prior to your request. This accounting does not include disclosures made for treatment, payment, or healthcare operations, or disclosures you authorized in writing.

We will respond within 60 days. The first accounting in any 12-month period is provided at no charge. For additional requests within the same period, we may charge a reasonable cost-based fee and will notify you of the fee in advance.

Right to Request Restrictions

You have the right to request that we restrict how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, with one important exception: if you pay for a service entirely out of pocket and request that we not disclose information about that service to your health plan for payment or healthcare operations purposes, we must honor that restriction.

To request a restriction, submit your request in writing, specifying what information you want limited and to whom the restriction should apply.

Right to Confidential Communications

You have the right to request that we communicate with you about your health information in a specific way or at a specific location. For example, you may ask that we contact you only by email or only at a particular phone number. We will accommodate all reasonable requests. You do not need to explain the reason for your request.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this notice at any time, even if you previously agreed to receive it electronically. Contact us using the information below to request a paper copy.

To file a complaint with Cognia Health:

Matias Massaro, DNP
Privacy Officer
Cognia Health PLLC
Phone: (206) 350-9411
Email: matias@cogniahealth.com

To file a complaint with the U.S. Department of Health and Human Services:

Office for Civil Rights
U.S. Department of Health and Human Services
Complaint Portal: https://www.hhs.gov/hipaa/filing-a-complaint