Our pledge regarding your health information
Pasadena Clinical Group is committed to protecting the privacy of your protected health information (PHI). We are required by law to:
- Maintain the privacy of your PHI;
- Provide you with this Notice describing our legal duties and privacy practices;
- Notify you following a breach of your unsecured PHI; and
- Follow the terms of the Notice currently in effect.
How we may use and disclose your health information
We use and disclose your PHI in the following ways without specific written authorization, as permitted by law:
Treatment
We use PHI to provide treatment to you. For example, your therapist may share information with another clinician on our team consulting on your care, or with a perinatal psychiatrist if you are receiving coordinated medication management.
Payment
We use and disclose PHI to bill and collect payment for the services we provide. For example, we may share information with your health plan to verify benefits, obtain authorization, or submit claims.
Health care operations
We use and disclose PHI for activities necessary to run our practice — quality assessment, training, accreditation, audits, and similar functions.
Required by law
We will disclose PHI when required by federal, state, or local law, including mandated reporting of suspected child abuse, dependent adult abuse, or elder abuse.
To prevent serious harm
We may disclose PHI when necessary to prevent a serious threat to your health or safety or the safety of others, including duty-to-warn obligations under California law.
Public health and safety
We may disclose PHI for public health activities, judicial proceedings (in response to a court order or valid subpoena), law enforcement purposes when permitted, and oversight activities.
Special protections for psychotherapy notes
Psychotherapy notes — separate from your medical record — receive heightened protection under HIPAA. Most uses and disclosures of psychotherapy notes require your specific written authorization. Limited exceptions exist for certain treatment, training, and legal contexts.
Uses and disclosures requiring your authorization
Other uses and disclosures of your PHI require your specific written authorization, including:
- Most uses of psychotherapy notes;
- Uses or disclosures for marketing purposes; and
- Disclosures that constitute a sale of PHI.
You may revoke an authorization at any time, in writing, except to the extent we have already acted in reliance on it.
Your rights regarding your health information
Under HIPAA, you have the following rights:
Right to inspect and copy
You may request to inspect and obtain a copy of your PHI in our designated record set. We may charge a reasonable fee for copies.
Right to amend
You may request that we amend your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances.
Right to an accounting of disclosures
You may request a list of certain disclosures we have made of your PHI for the past six years.
Right to request restrictions
You may request that we restrict certain uses or disclosures. We are not required to agree to all restriction requests, but we are required to honor a request to restrict disclosure to a health plan if you pay for the service in full out of pocket.
Right to confidential communications
You may request that we communicate with you in a specific way (for example, by mail to a P.O. Box rather than your home).
Right to a paper copy of this Notice
You may request a paper copy of this Notice at any time.
Right to be notified of a breach
You will be notified following a breach of your unsecured PHI.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
To file a complaint with HHS: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201; or visit www.hhs.gov/ocr.
Changes to this Notice
We reserve the right to change this Notice and apply the new terms to all PHI we maintain. The current Notice will always be posted at our office and on our website. The effective date of the most recent revision is shown at the top of this page.
Contact our Privacy Officer
Questions about this Notice or our privacy practices? Contact:
Pasadena Clinical Group · Privacy Officer
301 N. Lake Ave, STE 600
Pasadena, CA 91101
Phone: 626-354-6440
Email: office@pasadenaclinicalgroup.com