Notice of Privacy Practices
How NirvanaMed protects, uses, and discloses your protected health information (PHI).
Effective Date: [Insert Effective Date]
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.
Our Commitment to Your Privacy
NirvanaMed is required by law to maintain the privacy of your protected health information (PHI), provide you with this notice describing our legal duties and privacy practices, and follow the terms of the notice currently in effect.
How We May Use and Disclose Your Health Information
We may use and disclose your health information for the following purposes:
- Treatment — to provide, coordinate, or manage your medical care and related services.
- Payment — to bill and collect payment for the services you receive, including verification of insurance coverage.
- Healthcare Operations — for activities such as quality assessment, staff training, and practice management.
- Appointment Reminders & Health-Related Information — to contact you about appointments or treatment alternatives.
- As Required by Law — including public health, legal, or regulatory reporting obligations.
Your Rights Regarding Your Health Information
You have the right to:
- Request to inspect and obtain a copy of your medical record.
- Request corrections to your medical record.
- Request a list of certain disclosures we have made of your information.
- Request restrictions on certain uses or disclosures of your information.
- Request confidential communications by an alternative means or location.
- Obtain a paper copy of this notice upon request.
- File a complaint if you believe your privacy rights have been violated, without fear of retaliation.
Our Responsibilities
NirvanaMed is required to maintain the privacy of your health information, provide you with this notice, abide by its terms, and notify you if a breach of your unsecured PHI occurs.
Changes to This Notice
We reserve the right to change the terms of this notice and to make the revised notice effective for all PHI we maintain. Updated notices will be made available on this page and at our office.
Contact Information
If you have questions about this notice or wish to exercise any of the rights described above, please contact us at:
NirvanaMed
970 N Broadway STE 208, Yonkers, NY 10701
Phone: (914) 376-9349
Email: Info@nirvanamed.org
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.