Privacy Policy

Tal BH Privacy Policy – HIPAA Notice of Privacy Practices

Notice Of Privacy Practice

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU AND YOUR TREATMENT MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Tal BH is required by law to maintain the privacy and confidentiality of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Please also respect the privacy of others you encounter in treatment.

Tal BH collects health information about you and stores it in an electronic health record. This is your medical record. The medical record is the property of Tal BH, but the information in the medical record belongs to you. The Health Insurance Portability and Accountability Act (HIPAA) requires Tal BH to maintain the privacy of your medical record. HIPAA generally requires that any uses or disclosures of information in your medical record be limited to the minimum necessary to the purposes of the uses or disclosures. HIPAA also provides you certain rights with respect to the information in your medical record which are described below.

Information relating to your treatment at Tal BH is protected by federal regulations specific to drug and alcohol treatment, which are known as 42 CFR Part 2. These regulations protect the confidentiality of information relating to the identity, diagnosis, prognosis, or treatment of any patient in a drug or alcohol treatment program. Tal BH may not disclose records relating to your treatment without your written consent, except in narrowly limited circumstances. Under 42 CFR Part 2, the terms of a written consent to disclose information must specify the scope and types of information to be disclosed, the parties to whom the information may be disclosed, the purpose of the disclosure and the timeframe of the consent. You may revoke a consent to disclose information relating to drug and alcohol verbally or in writing at any time.

Tal BH may ask for your written consent to disclose treatment information for certain purposes, including releasing treatment information to or obtaining information from your other medical providers, obtaining payment from insurance or other payors, contacting your family either for treatment purposes or in the case of a medical or other emergency. Tal BH will not disclose your treatment information for these purposes without your consent.

Tal BH may disclose treatment information without your written consent under certain narrow circumstances as permitted by 42 CFR Part 2. For treatment purposes, Tal BH is permitted to use and disclose treatment information internally and to entities with which it shares administrative control. Tal BH is permitted to share treatment information as necessary with qualified service organizations that agree to maintain the confidentiality of the information. Tal BH also may disclose treatment information to outside auditors, regulatory agencies, and evaluators and for certain research purposes.

Tal BH may disclose treatment information without your written consent when necessary in a life-threatening medical emergency and may disclose to report a crime on the premises or against Tal BH personnel. Tal BH also may disclose patient information without consent where the state mandates child abuse and neglect reporting; when cause of death is being reported; or when required by a valid court order that contains specific required findings. Tal BH may contact you to share information about Tal BH treatment services or to send you reminder notices of future appointments for your treatment.

Your Health Information Rights

In addition to protecting privacy and confidentiality, HIPAA and 42 CFR Part 2 afford you the following rights with respect to your medical record and drug or alcohol treatment information:

You have the right to a paper copy of this written notice of Tal BH privacy practices.
You have a right to request a copy of your treatment record or to receive your health information through a reasonable alternative means or at an alternative location. Tal BH requires that all such requests be put in writing. A reasonable fee will be charged for copying your health information.
You have a right to request that Tal BH amend health information that is incorrect or incomplete. If Tal BH determines not to amend the health information, it will provide you with an explanation of the reason for the denial and your rights to disagree with the denial.
You have a right to request restrictions on otherwise permitted uses and disclosures of your health information. Tal BH is not obligated to comply with such requests.
You may request that we provide you with a written accounting of all disclosures made by us during a specific time period (not to exceed 6 years). We ask that such requests be made in writing on a form provided by our facility. Please note that an accounting will not apply to any of the following types of disclosures: disclosures made with your written consent for reasons of treatment, payment or health care operations; disclosures made to you or your legal representative, or any other individual involved with your care. You will not be charged for your first accounting request in any 12-month period. However, for any requests that you make thereafter, you will be charged a reasonable, cost-based fee.

Changes to this Notice of Privacy Practices

Tal BH reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until amendment is made,Tal BHis required by law to comply with this Notice. Should our privacy practices change, we will provide all current and future patients with a copy of the revised Notice of Privacy Practices

Effective 05.16.2022

Complaints Regarding Privacy Practices

Complaints about this Notice of Privacy Practices or how Tal BH handles your health information should be directed to Tal BH.

If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to one of the following:

Department of Drug and Alcohol Programs
Bureau of Quality Assurance for Prevention and Treatment
‍200 Independence Avenue, SW Room 509F, HHH Building
Washington, DC 20201

Department of Health and Human Services
Office of Civil Rights
‍State Health and Human Services
Oregon Department of Human Services
500 Summer St. NE E-15Salem, OR 97301

You may also address your complaint to one of the regional U.S Department of Health and Human Services Offices for Civil Rights. A list of these offices can be found online at: www.2.ed.gov

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This Privacy Policy applies only to information collected on or through the websites owned and operated by Tal BH Manager, LLC or any of its affiliates or subsidiary entities (“Tal BH”). Any specific website, including all subordinate web pages, owned, and operated by Tal BH is referred to as a “Website”. Tal BH may engage third parties such as a hosting service to assist in the operation of any Website, including the Website through which you linked to view this Privacy Policy. As used in this Privacy Policy, the terms “we,” “us” and “our” refer to Tal BH or any of its affiliate or subsidiary entities.

By your use of the Website, “you” and “your” (the person using this Website on behalf of yourself, as well as on behalf of any other person or entity on whose behalf of for whose benefit you are using the Website) agree to the terms of and accept the practices described in this Privacy Policy, including any changes to the Privacy Policy.

Information Collected

The type of information collected on this Website will depend upon the features and functionalities available and that you access on this Website. For example, portions of this Website may operate as a “read-only” website, meaning we do not collect any personal information about you and will not learn who you are.

On the other hand, portions of this Website may permit you to “request more information,” “create an account,” or take similar actions, which means we will collect information from you that can be used to specifically identify you as an individual (such as your name, telephone number, postal address, and email address, collectively “Personal Data”). This Website also may collect aggregated information that is not linked to any specific individual such as information about traffic patterns on the Website, or the number of times a specific page was viewed in a particular month. We may use and share aggregate, de-identified, and anonymous data without restriction as it does not identify you or any other individual user.

Personal Data, Use, & Sharing

We use the collected information primarily for our own internal purposes, such as providing, maintaining, and improving our services and Website, and fulfilling requests for information.

If portions of this Website permit you to request more information, create an account, or take similar actions, and if you choose to take such actions, then we will ask you to provide us with certain Personal Data about yourself. It is always your choice whether you wish to provide Personal Data through this Website.

Personal Data may be combined with other information we receive through other methods, such as from you in-person if you visit one of our facilities. Personal Data will not be sold or given to third parties for marketing purposes without your express written permission.

We reserve the right to share your Personal Data with third parties if we determine, in our sole discretion, that such action is necessary to comply with legal requirements or with legal process served upon us, or to protect the safety of you, members of the public, other users of this Website, or any other person, or to protect Tal BH or any of its affiliate or subsidiary entities’ rights.

Use of Cookies

We use “cookies” on this Website to function effectively. A cookie is a piece of data stored on a Website visitor’s hard drive to help us improve your access to our Website and understand which content is most popular. Cookies can enable us to track and target the interests of our users to enhance the experience on our Website. Usage of a cookie is in no way linked to any personally identifiable information on our Website.

Public Forums

This Website, now or in the future, may include public forums such as message boards, bulletin boards, chat rooms, or similar activities through which users of the Website can communicate with one another. THIS PRIVACY POLICY DOES NOT PROTECT YOU WHEN YOU USE PUBLIC FORUMS OR PROVIDE INFORMATION (INCLUDING PERSONALLY IDENTIFIABLE INFORMATION) ABOUT YOURSELF. Ultimately, you are solely responsible for maintaining the secrecy of your personal information. Please be careful and responsible whenever you are sharing information online.

Links to Other Websites

This Website may contain links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other site that collects personally identifiable information.

Children’s Privacy

We are committed to protecting the privacy of children. Our Website is not designed for or directed toward children under the age of 17. Tal BH, including its affiliate and subsidiary entities shall not be liable for any unauthorized use of the Website by minors. Please contact us if you believe a child under the age of 13 has provided Personal Data to this Website without parental consent.

Consent

By using this Website, you consent to the collection and use of information as specified above. If we make changes to our Privacy Policy, we will post those changes on this page. Please review this page frequently to remain up-to-date with the information we collect, how we use it, and under what circumstances we disclose it. You must review and new or updated Privacy Policy carefully to make sure you understand our practices and procedures.

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If you feel that we are not abiding by this Privacy Policy, you should contact us immediately:

Casey Papp, Corporate Compliance Counsel

Office Address: 25201 Chagrin Blvd Suite 390, Beachwood, OH 44122

Email Address: info@talbh.com

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TAL BH NOTICE OF PRIVACY PRACTICES

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.

1. Your Information

While receiving care in one of our facilities, our healthcare practitioners make several notes in your electronic health record to document your care. Typically, this record contains things like your symptoms, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all the records of your care generated or received by MSRCOne, LLC d/b/a Tal BH (“Tal”).

2. Our Uses and Disclosures
How do we typically use or share your health information? We typically use or share your health information in the following ways:

Treatment. We can use your health information and share it with other professionals who are treating you or supervising your treating professional.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Running our organization. We can use and share your health information to run our facility, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Billing for our services. We can use and share your health information to bill and get payment from health plans or other entities for services we provided.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes.

To help with public health and safety issues. We can share health information about you for certain situations, including, but not limited to, preventing disease, reporting suspected abuse, neglect, or domestic violence, and/or preventing or reducing a serious threat to anyone’s health or safety.

PROPRIETARY & CONFIDENTIAL 1 Notice of Privacy Practices:

To conduct research. We can use or share your information for health research.
To comply with the law. We will share information about you if state or federal laws require it.

To respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.
For work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
To address workers’ compensation, law enforcement, and other government requests.
To respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.

We will not share any substance use disorder treatment records without your written permission. With very few exceptions as required by law, we will not use or disclose your psychotherapy notes (private notes of a mental health professional marked separately from your medical record).

3.WE NEVER MARKET OR SELL PERSONAL INFORMATIONOur Responsibilities

We are required by law to maintain the privacy and security of your health records.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and give you ac opy of it.

We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

In certain circumstances, we may be required by law to ask you to sign a written authorization form should we need to release your health records to certain third parties.

Your Rights

4.You have the right to request the following from us:

A paper or electronic copy of your medical record. You can ask to see or get a paper or electronic copy of your medical record and other health information we have about you.

PROPRIETARY & CONFIDENTIAL 2 Notice of Privacy Practices TAL BH

We will provide a copy or a summary of your health information, as expeditiously as possible.

Ask us to correct your medical record. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we will tell you why in writing within sixty (60) days.
Confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes”to all reasonable requests.
Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care or our operations.Additionally, if you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of our operations with your health insurer.
A list of those with whom we have shared information. You can ask for a list (accounting) of the times we have shared your health information for 6 years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within twelve (12) months.
A copy of this privacy notice. You can ask for a paper copy of this notice at any time. We will provide you with a paper copy promptly.
Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information below:
Tal BH
Attention: Casey Papp, Corporate Compliance CounselPhone: 571-774-9887

If we are unable to satisfactorily resolve your concern, you can file a complaint with theU.S. Department of Health and Human Services Office for Civil Rights by sending a letterto 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696- 6775, orvisiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against youfor filing a complaint.

PROPRIETARY & CONFIDENTIAL 3 Notice of Privacy Practices Tal BH

5.For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have the choice to tell us to: (i) Share information with your family, close friends, or others involved in your care; (ii) Share information in a disaster relief situation; and/or (iii) Include your information in a hospital directory.

If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In the following cases, we never share your information unless you give us written permission: (i) Marketing to you; (ii) Sale for your information; and (iii) Most sharing of psychotherapy notes.

In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.

Record Destruction. Your records will only be destroyed in a manner that protects your confidentiality, such as by incineration or shredding.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office. If you have any questions, you can contact us at the address below:

Tal BH

25201 Chagrin Blvd Suite 390, Beachwood, OH 44122

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