Effective Date: March 2nd, 2025
This Notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.
Our Legal Duty
Dope Health is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this Notice of Privacy Practices, and to abide by the terms of this Notice currently in effect. We are also required to notify you if a breach occurs that may have compromised the privacy or security of your PHI.
How We May Use and Disclose Your Information
We may use and disclose your PHI for the following purposes, as permitted or required by law:
Treatment: We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes consultation with other healthcare providers involved in your care.
Payment: We may use and disclose your PHI to obtain reimbursement for services provided to you, to determine eligibility for insurance coverage, and to coordinate benefits.
Healthcare Operations: We may use and disclose your PHI for healthcare operations, including quality assessment, staff training, business planning, and administrative activities necessary to operate our practice.
As Required by Law: We may disclose your PHI when required to do so by federal, state, or local law, including for public health reporting, reporting of abuse or neglect, responding to court orders, or cooperating with law enforcement investigations.
Other Permitted Uses and Disclosures: Your PHI may also be disclosed for organ and tissue donation, medical examiner or funeral director purposes, workers’ compensation claims, oversight activities authorized by law, and in situations of serious threat to health or safety. Other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke such authorization in writing at any time, except to the extent that we have already relied upon it.
Your Rights Regarding Your Information
You have the following rights with respect to your PHI:
–Right to Access: You have the right to inspect and obtain a copy of your medical record in paper or electronic form, subject to limited exceptions.
–Right to Amend: If you believe your medical information is incorrect or incomplete, you may request an amendment. We may deny your request under certain circumstances, but we will provide a written explanation if we do.
–Right to an Accounting of Disclosures: You have the right to receive a list of certain disclosures of your PHI made by Dope Health in the six years prior to your request.
–Right to Request Restrictions: You may request limitations on the use or disclosure of your PHI. While we are not required to agree to all requested restrictions, we will comply with restrictions related to services paid in full out-of-pocket.
–Right to Confidential Communications: You may request that we contact you by alternative means (such as at a different address or phone number). We will accommodate reasonable requests.
–Right to a Copy of This Notice: You are entitled to a paper or electronic copy of this Notice upon request.
–Right to File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice at any time. Any revisions will apply to all PHI that we maintain, including information created or received before the change. A current copy of this Notice will always be available on our website at http://www.dopehealth.com/privacy.
Contact Information
If you have questions about this Notice, or if you wish to exercise your rights described herein, please contact:
Privacy Officer – Dope Health
Tiffany Jory
tiffany@dopehealth.com