Wellbrook Health Privacy Policy

This Notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Your health records contain personal information about you and your health. This information may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to as Protected Health Information ("PHI"). This Notice of Privacy Practices describes how your provider may use and disclose your PHY in accordance with applicable law. It also describes your rights regarding how you may gain access to and control your PHI.

Under that Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Wellbrook Health is required to maintain the privacy of PHI and provide you with notice of his or her legal duties and privacy practices with respect to PHI. Wellbrook Health is required to abide by the terms of this Notice and reserves the right to change the terms of this Notice at any time. Any new Notice will be effective for all PHI that your provider maintains at that time. Your provider will provide you with a copy of the revised Notice of Privacy Practices by sending a copy to you upon request.

HOW WELLBROOK HEALTH MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

For Treatment: Your PHI may be used and disclosed by Wellbrook Health and those involved in your care for the purpose of providing, coordinating, or managing your healthcare treatment and related services. This includes consultation with clinical supervisors or other treatment team members. Your provider may disclose PHI to any individual or party only with your authorization.

For Payment: Wellbrook Health may use and disclose PHI to receive payment for services provided to you, such as making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, only the minimum amount of PHI necessary for purposes of collection will be disclosed.

For Healthcare Operations: Wellbrook Health may use or disclose, as needed, your PHI to support business activities including but not limited to quality assessments or other business activities. For example, your PHI may be shared with contracted third parties required to safeguard the privacy of your PHI. Your PHI may be used to contact you for appointment reminders or information about your treatment or other health-related communications.

Required by Law: Under the law, Wellbrook Health must make disclosures of your PHI upon your request. Disclosures must be made to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining compliance with the requirements of the Privacy Rule.

Without Authorization: Applicable law and ethical standards permit Wellbrook Health to disclose information about you without your authorization only in a limited number of other situations. The types of uses and disclosures that may be made without your authorization are those that are:

- Required by Law, such as the mandatory reporting of child abuse or neglect or elder abuse, or mandatory government agency audits or investigations.

- Required by Court Order

- Necessary to prevent or lessen a serious imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

Verbal Permission: Wellbrook Health may use or disclose your information to family members directly involved in your treatment with your verbal permission.

With Authorization: Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization, which may be revoked.

YOUR RIGHTS REGARDING YOUR PHI:

You have the following rights. To exercise any of these rights, please submit your request in writing to Wellbrook Health:

- Right of Access to Inspect and Copy: In most cases, you have the right to inspect and copy PHI that may be used to make decisions about your care. Your right to inspect and copy PHI will be restricted only in situations where there is compelling evidence that access would case serious harm to you.

- Right to Amend: If you feel that the PHI your provider has about you is incorrect or incomplete, you may ask for it to be amended, although your provider is not required to agree to the amendment.

- Right to an Accounting of Disclosures: Your have the right to request an accounting of certain disclosures that your provider makes of your PHI.

- Right to Request Restrictions: You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment or healthcare operations. Your provider is not required to agree to your request.

- Right to Request Confidential Communication: You have the right to request your provider communicate with you about medical matters in a certain way or certain location.

- Right to a Copy of this Notice: You may ask your provider for a paper copy of this notice at any time.

COMPLAINTS

If you believe your privacy rights have been violated, your may submit a complaint with Wellbrook Health and with the Federal Government. Filing a complaint will not affect your right to further treatment. To file a complain with Wellbrook Health, email contact@mywellbrook.com. To file a complaint with the Federal Government, contact:

Secretary of the US Department of Health and Human Services

200 Independence Ave, SW

Washington, DC 20201

(202) 619-0257