Who Is Covered By This Notice

This Notice applies to Meridian Health, Inc. and the licensed providers who review patient intakes on the Meridian platform (collectively, "Meridian"), to the extent they are Covered Entities or Business Associates under the Health Insurance Portability and Accountability Act (HIPAA).

Your Protected Health Information (PHI)

Protected Health Information (PHI) is information about you — including demographic data — that can be used to identify you and that relates to your past, present, or future physical or mental health condition, the provision of health care to you, or payment for that health care.

How We May Use and Disclose Your PHI

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and any related services. For example, we share your intake information with the licensed provider assigned to review your case, and we share prescription information with NABP-verified pharmacy partners who fill your prescriptions.

Payment

We may use and disclose your PHI for payment activities, such as processing your membership payments and coordinating with pharmacy partners for medication billing.

Health Care Operations

We may use and disclose your PHI for our health care operations, including quality assessment and improvement, clinical training, audit, compliance, and business management activities.

Uses and Disclosures Requiring Your Authorization

Certain uses and disclosures require your written authorization, including:

• Marketing purposes
• Sale of PHI
• Most uses and disclosures of psychotherapy notes
• Other uses not permitted under HIPAA

You may revoke your authorization in writing at any time, except where we have already relied on your authorization.

Other Permitted Disclosures

We may also use or disclose your PHI without your authorization as permitted by law, including:

• As required by law (court orders, law enforcement, public health authorities)
• To report suspected abuse or neglect as required by state law
• For public health activities required by law
• To avert a serious and imminent threat to health or safety
• For workers' compensation as required by law
• To business associates who have signed a HIPAA Business Associate Agreement with us

Your Rights Regarding Your PHI

Right to Access

You have the right to request access to your PHI. We will provide a copy or summary of your PHI, usually within 30 days of your request. We may charge a reasonable, cost-based fee for copies.

Right to Amend

If you believe your PHI is incorrect or incomplete, you may request that we amend it. We may deny the request if we did not create the information or if we determine the information is accurate and complete.

Right to an Accounting of Disclosures

You have the right to request an accounting of disclosures of your PHI made in the prior six years, except for disclosures for treatment, payment, and health care operations.

Right to Request Restrictions

You may request that we restrict certain uses or disclosures of your PHI. We are not required to agree, except that we must agree to a request to not disclose PHI to your health plan for a specific service if you pay out of pocket in full.

Right to Confidential Communications

You may request that we communicate with you about your health matters in a specific way or at a specific location. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time. Contact us at privacy@northmarkhealth.com to request one.

Our Duties

We are required by law to maintain the privacy of your PHI, to provide you with this Notice, and to follow the terms of the Notice currently in effect. We reserve the right to change this Notice and the terms of how we handle your PHI. If we make a material change, we will notify you and post the new Notice on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with Meridian or with the U.S. Department of Health and Human Services Office for Civil Rights:

• Meridian: privacy@northmarkhealth.com
• HHS OCR: hhs.gov/hipaa/filing-a-complaint

You will not be retaliated against for filing a complaint.

Contact Our Privacy Officer

For questions or to exercise your rights:
Privacy Officer, Meridian Health, Inc.
Email: privacy@northmarkhealth.com
Mailing address: [Address] · [City, State, ZIP]