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.
Effective Date: May 20, 2026 HIPAA Notice Required by 45 C.F.R. § 164.520
Addiction Outreach Clinic (“AOC,” “we,” “us,” or “our”) is required by law to maintain the privacy of your Protected Health Information (PHI), to provide you with this Notice of our legal duties and privacy practices with respect to your PHI, and to abide by the terms of the notice currently in effect. If you have any questions about this Notice, please contact us using the information at the bottom of this page.
Section 1
What Is Protected Health Information?
Protected Health Information (PHI) is any individually identifiable health information that we create, receive, maintain, or transmit in connection with your care. This includes information about your health condition, the treatment and services we provide to you, and payment for your care, in any format, including paper, electronic, and oral communications.
Examples of PHI include your name combined with diagnoses, treatment records, prescription information, test results, appointment history, billing records, and any other information that could identify you as a patient of Addiction Outreach Clinic.
Section 2
How We May Use and Disclose Your PHI
The following categories describe the ways we may use and disclose your PHI. Not every use or disclosure in a category will be listed, but all of the ways we are permitted to use and disclose information will fall within one of these categories.
Permitted Without Your Authorization
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your medical treatment and related services, including sharing information with other providers involved in your care (e.g., referring physicians, pharmacies, or labs).
Payment. We may use and disclose your PHI to bill and collect payment for the services we provide. This includes submitting claims to your health insurance, verifying coverage, and obtaining prior authorizations.
Healthcare Operations. We may use and disclose your PHI for our internal operations, such as quality assessment and improvement, staff training, compliance and legal activities, accreditation, and business planning.
As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law, including reporting to public health authorities and oversight agencies.
Public Health Activities. We may disclose PHI to public health authorities authorized to receive such information for disease prevention or control, reporting adverse events related to medications, and similar activities.
Health Oversight Activities. We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure.
Serious Threat to Health or Safety. We may use or disclose PHI to prevent or lessen a serious and imminent threat to the health or safety of a person or the public when disclosure is to someone reasonably able to prevent or lessen the threat.
Law Enforcement. Under certain circumstances required or permitted by law, we may disclose PHI to law enforcement officials.
Facility Directories. If you are treated at our facility, we may include certain limited information (name, general condition) in a facility directory unless you object.
Workers’ Compensation. We may disclose PHI as authorized or required by workers’ compensation laws.
Decedents. We may disclose PHI to a coroner, medical examiner, or funeral director as authorized by law.
Substance Use Disorder Records — Additional Protections
Because Addiction Outreach Clinic provides substance use disorder treatment services, certain records related to your substance use disorder treatment may be subject to additional federal confidentiality protections under 42 C.F.R. Part 2. These records generally may not be disclosed without your written consent, except in limited circumstances such as medical emergencies or as required by a court order. We will inform you if these additional protections apply to your records.
Uses and Disclosures That Require Your Written Authorization
In all other situations not described above — including most marketing communications, sale of your PHI, or disclosures for purposes not described in this Notice — we will obtain your written authorization before using or disclosing your PHI. You may revoke any authorization you have given us in writing at any time. Please note that revocation does not apply to actions we have already taken in reliance on your authorization.
Section 3
Your Rights Regarding Your PHI
You have the following rights with respect to the PHI we maintain about you. To exercise any of these rights, please submit a written request to our Privacy Officer using the contact information below.
Right to Access & Copies
You have the right to inspect and obtain a copy of your PHI, including medical and billing records. We may charge a reasonable, cost-based fee for copies.
Right to Amend
You have the right to request an amendment to your PHI if you believe it is inaccurate or incomplete. We may deny the request in certain circumstances and will explain why.
Right to Restrict Use
You may request that we restrict how we use or disclose your PHI. We are not required to agree, except for certain disclosures to health plans when you have paid in full out-of-pocket.
Right to Confidential Communications
You may request that we communicate with you about your PHI in a different way or at a different location (e.g., call you only at work). We will accommodate reasonable requests.
Right to Accounting of Disclosures
You have the right to receive a list of disclosures of your PHI we have made for purposes other than treatment, payment, and healthcare operations, for the past 6 years.
Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice of Privacy Practices at any time, even if you have agreed to receive it electronically. Contact us to request one.
Section 4
Our Duties
We are required by law to maintain the privacy and security of your Protected Health Information.
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 provide you with a copy 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 by letting us know in writing.
We may change the terms of this Notice. We will post the new Notice on our website and, upon your request, will provide you with a revised paper copy at your next visit. Changes apply to PHI we already have about you as well as any information we receive in the future.
Section 5
How to File a Complaint
If you believe your privacy rights have been violated, you have the right to file a complaint with Addiction Outreach Clinic or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.
To file a complaint with Addiction Outreach Clinic: contact our designated Privacy Officer, Sharra Atanasoff, Executive Director at 330-259-4849.
To file a complaint with HHS: Visit www.hhs.gov/ocr/privacy/hipaa/complaints/ or call 1-800-368-1019 (TDD: 1-800-537-7697). You may also mail a complaint to: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201.