HIPAA Notice of Privacy Practices
Effective Date: May 9, 2026
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.
Our Promise to You
We understand that your medical and personal information is private. We are committed to protecting your health information and maintaining the confidentiality of your records.
We will never market or sell personal information.
We will not share your mental health treatment records without your written consent unless it is for treatment or another law requires us to share the information.
We will not use or share your information other than as described in this Notice unless you tell us we can in writing.
Our Responsibilities
We are required by law to:
Maintain the privacy and security of your protected health information (“PHI”)
Provide you with this Notice of Privacy Practices
Follow the duties and privacy practices described in this Notice
Notify you if a breach occurs that may compromise the privacy or security of your information
We reserve the right to revise this Notice and make updated versions effective for all protected health information we maintain.
How We May Use and Disclose Your Information
Treatment
We may use and disclose your health information to provide, coordinate, or manage your psychiatric care.
Examples include:
Communicating with your therapist, primary care physician, pharmacy, or other healthcare providers involved in your care
Reviewing prior treatment records
Consulting with other healthcare professionals regarding your treatment
Payment
We may use and disclose your information to obtain payment for services provided.
Examples include:
Processing payments
Providing superbills or documentation requested by you for out-of-network reimbursement
Collecting unpaid balances
Healthcare Operations
We may use and disclose your information for practice operations necessary to run our practice.
Examples include:
Quality assessment and improvement
Practice management and administration
Legal and compliance activities
Training and business operations
Uses and Disclosures Requiring Authorization
We will obtain your written authorization before:
Sharing psychotherapy notes when required by law
Using your information for marketing purposes
Selling your information
Making disclosures not otherwise described in this Notice
You may revoke an authorization at any time in writing, except to the extent action has already been taken.
Special Protections for Substance Use Disorder Information (42 CFR Part 2)
Some records relating to substance use disorder diagnosis, treatment, or referral may be protected under federal law, including 42 CFR Part 2.
When applicable, these records receive additional confidentiality protections beyond those provided under HIPAA.
In general:
Substance use disorder records protected under 42 CFR Part 2 will not be used or disclosed without your written consent unless otherwise permitted or required by law.
Federal law may prohibit redisclosure of certain substance use disorder records unless expressly permitted by your written consent or by law.
Violations concerning these records may be reported to appropriate federal authorities.
Part 2-protected records may be disclosed without your consent only in limited circumstances permitted by law, including:
Medical emergencies
Certain public health activities
Scientific research
Audits and evaluations
Court orders meeting federal requirements
Other disclosures specifically authorized by law
Uses and Disclosures Without Authorization
We may disclose your information without authorization when permitted or required by law, including:
Emergencies and Safety
To prevent a serious threat to your health or safety or the safety of others
When emergency intervention is necessary
Abuse or Neglect
Reporting suspected abuse, neglect, or domestic violence as required by law
Public Health Activities
Reporting information required by public health authorities
Legal Proceedings
Responding to court orders, subpoenas, or lawful legal processes
Law Enforcement
When required or permitted by law
Telehealth
If services are provided via telehealth, reasonable safeguards will be used to protect the privacy and security of your information. However, electronic communications may involve certain security risks.
Your Rights
You have the right to:
Request access to or copies of your medical record, subject to limited exceptions permitted by law
Request corrections to your records if you believe information is incorrect or incomplete
Request confidential communications
Request restrictions on certain uses or disclosures of your information
Request an accounting of certain disclosures
Obtain a paper or electronic copy of this Notice
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Marisol Mental Health
301-500-5417
You may also file a complaint with the U.S. Department of Health and Human Services.
You will not be retaliated against for filing a complaint.
Contact Information
If you have questions regarding this Notice or your privacy rights, please contact:
Vedrana Hodzic, MD
Privacy Officer, Marisol Mental Health
301-500-5417