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Notice of Privacy Practices

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: January 10, 2021

Delphi Behavioral Health Group (Delphi) is required by law to maintain the privacy of your health information in accordance with federal and state law. Delphi is required by law to maintain the privacy and confidentiality of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Delphi will protect the privacy and security of your substance use disorder patient records in accordance with 42 U.S.C. § 290dd–2 and 42 C.F.R. Part 2, the Confidentiality of Substance Use Disorder Patient Records (“Part 2”), in addition to HIPAA and applicable state law.  These regulations protect the confidentiality of information relating to the treatment of any patient in a drug or alcohol treatment program. 

This Notice of Privacy Practices (“Notice”) outlines our legal duties and privacy practices with respect to health information. We are required by law to provide you with a copy of this Notice and to notify you following a breach of your unsecured health information. Delphi may not disclose records relating to your treatment without your written consent, except in narrowly limited circumstances. Under 42 CFR Part 2, the terms of a written consent to disclose information must specify the scope and types of information to be disclosed, the parties to whom the information may be disclosed, the purpose of the disclosure and the timeframe of the consent. You may revoke a consent to disclose information relating to drug and alcohol verbally or in writing at any time.

Delphi may disclose treatment information without your written consent under certain narrow circumstances as permitted by 42 CFR Part 2. Delphi is permitted to use and disclose treatment information internally to entities with which it shares administrative control, qualified service organizations that agree to maintain the confidentiality of the information, auditors, regulatory agencies, and evaluators and for certain research purposes. Delphi may also disclose treatment information without your written consent when necessary in a life-threatening medical emergency, to report a crime on the premises or against an employee, where the state mandates child abuse and neglect reporting, when cause of death is being reported, or by a valid court order. 

Delphi will abide by the terms of the Notice. Delphi reserves the right to make changes to this Notice as permitted by law and the right to make the new Notice provisions effective for all health information we currently maintain, as well as any health information we receive in the future. If we make material or important changes to our privacy practices, we will promptly revise our Notice. Should our privacy practices change, we will provide all current and future patients with a copy of the revised Notice of Privacy Practices.

You have the right to file a complaint if you believe your privacy rights have been violated. If you would like to file a complaint about our privacy practices, please direct to:

Delphi Compliance, 1901 W. Cypress Creek Road, 5th Floor, Ft. Lauderdale, FL 33309 or by email at compliance@delphihealthgroup.com. You also have the right to complain to the Secretary of the United States Department of Health and Human Services, the United States Attorney for the judicial district in which the violation occurs, and the Substance Abuse and Mental Health Services Administration (SAMHSA) office responsible for opioid treatment program oversight. Delphi shall not retaliate against any patient filing a complaint in any way.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION:

This section describes your rights regarding the health information we maintain about you. All requests or communications to exercise your rights discussed below must be submitted in writing to Delphi Compliance, 1901 W. Cypress Creek Road, 5th Floor, Ft. Lauderdale, FL 33309 or by email at compliance@delphihealthgroup.com.

Right to Inspect and Copy. You have the right to inspect and receive a copy of your health information, excluding your psychotherapy notes. Your written, signed request must clearly identify such designated person or entity and where you would like us to send the copy. We may deny your request to inspect and copy in limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed by a licensed health care professional chosen by us. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Request Confidential Communications. You have the right to request that we communicate your health information to you in a certain manner or at a certain location

Right to Amend. You have a right to request that Delphi amend health information that is incorrect or incomplete. If Delphi determines not to amend the health information, it will provide you with an explanation of the reason for the denial and your rights to disagree with the denial.

Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures we make of your health information. Your request must state a time period which may not go back further than six years. Please note that an accounting will not apply to any of the following types of disclosures: disclosures made with your written consent for reasons of treatment, payment or health care operations; disclosures made to you or your legal representative, or any other individual involved with your care. You will not be charged for your first accounting request in any 12-month period. 

Right to Request Restrictions. You have a right to request restrictions on otherwise permitted uses and disclosures of your health information. Delphi is not obligated to comply with such requests.

Right to a Paper Copy of This Notice. You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive this Notice electronically. 

CONTACT INFORMATION:

If you have questions or concerns about your privacy rights, or the information contained in this Notice, please contact the Delphi Compliance, 1901 W. Cypress Creek Road, 5th Floor, Ft. Lauderdale, FL 33309 or compliance@delphihealthgroup.com 

Contact Info

(844) 326-4514
info@serenityatsummit.com
3500 Quakerbridge Road
Hamilton, NJ 08619

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