SYHealth HIPAA Notice of Privacy Practices ENG June 2020 - Page 2

OUR PLEDGE TO YOU San Ysidro Health (SYHealth) is committed to protecting your medical, behavior health and personal information from unauthorized use and disclosure. SYHealth is required to give you this Notice to tell you how we use and give out (“disclose”) your health information. SYHealth must follow the terms of the Notice that is currently in effect. 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. Let us know in writing if you change your mind. CHANGES TO SYHEALTH’s PRIVACY PRACTICES AND THIS NOTICE We reserve the right to change SYHealth’s privacy practices and this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you as well as any information we receive in the future. We will post a copy of the current Notice throughout SYHealth. In addition, at any time you may request a copy of the current Notice in effect in your preferred language. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION The health and billing records we maintain are the physical property of San Ysidro Health. The information in it, however, belongs to you. You have a right to: • A copy of this Notice of Privacy Practices (NPP). Although we have posted a copy in prominent locations throughout the clinic sites and on our website, you have the right to request a paper copy. • Inspect and obtain a copy. Again, this right is not absolute. With certain exceptions, you have the right to inspect and/or receive a copy of your Health Information usually within 30 days of your request. If we have the information in electronic format then you have the right to get your health information in electronic format if it is possible for us to do so. We reserve the right to charge a reasonable, cost-based fee for making copies. In certain situations, we can deny access if access would cause harm to yourself or another. • Request an Amendment or Addendum: If you feel that Health Information we have about you is incorrect or incomplete, you may ask us to amend the information or add an addendum (addition to the record). You have the right to request an amendment or addendum for as long as the information is kept by or for SYHEALTH. • Amendment: To request an amendment, your request must be made in writing and submitted to the Medical Records Department - SYHealth – 1601 Precision Park Lane, San Diego, CA 92173. You must be specific about the information that you believe to be incorrect or incomplete and you must provide a reason that supports the request. We may deny your request for an amendment if it is not in writing, we cannot determine from the request the information you are asking to be changed or corrected or your request does not include a reason to support the change or addition. In addition, we may deny your request if you ask us to amend information that: • We did not create the record. We cannot confirm if the information is accurate or not because we are not the source. In such cases, you must seek an amendment/correction from the party creating the record. If they amend or correct the record, we will put the 1 SYHealth | HIPAA - NPP