The entities and individuals covered by this Notice are referred to collectively as “CookUnity” (“we,” “us,” or “our”). The healthcare professionals who provide services through CookUnity are independent providers who practice within multiple independently owned professional practices.
This Notice of Privacy Practices (this “Notice”) explains how we may use and disclose medical records, billing records, and other health information that we use to make decisions about you (“Protected Health Information” or “PHI”). It also describes your rights with respect to your PHI, our legal obligations regarding your information, and how you may access your PHI.
Your Rights
We recognize that information about your health is highly sensitive, and we are committed to protecting the privacy and security of your PHI. PHI is protected health information as defined under federal law, including the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and its implementing regulations. We believe individuals should have meaningful
control over their health information, and you have the following rights with respect to your PHI.
Except as described in this Notice, we will not use or disclose your PHI without your written authorization.
You have the right to:
Get an electronic or paper copy of your medical record
You may request to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will provide a copy or summary of your health information within the time required by applicable state law.
Request corrections to your medical record
You may ask us to correct health information that you believe is incorrect or incomplete. We may deny your request, but we will provide you with a written explanation within sixty (60) days.
Request confidential communications
You may ask that we communicate with you about your PHI in a specific manner or at a different address (for example, sending mail to an alternate location). Reasonable requests will be accommodated.
Request restrictions on use or disclosure
You may ask us to limit how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to all requests and may decline if the restriction would interfere with your care. If you pay for a healthcare service in full out-of-pocket, you may LEGAL\114008603\1 request that we not disclose related information to your health plan for payment or healthcare operations purposes. We will honor this request unless disclosure is required by law.
Receive an accounting of disclosures
You may request a list of certain disclosures of your PHI made during the six (6) years prior to your request, including to whom the information was disclosed, when, and for what purpose. Disclosures for treatment, payment, and healthcare operations, as well as certain other disclosures (such as those made at your request), are excluded. One accounting per year is provided at no cost; additional requests within a twelve (12) month period may be subject to a reasonable, cost-based fee.
Obtain a copy of this Notice
If you received this Notice electronically or via our Website, you are entitled to receive a paper copy upon request.
File a complaint
If you believe your privacy rights have been violated, you may file a complaint with us by emailing [CookUnity’s privacy email address] or by writing to the address listed in the “Contact Us” section below. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mailing a letter to:
200 Independence Avenue, S.W.,
Washington, D.C. 20201,
calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
We will not retaliate against you for filing a complaint.
Your Choices
For certain types of health information, you have choices about how we share your PHI. If you have a preference regarding disclosures in the situations described below, please let us know and we will follow your instructions.
You may direct us to:
● Share information with family members, close friends, or others involved in your care
● Share information during disaster relief efforts
If you are unable to communicate your preferences (for example, if you are unconscious), we may disclose your PHI if we determine it is in your best interests. We may also disclose PHI as necessary to reduce a serious and imminent threat to health or safety.
We will not use or disclose your PHI without your written authorization for:
● Marketing activities
● Sale of your PHI
● Most disclosures of psychotherapy notes
Uses and Disclosures Without Your Written Authorization
In certain circumstances, we are permitted to use and disclose your PHI without your written authorization. Unless your PHI qualifies as and applicable law imposes additional restrictions, we may use and disclose PHI for the purposes described below.
“Highly Confidential Information” includes certain categories of health information that receive enhanced protection under state or federal law, such as substance use disorder treatment records, mental health records, reproductive health information, and other specially protected health data. Where required, we will obtain your authorization before disclosing Highly Confidential
Information unless disclosure is otherwise permitted by law.
Permitted Uses and Disclosures
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare, including sharing information with other healthcare professionals involved in your treatment. We may also share information with your health plan for care coordination activities.
Payment and Billing
We may use and disclose your PHI to bill for services and obtain payment from health plans, insurers, or other responsible parties.
Healthcare Operations
We may use and disclose PHI for our healthcare operations, including quality assessment, practice management, service improvement, and necessary communications related to your care.
Health Information Exchanges
We may participate in health information exchanges (“HIEs”) to electronically share PHI for treatment, payment, and healthcare operations with other participating providers and organizations. Participation in HIEs may be subject to opt-in or opt-out rights under applicable state law.
Disclosure to Family and Caregivers
We may disclose PHI to a family member, friend, or other person involved in your care if you agree, do not object after being given an opportunity to do so, or if we reasonably infer your consent. If you are unavailable, we may exercise professional judgment and disclose information that is directly relevant to that person’s involvement in your care.
Public Health and Safety Activities
We may disclose PHI for public health purposes, including reporting diseases, injuries, adverse events, abuse or neglect, workplace-related health conditions, or potential exposure to communicable diseases.
Victims of Abuse, Neglect, or Domestic Violence
We may disclose PHI to appropriate authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence.
Health Oversight Activities
We may disclose PHI to health oversight agencies responsible for monitoring the healthcare system and compliance with government programs such as Medicare or Medicaid.
Serious Threats to Health or Safety
We may disclose PHI as necessary to prevent or lessen a serious and imminent threat to your health or safety or that of others.
Law Enforcement and Legal Proceedings
We may disclose PHI as required by law, in response to court orders or subpoenas, or for law enforcement purposes.
Military, National Security, and Other Government Functions
We may disclose PHI to authorized federal officials for lawful intelligence, national security, or military activities.
Research
We may use or disclose PHI for research purposes as permitted by law, subject to applicable privacy safeguards. In most cases, we will obtain your authorization unless an Institutional Review Board or privacy board approves the research with appropriate protections in place.
Decedents
We may disclose PHI to coroners, medical examiners, or funeral directors as authorized by law. Workers’ Compensation
We may disclose PHI as necessary to comply with workers’ compensation or similar programs.
Business Associates
We may share PHI with third-party service providers who perform functions on our behalf, such as IT services, billing, auditing, or communications. These business associates are required by contract to protect the privacy and security of your PHI.
Uses and Disclosures Requiring Your Written Authorization
Except as described above, we will use or disclose your PHI only with your written authorization. Examples include the following:
Marketing.
We are required to obtain your written authorization before using or disclosing your PHI for marketing purposes, as defined under HIPAA. For example, we will not receive payment from third parties in exchange for communicating with you about treatments, therapies, healthcare providers, settings of care, care coordination, products, or services unless you have authorized such communications or they are otherwise permitted by law. Certain communications, such as refill reminders or information about medications or biologics currently prescribed to you, may be permitted without authorization where any payment received is reasonably related to the cost of making the communication. We may also engage in face-to-face marketing communications and provide promotional items of nominal value without obtaining your written authorization, as allowed by law.
Sale of Protected Health Information.
We will not sell your PHI without your written authorization.
Our Responsibilities
We are required by law to maintain the privacy and security of your PHI. We will notify you promptly if a breach occurs that compromises the privacy or security of your
information. We are required to follow the terms of this Notice currently in effect and to provide you with a copy upon request. We will not use or disclose your PHI other than as described in this Notice unless you authorize us to do so in writing. You may revoke such authorization at any time by notifying us in writing.
For additional information about HIPAA privacy rights, please visit:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to This Notice
We may revise this Notice from time to time. Any changes will apply to all PHI we maintain, including information created or received prior to the effective date of the revised Notice. If we update this Notice, we will post the revised version on our Websites. You may also request a current copy by contacting us using the information provided below.
Contact Us
For all inquiries, requests for records, special requests, or to file a complaint, you can email us
at support@cookunity.com or write to us at the following address:
630 flushing ave NY, NY11206