HIPAA Notice

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 Commitment to Your Privacy

Serene Urgent Care and Mind Clinic (“Serene,” “we,” “us,” “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, and to notify you following a breach of your unsecured PHI. We are required to follow the terms of this Notice while it is in effect.

This Notice applies to all patients treated at Serene, including patients receiving urgent care, family primary care, and mental health / mind clinic services.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care, including sharing information with other providers involved in your care (for example, referring you to a specialist).

Payment

We may use and disclose your PHI to obtain payment for services, including billing your insurance, Medi-Cal, or Medicare, and verifying coverage or eligibility.

Health Care Operations

We may use and disclose your PHI for internal operations such as quality improvement, staff training, and business planning.

Appointment Reminders & Health-Related Communications

We may contact you by phone, mail, email, or text message (if you have opted in) to remind you of appointments or share information about treatment alternatives or health-related services.

Individuals Involved in Your Care

With your permission, or when it is in your best interest and you have not objected, we may share relevant information with a family member, friend, or other person involved in your care or payment for care.

As Required by Law

We will disclose PHI when required by federal, state, or local law, including:

  • Public health activities (e.g., disease reporting, vaccine adverse events)
  • Reporting suspected abuse, neglect, or domestic violence
  • Health oversight activities (audits, investigations, licensure)
  • Judicial and administrative proceedings, in response to a valid court order or subpoena
  • Law enforcement purposes, under limited circumstances defined by law
  • To avert a serious and imminent threat to health or safety
  • Workers’ compensation, as authorized by law

Special Protections for Mental Health Information

Records related to mental health treatment are subject to additional confidentiality protections under California law (including the Lanterman-Petris-Short Act). Psychotherapy notes, if created and maintained separately by a mental health provider, receive heightened protection under HIPAA and generally require your specific written authorization before they are used or disclosed, even for most treatment, payment, or operations purposes.

All Other Uses and Disclosures

Any use or disclosure not described in this Notice will be made only with your written authorization. You may revoke that authorization in writing at any time, except to the extent we have already relied on it.

Your Rights Regarding Your Health Information

You have the right to:

  • Request Restrictions — Ask us to limit how we use or disclose your PHI for treatment, payment, or operations. We are not required to agree, except where you paid out-of-pocket in full for a service and ask that we not disclose it to your health plan.
  • Request Confidential Communications — Ask that we contact you in a specific way (e.g., a different phone number) or at a different location.
  • Inspect and Copy — Request access to and a copy of your medical and billing records, with limited exceptions.
  • Request Amendment — Ask us to correct your PHI if you believe it is incomplete or inaccurate.
  • Receive an Accounting of Disclosures — Request a list of certain disclosures of your PHI made outside of treatment, payment, and health care operations.
  • Receive a Paper Copy of This Notice — Even if you agreed to receive it electronically, you may request a paper copy at any time.
  • File a Complaint — If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

To exercise any of these rights, contact our Privacy Officer using the information below.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your PHI.
  • 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 give you 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. You may change your mind at any time by letting us know in writing.

Changes to This Notice

We reserve the right to change the terms of this Notice, and the changes will apply to all information we already have as well as information we receive in the future. A revised Notice will be posted at our clinic and on our website, and will be available upon request.

Contact Information / Privacy Officer

If you have questions about this Notice or would like to exercise any of the rights described above, contact:

Privacy Officer

Serene Urgent Care and Mind Clinic
4508 W Imperial Highway, Inglewood, CA 90304
Phone: (310) 431-4558

You may also file a complaint with:

U.S. Department of Health and Human Services, Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201

www.hhs.gov/ocr/privacy/hipaa/complaints