Notice of Privacy Practices

We are committed to protecting clients’ privacy and required by federal law to maintain the privacy of medical and behavioral health information about our clients, which is information that identifies or could be used to identify our clients. We are required to provide you with this Notice of Privacy Practices which explains our legal duties and privacy practices and our clients’ rights regarding health information that we collect and maintain.

Client Rights

Clients and their legal representative have certain rights explained below. To exercise these rights, please submit a written request to the address noted below.

Inspect and copy of the client’s medical record.
  • You can ask for an electronic or paper copy of the client’s medical record and other health information we have about the client. We may charge you a reasonable fee.
  • We may deny your request if it believes the disclosure will endanger your life or another person’s life. You may have a right to have this decision reviewed.
Amend the client’s medical record.
  • You can ask to correct any health information you believe is incorrect or incomplete. We may require you to make your request in writing and provide a reason for the request.
  • We may deny your request but will send a written explanation for the denial and allow you to submit a written statement of disagreement.
Request confidential communications.
  • You can ask us to contact you in a specific way. We will say “yes” to all reasonable requests.
Limit what is used or shared.
  • You can ask us not to use or share certain health information for treatment, payment, or business operations. We are not required to agree if it would affect client care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share client health information with your health insurer.
  • You can ask for us not to share client health information with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.
  • We never market or sell personal information
Obtain a list with whom we’ve shared information.
  • You can ask for a list, called an accounting, of the times your health information has been shared. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.
Receive a copy of this Notice.
  • You can ask for a paper copy of this Notice, even if you have agreed to receive the Notice electronically.
Choose someone to act for the client.
  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights.
File a complaint
  • If you feel we have violated client rights, contact us using the following information:
    By Mail:
    Forte Behavioral Health LLC
    2139 Glendon Ave
    Los Angeles, CA 90025
    Attn: Privacy OfficerBy Phone:
    1-888-260-1621By Email:
    [email protected]
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints/
  • For services funded by educational agencies or institutions, you can file a written complaint with the Family Policy Compliance Office, U.S. Department of Education, 400 Maryland Avenue, S.W., Washington, D.C. 20202.
  • We will not retaliate against you or the client for filing a complaint.
To opt out of receiving fundraising communications.
  • We may contact you for fundraising efforts, but you can ask not to be contacted again.

OUR USES AND DISCLOSURES

Routine Uses and Disclosures of Client Health Information

We are permitted under federal law to use and disclose health information, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. We typically use or share client health information in the following ways:

To treat the client.
  • We can use and share client health information with other professionals who are treating the client.
  • Example: A behavioral therapist requests notes about the client from a behavioral interventionist.
To run our health care operations.
  • We can use and share client health information to run the business, improve the client’s care, and contact you.
  • Example: We use clients health information for the treatment and services provided to the client.
To bill or receive payment for services.
  • We can use and share clients’ health information to bill and receive payment from health plans or other entities.
  • Example: We provide client health information to their health insurance plan to receive payment for the client services.

We may use or disclose client’s health information without authorization or an opportunity to object, including;

Help with public health and safety issues
  • Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.
  • Required by the Secretary of Health and Human Services: We may be required to disclose client health information to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
  • Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
  • If it is known, or we have reason to suspect, that a child under 18 has been abused, abandoned, or neglected by a parent, legal custodian, caregiver, or any other person responsible for the child’s welfare.
  • If we believe there is a clear and immediate probability of physical harm to the client, to other individuals, or to society, we may be required to disclose information to take protective action, including communicating the information to the potential victim, and/or appropriate family member, and/or the police or to seek hospitalization of the patient.
Comply with law, law enforcement, or other government requests
  • Required by law: If required by federal, state or local law.
  • Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.
  • Law enforcement: For law locate and identify you or disclose information about a victim of a crime.
  • Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.
  • National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons or foreign heads of state, for purpose of determining your own security clearance and other national security activities authorized by law.
  • Workers’ Compensation: To comply with workers’ compensation laws or support claims.
Uses and Disclosures of Client Health Information Based Upon Client Written Authorization

We must obtain client written authorization through a separate Release of Information document to use and/or disclose health information for the following purposes:

  • Collaboration with other health care professionals treating you, release of any information contained in psychotherapy notes and your patient file, and marketing.
  • Clients may revoke authorization, at any time, by contacting us in writing, using the information above. We will not use or share client health information other than as described in Notice unless you give your permission in writing.

Uses and Disclosures of Client’s Health Information That May Be Made With Authorization or Opportunity to Object Unless objection, we may disclose client health information:

To the client’s family, friends, or others if the client’s health information directly relates to the involvement in the client’s care, and the client or client’s legal representative signed a separate Release of Information giving written permission to do so.
If it is in our client’s best interest because the client is unable to state their preference.

OUR RESPONSIBILITIES

  • We are required by law to maintain the privacy and security of client’s health information.
  • We are required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs client health information, we will abide by the more stringent law.
  • We reserve the right to amend this Notice. All changes are applicable to client health information collected and maintained by us. Should we make changes, our client or client’s legal representative may obtain a revised Notice by requesting a copy from us, using the information above, or by viewing a copy on the website https://fortebh.com/privacy
  • We will inform you if a client’s health information is compromised in a breach.

This Notice is effective on September 24, 2022

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