HIPAA Notice of Privacy Practices

HIPAA Notice of Privacy Practices

Notice of Privacy Practices

Effective Date: January 1, 2026

This Notice describes how your protected health information (PHI) may be used and disclosed and explains your rights regarding your medical information. Please review it carefully.

AI and Five, Inc. is committed to protecting the privacy and confidentiality of your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and New York State laws.

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information (PHI).

• Provide you with this Notice of Privacy Practices.

• Follow the terms of this Notice currently in effect.

• Notify you if a breach occurs that may have compromised the privacy or security of your information.

How We May Use and Disclose Your Health Information

We may use or disclose your health information for the following purposes:

Treatment

To provide, coordinate, and manage your healthcare. This may include sharing information with physicians, specialists, hospitals, pharmacies, home health agencies, therapists, laboratories, or other healthcare providers involved in your care.

Payment

To bill and receive payment for healthcare services from you, your insurance company, Medicare, Medicaid, or other payers.

Healthcare Operations

To improve the quality of care we provide, conduct quality assessments, perform administrative functions, train staff, comply with licensing requirements, and operate our practice efficiently.

Other Permitted Uses and Disclosures

We may disclose your health information when permitted or required by law, including:

• Public health reporting

• Health oversight activities

• Reporting abuse or neglect

• Judicial or administrative proceedings

• Law enforcement requests

• Organ and tissue donation

• Workers’ compensation claims

• To prevent a serious threat to health or safety

• As otherwise required by federal or state law

Uses Requiring Your Written Authorization

Certain uses and disclosures require your written authorization, including most uses of psychotherapy notes (if applicable) and certain uses of your information for marketing purposes.

You may revoke your authorization at any time in writing, except to the extent we have already acted upon it.

Your Rights

You have the right to:

• Inspect and obtain a copy of your medical records, subject to applicable law.

• Request corrections to your medical record if you believe information is incorrect or incomplete.

• Request restrictions on certain uses or disclosures of your information.

• Request confidential communications using alternative methods or locations when reasonable.

• Receive an accounting of certain disclosures of your health information.

• Obtain a paper or electronic copy of this Notice upon request.

Our Commitment to Privacy

We maintain administrative, technical, and physical safeguards designed to protect the confidentiality, integrity, and security of your protected health information.

Changes to This Notice

We reserve the right to revise this Notice at any time. Any changes will apply to all protected health information maintained by AI and Five, Inc. The most current version will always be available on our website.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, please contact us.

AI and Five, Inc.

Phone: 917-370-4556

Email: arielnp@aiandfive.com

You also have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. Filing a complaint will not affect the quality of care you receive.

Thank you for trusting AI and Five, Inc. with your healthcare. We are committed to protecting your privacy while providing compassionate, high-quality home-based primary care.