HIPPA Novice of Privacy Policy

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Peak Midlife Solutions LLC 2804 W Northern Lights Blvd Anchorage, AK 99517 Phone: (907) 312-5345 Email: peakmidlifesolutions@gmail.com

Effective Date: July 12, 2025

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

Peak Midlife Solutions LLC is dedicated to maintaining the privacy of your protected health information (PHI). PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services. This Notice of Privacy Practices describes how we may use and disclose your PHI to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI.

How We May Use and Disclose Your Protected Health Information

The following categories describe different ways that we use and disclose your PHI. For each category, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment: We may use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we may disclose your PHI to a specialist as part of a referral.

For Payment: We may use and disclose your PHI so that the treatment and services you receive at our practice may be billed to and payment may be collected from you, an insurance company, or a third party. As you are a cash-only practice, this will be limited, but may apply if you seek reimbursement from an insurer.

For Health Care Operations: We may use and disclose your PHI for our health care operations. These uses and disclosures are necessary to run our practice and make sure that all of our patients receive quality care. For example, we may use your PHI to review our treatment and services and to evaluate the performance of our staff in caring for you.

Other Permitted and Required Uses and Disclosures

We may use or disclose your PHI in the following situations without your authorization. These situations include:

• As Required By Law: We will disclose your PHI when required to do so by federal, state, or local law.
• Public Health: For public health activities, such as controlling disease, injury, or disability.
• Health Oversight: To a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
• Abuse or Neglect: To a public health authority that is authorized by law to receive reports of child abuse or neglect.
• Legal Proceedings: In response to a court order, subpoena, discovery request, or other lawful process.
• Law Enforcement: To a law enforcement official for law enforcement purposes, such as to identify or locate a suspect, fugitive, material witness, or missing person.
• Coroners, Medical Examiners, and Funeral Directors: To a coroner or medical examiner for identification purposes, determining cause of death, or for the coroner or medical examiner to perform other duties authorized by law.
• Organ and Tissue Donation: If you are an organ donor, to an organization that handles organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
• Research: Under certain circumstances, for research purposes.
• To Avert a Serious Threat to Health or Safety: To prevent a serious threat to your health and safety or the health and safety of the public or another person.
• Military and Veterans: If you are a member of the armed forces, as required by military command authorities.
  • Workers’ Compensation: To the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
• Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, to the correctional institution or law enforcement official.

Uses and Disclosures Requiring Your Written Authorization
Except for the uses and disclosures described in this Notice, we will not use or disclose your PHI without your written authorization. You may revoke an authorization at any time by submitting a written revocation to our Privacy Officer, except to the extent that we have already relied on the authorization.

Marketing and Sale of PHI
We may contact you to provide appointment reminders or information about treatment alternatives and health‑related benefits and services. Such communications are considered “health care operations” and do not require your authorization. However, any other marketing communications or the sale of your PHI will occur only with your written authorization.

Your Rights Regarding Your Protected Health Information

You have the following rights regarding PHI we maintain about you:

• Right to Inspect and Copy: You have the right to inspect and copy your PHI. To inspect and copy your PHI, you must submit your request in writing to our Privacy Officer.
• Right to Amend: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to our Privacy Officer.
• Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of your PHI for purposes other than treatment, payment, and health care operations. To request this list, you must submit your request in writing to our Privacy Officer.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer.
• Right to a Paper Copy of This Notice: You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
• Right to Breach Notification
  You have the right to be notified if we (or one of our Business Associates) discover a breach of your unsecured PHI, as required by law.

Changes to This Notice

We reserve the right to change 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 in our practice and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact our Privacy Officer. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

You also have the right to file a complaint with the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services. You may submit a complaint online at https://www.hhs.gov/ocr/privacy/hipaa/complaints or send it to:
    U.S. Department of Health & Human Services
    200 Independence Avenue, S.W.
    Room 509F, HHH Building
    Washington, D.C. 20201

Contact Information

If you have any questions about this notice, please contact:

Privacy Officer: Kari Ivany Peak Midlife Solutions LLC 2804 W Northern Lights Blvd Anchorage, AK 99517 Phone: (907) 312-5345 Email: peakmidlifesolutions@gmail.com