Hippa Notice

Abiliquest, INC.

Notice of Privacy Practices

Effective Date: May 12, 2024

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Uses and Disclosures of Protected Health Information

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION BASED UPON YOUR WRITTEN CONSENT

Your protected health information may be used and disclosed by Abiliquest, Inc. and its affiliates (collectively, "Abiliquest") and others outside Abiliquest that are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed as necessary to pay health care bills and to otherwise support the operation of Abiliquest.

Set forth below are examples of the types of uses and disclosures of your protected health information that Abiliquest is permitted to make. These examples are not meant to be exhaustive but rather to describe the types of uses and disclosures that may be made by Abiliquest:

Payment: Your protected health information may be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed by our health plan to obtain approval for the hospital admission.

Healthcare Operations: We may use or disclose, as needed, your protected health information to support the normal business activities of Abiliquest. Examples of these activities include, but are not limited to, quality assessment activities, employee review activities, training, licensing, and conducting or arranging for other business activities.

We may need to share your protected health information with certain of our "business associates" or other third parties that perform various activities (e.g., billing, coordinating care, transcribing records) for Abiliquest. Whenever an arrangement between Abiliquest and a business associate involves the use or disclosure of your protected health information, we will have in place the legally required safeguards to protect the privacy of your health information.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION BASED UPON YOUR WRITTEN AUTHORIZATION

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke your authorization at any time, in writing, except to the extent that Abiliquest has taken action in reliance on the use or disclosure indicated in the authorization.

OTHER USES AND DISCLOSURES THAT MAY BE MADE AND TO WHICH YOU MAY AGREE OR OBJECT

Individuals Involved in Your Care or Payment for Your Care: We may disclose your protected health information to a family member, other relative, close personal friend, or any other person you identify. This information is limited to what is directly relevant to the person's involvement in your care or payment related to your care. If you are present and able to agree or object to the disclosure, we will give you the opportunity to do so. If you are not present or are unable to agree or object, we may use our professional judgment to determine whether the disclosure is in your best interest.

Disaster Relief Efforts:We may use or disclose your protected health information to authorized public or private entities to assist in disaster relief efforts and to coordinate notifying your family members of your location and condition. You will have the opportunity to agree or object to such disclosures whenever possible.

Fundraising Activities:We may use certain information to contact you for fundraising activities supported by Abiliquest. This information will be limited to your name, address, phone number, and the dates you received treatment or services. You have the right to opt-out of receiving such communications by following the opt-out instructions in the communication or by contacting us directly.

Your Rights

You have the following rights regarding your protected health information:

Right to Inspect and Copy: You have the right to inspect and obtain a copy of your protected health information that may be used to make decisions about your care. This includes medical and billing records but does not include psychotherapy notes.

Right to Request Amendments: If you feel that the protected health information we have about you is incorrect or incomplete, you may ask us to amend the information. While we may deny your request under certain circumstances, we will inform you of the reason for the denial.

Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we have made of your protected health information.

Right to Request Restrictions: You have the right to request a restriction or limitation on the protected health information we use or disclose for treatment, payment, or health care operations. We are not required to agree to your request, but if we do, we will comply unless the information is needed to provide you emergency treatment.

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.

Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

Complaints

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

Contact Information

For any questions regarding this notice or to exercise any of your rights, please contact us at contact@abiliquest.com

By using the Abiliquest App, you acknowledge that you have read, understood, and agreed to this HIPPA NOTICE.

Last Updated: May 12, 2024