Notice of Privacy Practices (HIPPA)
Effective Date: 04/15/2026
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.
At Gallant Minds Psychiatry, we are committed to protecting the privacy and confidentiality of your Protected Health Information (PHI). This Notice of Privacy Practices outlines our legal duties and privacy practices regarding your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
1. Our Pledge Regarding Your Health Information
We understand that health information about you and your mental health is personal. We are required by law to:
- Maintain the privacy of your PHI.
- Provide you with this notice of our legal duties and privacy practices.
- Notify you following a breach of unsecured PHI.
- Abide by the terms of the Notice currently in effect.
2. How We May Use and Disclose Your PHI
We may use and disclose your PHI for the following purposes:
- For Treatment: We may use your PHI to provide, coordinate, or manage your psychiatric care and related services.
- For Payment: We may use and disclose your PHI to bill and collect payment for the services we provide to you. We partner with Headway to manage insurance claims, billing, and administrative tasks, and your PHI is securely shared with them for these purposes.
- For Health Care Operations: We may use and disclose your PHI to run our practice, improve your care, and contact you when necessary.
- As Required by Law: We will disclose your PHI when required to do so by federal, state, or local law, including reporting suspected abuse, neglect, or domestic violence.
- To Avert a Serious Threat to Health or Safety: We may use and disclose your PHI to prevent a serious threat to your health and safety or the health and safety of the public or another person.
3. Your Privacy Rights
You have the following rights regarding the PHI we maintain about you:
- Right to Inspect and Copy: You have the right to inspect and receive a copy of your medical and billing records.
- Right to Amend: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information.
- Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we made of your PHI.
- 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. (Note: We are not legally required to agree to all requests).
- 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.
4. Changes to This Notice
We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have, as well as any information we receive in the future.
5. 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. You will not be penalized for filing a complaint.
Contact Information:
To exercise any of your rights or file a complaint, please contact our Privacy Officer:
Ann-Marie Anthony, PMHNP-BC
Gallant Minds Psychiatry
108 Watchung Avenue, #1010, Plainfield, NJ 07060
Email: [email protected]
Phone: +1 (640) 204-5246
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