For individuals suffering from ADHD & other adult mood disorders
Dr. Jacob Moussai psychiatry
Do you suffer from anxiety, depression, ADHD or low self-esteem? Are you stuck in an unwanted repetitive pattern or struggling to find a healthy relationship? I'll work with you to shift gears and overcome obstacles that are holding you back. I tailor the treatment to meet your individual needs, whether that's psychotherapy or a combination of therapy and medication. I am a board-certified psychiatrist, completing my training at Yale School of Medicine. I'll provide a comprehensive evaluation and an integrated approach to care, building on your existing strengths.
My approach includes evidence-based psychotherapies like Cognitive Behavioral Therapy (CBT) to address issues of depression and anxiety. I also employ more practical treatments for depression, ADHD and anxiety. I have extensive clinical experience in anxiety, depression, ADHD, OCD, Post-traumatic Stress Disorder (PTSD), eating disorders, marital/relationship conflicts and issues related to low self-esteem. Previously, I was an Associate Clinical Professor of Psychiatry at UCLA School of Medicine as well as an Assistant Clinical Professor at Keck-USC School of Medicine. I am currently taking on new clients and I look forward to working with you.
Phone
(310) 775-1866
Location
420 South Beverly Drive
Suite 100
Beverly Hills, CA 90212
info@drmoussai.com
Established patients can book and manage appointments using our online scheduling portal:
Mental Health Links
The following links are listed to provide you with additional online mental health care information and counseling resources. Note: We are not responsible for the content, claims or representations of the listed sites.
Dr. Moussai's podcast on medications - Help Me Be Me with Sarah May B.
Addiction & Recovery
Alcoholics Anonymous
Alcoholics Anonymous Recovery Resources
Center for On-Line Addiction
Sexual Addiction Anonymous
Anxiety Disorders
Answers to Your Questions About Panic Disorder
National Center for PTSD
Obsessive Compulsive Disorder
Attention-Deficit Hyperactivity Disorder
ADDA - Attention Deficit Disorder Association
Attention-Deficit Hyperactivity Disorder, NIH
Dr. Moussai’s podcast on ADHD – Psych Sessions
Depression
Suicide Awareness and Hotlines
Eating Disorders
Mental Health Care General Links
Let’s Talk Facts, APA
Mental Health Counselor Resources, About.com
Mental Help Net
PsychCentral.com
About Dr. Jacob Moussai, M.D.
Dr. Moussai is an expert in the field of adult psychiatry, with an emphasis in mood disorders, depression, anxiety and adult ADHD. is board certified by the American Board of Psychiatry and Neurology. He completed his residency at Yale School of Medicine’s psychiatry program with additional training in neurobehavior and is a former Associate Professor of psychiatry at UCLA School of Medicine, Department of Psychiatry and a former Assistant Clinical Professor at USC Keck School of Medicine, Department of Psychiatry.
He was also the Medical Director of the Post Deployment Clinic at the VA Medical Center and has been featured on Fox News Channel in 2012 for his work with our returning combat veterans. He has been recognized by his peers and his patients for his outstanding work and has been voted “Top Psychiatrist” and featured in Super Doctors directory.
In addition to his clinical work, he is also actively involved with teaching medical students and psychiatry residents. Dr. Moussai is also an Independent Medical Evaluator and providers expert testimony on various psychiatric topics and is a Qualified Medical Evaluator for the state of California.
He has been recognized for seven years in a row as "Southern California Super Doctors"
Professional Experience
• Jacob Moussai MD INC: Expertise in individual evaluation for ADHD, depression, anxiety and life-management skills (2008 - present)
• Expertise in legal testimony, Qualified Medical Evaluator
• Associate Clinical Professor of Psychiatry at UCLA David Geffen School of Medicine's Department of Psychiatry (2008 - 2016)
• Assistant Clinical Professor of Psychiatry at USC School of Medicine's Department of Psychiatry (2016 - 2020)
• Former Medical Director of Post Deployment Clinic at West Los Angeles Veteran Affairs Medical Center (2009 - 2016)
For Dr. Moussai's complete Curriculum Vitae, click here to download.
Featured On:
Should I see a psychiatrist? 2017
ABOUT LEYLA MALLAK, PMHNP
Leyla Mallak is a dedicated Psychiatric Nurse Practitioner, board-certified by the American Nurses Credentialing Center. She completed her education at Charles R. Drew University of Medicine and Science in California. Leyla holds a steadfast belief that everyone, regardless of age, gender, or background, may require support for their mental well-being at some point in their lives. She emphasizes that seeking help is a sign of strength amidst life's complexities, not a display of weakness.
Beyond her professional endeavors, Leyla enjoys spending time on the beach, going on hikes, and expressing her creativity through painting.
ABOUT MELANIE JIMENEZ, PMHNP
Melanie is a board-certified Psychiatric Mental Health Nurse Practitioner with eight years of nursing experience. She earned her Bachelor of Science in Nursing from California State University, San Marcos, and has worked as a Registered Nurse at Huntington Hospital and UCLA. Her dedication to psychiatric care emerged from personal experiences and a keen recognition of the gaps in mental health services.
Melanie obtained a Master’s degree in Nursing from Maryville University. She specializes in medication management and has extensive experience treating patients with conditions such as depression, anxiety, ADHD, PTSD, and mood disorders. She finds great fulfillment in working closely with her patients, assisting them in managing their conditions and navigating their treatment journey with confidence.
• Comprehensive initial evaluation
• Integrated treatment plan including possible herbal supplements and mindfulness tools
• Psychopharmacology (Medication management)
• Individual psychotherapy
• Couples/Marital therapy
• Legal testimony (Independent Medical Evaluator)
• Qualified Medical Evaluator – State of California
• Guest speaker on various psychiatric topics
• Cognitive Behavioral Therapy
• Psychodynamic psychotherapy
• Supportive therapy
• Bereavement/loss
• Attention Deficit Hyperactivity Disorder (ADHD/ADD)
• Depression
• Anxiety
• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Panic Disorder
• Insomnia
• Self-esteem issues
• Anger/Irritability
• Work-related stress
• Marital discord
• Grief
• Eating disorders
• Coping skills
• Relationship issues
• Sleep / insomnia
Contact
420 South Beverly Drive
Suite 100
Beverly Hills, CA 90212
T: 310 775 1866
E: info@drmoussai.com
We also provide virtual (telemedicine) appointments for established and new patients.
Questions?
Just call us at (310) 775-1866 and we'll be happy to answer or fill out the inquiry form below.
Established patients can book and manage appointments using our online scheduling portal:
Insurances accepted
Aetna
ComPsych
UnitedHealth (Optum)
Cigna
Anthem
RATES
Initial comprehensive medical and psychiatric evaluation: $395
Follow-up (30 minute) medication management visit: $225
Follow-up (60 minute) psychotherapy and medication management visit: $325
SMS consent and phone numbers will never be shared with third parties or affiliates under any circumstances
Jacob Moussai MD’s Privacy Notice only applies to Jacob Moussai MD Websites and Services that link to or reference this Notice. Additional information on our personal information practices may be provided in supplemental terms and conditions, supplemental privacy statements, or notices provided prior to or at the time of data collection.
Please read this Privacy Notice carefully. By using and/or accessing our Websites, Apps and Services, you acknowledge that you have read and understood this Privacy Notice. This Notice is not, however, a contract and does not create any legal rights or obligations.
How We Gather Personal Information
We may collect personal information from or about you in a variety of ways.
We collect your personal information when you actively provide it to us. For example, users directly give us personal information when signing up for an account and communicating with our office.
CATEGORIES OF PERSONAL INFORMATION WE COLLECT AND USE
As used in this Notice, “personal information” or “personal data” means any information or data relating to an identified or identifiable natural person or household that we process in connection with our Websites and Services; an identifiable natural person or household is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person or household.
We and our third-party marketing service providers may also use the information customers send to us for our marketing purposes, if this is in accordance with your marketing preferences and applicable law. However, you may opt out of marketing communications from us by using the “unsubscribe” link within each email or by following the opt-out process described in the SMS communications. For further information, see the "Unsubscribe from our mailing List" section below.
Lawful basis for processing personal information
When we collect personal information from you in connection with offering our Services, our lawful basis for collecting and using the personal information described above will depend on the personal information concerned and the specific context in which we collect it.
We will normally collect personal information from you where we need the personal information to perform a contract with you (i.e. to provide the Services), or where the processing is in our legitimate interests and not overridden by your data protection interests or fundamental rights and freedoms. In some cases, we may also have a legal obligation to collect the personal information in question (i.e. Service Usage Data) or we may process your personal information where we have your consent to do so.
If we ask you to provide personal information to comply with a legal requirement or enter into a contract with you, we will make this clear at the relevant time and advise you whether the provision of your personal information is mandatory or not (as well as of the possible consequences if you do not provide your personal information).
Similarly, if we collect and use your personal information in reliance on our or a third party's legitimate interests and those interests are not already listed above (see the "Personal Information We Collect and Use" section), we will make clear to you at the relevant time what those legitimate interests are.
If you have questions about or need further information concerning the legal basis on which we collect and use your personal information, please contact us using the contact details provided under the "Contact Us" section below.
SHARING AND DISCLOSURE OF PERSONAL INFORMATION TO THIRD PARTIES
We will not rent or sell personal information about you. We may share and disclose personal information that we collect (as identified in the "Personal Information We Collect and Use" section) with the following third parties either with Your consent, or for business or legal purposes and in accordance with applicable law:
Jacob Moussai MD
YOUR PRIVACY RIGHTS
Update and access to your information
Where we process personal information collected via our Website for our own account management, and billing and where required by applicable law, we provide individuals with the opportunity to access, review, modify, and delete any such personal information that we process.
Unsubscribe from our mailing list
We give you the choice of opting out of our mailing list.
SECURITY
Keeping your information secure is important to us. Like all businesses, we cannot guarantee the security of the personal information we collect and process in connection with our Services. Jacob Moussai MD has no control over or responsibility for the security or privacy policies or practices of other sites on the Internet you might visit, interact with, or from which you might buy products or services, even if you visit them using links from our Website.
CONTACT US
If you have any questions, comments or concerns about this Notice, please e-mail us at info@drmoussai.com or, you can write to us at:
Jacob Moussai MD, Inc.
420 S Beverly Dr. Ste 100-07
Beverly Hills, California 90212
E-MAIL AND TEXT MESSAGE MEDICAL COMMUNICATION
Disclaimer: By providing my phone number to “Jacob Moussai MD”, I agree and acknowledge that “Jacob Moussai MD” may send text messages to my wireless phone number for any purpose. Message and data rates may apply. Message frequency will vary, and you will be able to Opt-out by replying “STOP”. For more information on how your data will be handled please visit our privacy policy below.
Privacy Policy: No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.
Established patients agree to the following:
I am engaging in email/text communication with my physician realizing that, because there is no way to absolutely secure any electronic exchange of information, the probability of compromise of confidentiality of personal medical information is substantially increased compared to face-to-face information exchange. As such, email/text communication on personal medical matters should be limited as possible and reserved for situations not practically allowing for face-to-face communication, but in which the failure to timely inform the patient or their agent on personal medical issues could significantly compromise the patient’s best interests and outcome. No guarantee is made for the timely receipt of email communication, and no guarantee of response is made. Notwithstanding the above, email/text communication should, as much as possible, avoid discussion of highly sensitive medical matters that could be, in the event of an information leak, deleterious personally or publicly to the patient and/or their agents. Such topics best be avoided are medical disability, sexually transmitted diseases, substance abuse, psychiatric conditions, prognoses (medical outcomes), end-of-life conditions or prognostications, disclosure of demise of an individual, and any other matter that reason could suggest might result in unpredictable emotional distress or reaction in the recipient and possibly lead to behavior harmful to the recipient or others. In a word, remote communicating is a minimally controlled circumstance. Language used should be careful, deliberate, and avoid “emotionally charged” terms.
Email/text medical communication is a temporary convenience and intervention, not a substitute for proper face-to face medical encounters. Habitual, ongoing use of email/text for communicating medical information is discouraged in the best interests of medical professionals and patients and their agents. I indicate that I have read the above content and policy of my healthcare provider and I agree to abide by the principles and spirit set forth in this document. I further understand the risks and limitations of transmission of medical information communication electronically, and so release from all and any liability my healthcare provider for any unauthorized disclosure or leak of such information inadvertently to parties outside the intended senders and recipients of such communications. I will not hold responsible the sender of medical information by email for any delays in receiving such communications and resulting harm from such delays. I am aware that when communicating from the workplace some companies consider email “at work company property,” and such messages may be monitored and read by the company’s officials. Furthermore, email sent to your home may be intercepted by others. Email/text sent to your doctor’s office, though directed to a specific individual, may be read by other than the designated recipient since all incoming messages in a medical facility must be reviewed timely, including when a staff member is absent for any reason. Finally, communicating by email/text always exposes both parties to the risk of computer software virus invasion which can jeopardize and destroy databases and software.
I release from any liability for damage from computer viruses my healthcare providers and their staff. I also release my healthcare provider with whom I am communicating voluntarily in medical matters by email/text from any adverse effects such information has on me or my agents that might have been otherwise avoided or lessened by exchange of such information in face-to-face encounters. Taking all of the above into consideration, I wish to engage in email/text communications regarding my personal medical information or that for which I am a responsible agent. I have had an opportunity to ask questions on all the aforementioned and provide my consent freely.
Customer consent SMS and phone numbers will not be shared with third parties.
NOTICE OF PRIVACY PRACTICES
[Jacob Moussai MD 420 S Beverly Drive Suite 100 Beverly Hills CA 90212]
Effective Date:[12/2008]
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.
We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We make a record of the medical care we provide and may receive such records from others. We use these records to provide or enable other health care providers to provide quality medical care, to obtain payment for services provided to you as allowed by your health plan and to enable us to meet our professional and legal obligations to operate this medical practice properly. We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. This notice describes how we may use and disclose your medical information. It also describes your rights and our legal obligations with respect to your medical information. If you have any questions about this Notice, please contact our Privacy Officer listed above.
A. How This Medical Practice May Use or Disclose Your Health Information
This medical practice collects health information about you and stores it in a chart [and on a computer][and in an electronic health record/personal health record]. This is your medical record. The medical record is the property of this medical practice, but the information in the medical record belongs to you. The law permits us to use or disclose your health information for the following purposes:
1. Treatment. We use medical information about you to provide your medical care. We disclose medical information to our employees and others who are involved in providing the care you need. For example, we may share your medical information with other physicians or other health care providers who will provide services that we do not provide. Or we may share this information with a pharmacist who needs it to dispense a prescription to you, or a laboratory that performs a test. We may also disclose medical information to members of your family or others who can help you when you are sick or injured, or after you die.
2. Payment. We use and disclose medical information about you to obtain payment for the services we provide. For example, we give your health plan the information it requires before it will pay us. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to you.
3. Health Care Operations. We may use and disclose medical information about you to operate this medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this information to get your health plan to authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may also share your medical information with our "business associates," such as our billing service, that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your protected health information. We may also share your information with other health care providers, health care clearinghouses or health plans that have a relationship with you, when they request this information to help them with their quality assessment and improvement activities, their patient-safety activities, their population-based efforts to improve health or reduce health care costs, their protocol development, case management or care-coordination activities, their review of competence, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, or their health care fraud and abuse detection and compliance efforts. [Participants in organized health care arrangements only should add: We may also share medical information about you with the other health care providers, health care clearinghouses and health plans that participate with us in "organized health care arrangements" (OHCAs) for any of the OHCAs' health care operations. OHCAs include hospitals, physician organizations, health plans, and other entities which collectively provide health care services. A listing of the OHCAs we participate in is available from the Privacy Official.]
4. [Optional]: Appointment Reminders. We may use and disclose medical information to contact and remind you about appointments. If you are not home, we may leave this information on your answering machine or in a message left with the person answering the phone.]
5. Sign In Sheet. We may use and disclose medical information about you by having you sign in when you arrive at our office. We may also call out your name when we are ready to see you.
6. Notification and Communication With Family. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or, unless you had instructed us otherwise, in the event of your death. In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts. We may also disclose information to someone who is involved with your care or helps pay for your care. If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures, although we may disclose this information in a disaster even over your objection if we believe it is necessary to respond to the emergency circumstances. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
7. Marketing. Provided we do not receive any payment for making these communications, we may contact you to give you information about products or services related to your treatment, case management or care coordination, or to direct or recommend other treatments, therapies, health care providers or settings of care that may be of interest to you. We may similarly describe products or services provided by this practice and tell you which health plans this practice participates in. We may also encourage you to maintain a healthy lifestyle and get recommended tests, participate in a disease management program, provide you with small gifts, tell you about government sponsored health programs or encourage you to purchase a product or service when we see you, for which we may be paid. Finally, we may receive compensation which covers our cost of reminding you to take and refill your medication, or otherwise communicate about a drug or biologic that is currently prescribed for you. We will not otherwise use or disclose your medical information for marketing purposes or accept any payment for other marketing communications without your prior written authorization. The authorization will disclose whether we receive any compensation for any marketing activity you authorize, and we will stop any future marketing activity to the extent you revoke that authorization.
8. Sale of Health Information. We will not sell your health information without your prior written authorization. The authorization will disclose that we will receive compensation for your health information if you authorize us to sell it, and we will stop any future sales of your information to the extent that you revoke that authorization.
9. Required by Law. As required by law, we will use and disclose your health information, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.
10. Public Health. We may, and are sometimes required by law, to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.
11. Health Oversight Activities. We may, and are sometimes required by law, to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by law.
12. Judicial and Administrative Proceedings. We may, and are sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.
13. Law Enforcement. We may, and are sometimes required by law, to disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order, warrant, grand jury subpoena and other law enforcement purposes.
14. Coroners. We may, and are often required by law, to disclose your health information to coroners in connection with their investigations of deaths.
15. Organ or Tissue Donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.
16. Public Safety. We may, and are sometimes required by law, to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
17. Proof of Immunization. We will disclose proof of immunization to a school that is required to have it before admitting a student where you have agreed to the disclosure on behalf of yourself or your dependent.
18. Specialized Government Functions. We may disclose your health information for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.
19. Workers’ Compensation. We may disclose your health information as necessary to comply with workers’ compensation laws. For example, to the extent your care is covered by workers' compensation, we will make periodic reports to your employer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or workers' compensation insurer.
20. Change of Ownership. In the event that this medical practice is sold or merged with another organization, your health information/record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another physician or medical group.
21. Breach Notification. In the case of a breach of unsecured protected health information, we will notify you as required by law. If you have provided us with a current e-mail address, we may use e-mail to communicate information related to the breach. In some circumstances our business associate may provide the notification. We may also provide notification by other methods as appropriate. [Note: Only use e-mail notification if you are certain it will not contain PHI and it will not disclose inappropriate information. For example if your e-mail address is "digestivediseaseassociates.com" an e-mail sent with this address could, if intercepted, identify the patient and their condition.]
22. Psychotherapy Notes. We will not use or disclose your psychotherapy notes without your prior written authorization except for the following: 1) use by the originator of the notes for your treatment, 2) for training our staff, students and other trainees, 3) to defend ourselves if you sue us or bring some other legal proceeding, 4) if the law requires us to disclose the information to you or the Secretary of HHS or for some other reason, 5) in response to health oversight activities concerning your psychotherapist, 6) to avert a serious and imminent threat to health or safety, or 7) to the coroner or medical examiner after you die. To the extent you revoke an authorization to use or disclose your psychotherapy notes, we will stop using or disclosing these notes.
B. When This Medical Practice May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, this medical practice will, consistent with its legal obligations, not use or disclose health information which identifies you without your written authorization. If you do authorize this medical practice to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
C. Your Health Information Rights
1. Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information by a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed. If you tell us not to disclose information to your commercial health plan concerning health care items or services for which you paid for in full out-of-pocket, we will abide by your request, unless we must disclose the information for treatment or legal reasons. We reserve the right to accept or reject any other request, and will notify you of our decision.
2. Right to Request Confidential Communications. You have the right to request that you receive your health information in a specific way or at a specific location. For example, you may ask that we send information to a particular e-mail account or to your work address. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
3. Right to Inspect and Copy. You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request detailing what information you want access to, whether you want to inspect it or get a copy of it, and if you want a copy, your preferred form and format. We will provide copies in your requested form and format if it is readily producible, or we will provide you with an alternative format you find acceptable, or if we can’t agree and we maintain the record in an electronic format, your choice of a readable electronic or hardcopy format. We will also send a copy to any other person you designate in writing. We will charge a reasonable fee which covers our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an explanation or summary. We may deny your request under limited circumstances. If we deny your request to access your child's records or the records of an incapacitated adult you are representing because we believe allowing access would be reasonably likely to cause substantial harm to the patient, you will have a right to appeal our decision. If we deny your request to access your psychotherapy notes, you will have the right to have them transferred to another mental health professional.
4. Right to Amend or Supplement. You have a right to request that we amend your health information that you believe is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information, and will provide you with information about this medical practice's denial and how you can disagree with the denial. We may deny your request if we do not have the information, if we did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is. If we deny your request, you may submit a written statement of your disagreement with that decision, and we may, in turn, prepare a written rebuttal. All information related to any request to amend will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.
5. Right to an Accounting of Disclosures. You have a right to receive an accounting of disclosures of your health information made by this medical practice, except that this medical practice does not have to account for the disclosures provided to you or pursuant to your written authorization, or as described in paragraphs 1 (treatment), 2 (payment), 3 (health care operations), 6 (notification and communication with family) and 18 (specialized government functions) of Section A of this Notice of Privacy Practices or disclosures for purposes of research or public health which exclude direct patient identifiers, or which are incident to a use or disclosure otherwise permitted or authorized by law, or the disclosures to a health oversight agency or law enforcement official to the extent this medical practice has received notice from that agency or official that providing this accounting would be reasonably likely to impede their activities.
6. Right to a Paper or Electronic Copy of this Notice. You have a right to notice of our legal duties and privacy practices with respect to your health information, including a right to a paper copy of this Notice of Privacy Practices, even if you have previously requested its receipt by e-mail.
If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact our Privacy Officer listed at the top of this Notice of Privacy Practices.
D. Changes to this Notice of Privacy Practices
We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we are required by law to comply with the terms of this Notice currently in effect. After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received. We will keep a copy of the current notice posted in our reception area, and a copy will be available at each appointment. [For practices with websites add: We will also post the current notice on our website.]
E. Complaints
Complaints about this Notice of Privacy Practices or how this medical practice handles your health information should be directed to our Privacy Officer listed at the top of this Notice of Privacy Practices.
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:
[local DHHS Office of Civil Rights] OCRMail@hhs.gov
The complaint form may be found at www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf. You will not be penalized in any way for filing a complaint.