Legal Notices and Disclaimers / Terms and Conditions of Use
Welcome to the Helios website (the "site") . The following terms and conditions of use (the "terms") shall govern all use of the "site" and serve as disclaimer.
You shall not substitute any information on the Helios site for medical or professional advice.
The Helios website provides general information about Dr. Jennifer Dore's medical practice as well as educational materials. The information is not intended to be, and should not be used as, a substitute for medical treatment by a healthcare professional.
Dr. Dore does not make any diagnosis on the basis of any of the content contained on this site. You should not assume any information on this site is up to date or directly applies to your condition. You should not disregard concerns or delay in seeking medical attention based on any of this site's content.
This site may at time link to other sites or scholarly articles. These links are provided for educational benefit only and are not under the control of Dr. Dore or the Helios website. Dr. Dore can assume no liability or responsibility for the content contained on any other website. Please do not assume a link to any site to be an endorsement by Dr. Dore of the contents of that site.
You are responsible for your use of the Helios website. Your use of the Helios website constitutes your agreement to these terms and any modifications to these terms made by Dr. Dore.
PRIVACY NOTICE
Your Information. Your Rights. Our Responsibilities.
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.
YOUR RIGHTS
You have the right to:
• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated
YOUR CHOICES
You have some choices in the way that we use and share information as we:
• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds
OUR USES AND DISCLOSURES
We may use and share your information as we:
• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions
YOUR RIGHTS
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
YOUR CHOICES
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes
In the case of fundraising:
• We may contact you for fundraising efforts, but you can tell us not to contact you again.
OUR USES AND DISCLOSURES
HOW DO WE TYPICALLY USE OR SHARE YOUR HEALTH INFORMATION?
We typically use or share your health information in the following ways.
Treat you
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
HOW ELSE CAN WE USE OR SHARE YOUR HEALTH INFORMATION?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
OUR RESPONSIBILITIES
• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Open Payments Database NOTICE - Effective Jan 1, 2023
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.
https://openpaymentsdata.cms.gov
Controlled Substance Utilization Review and Evaluation System (CURES) - California’s Prescription Drug Monitoring Program
The State of California maintains a database of all controlled substances prescribed. Pharmacies are mandated to report prescriptions of controlled substances to this database and all physicians are mandated to check this database in the course of treatment of any patient.
If you and your Helios provider determine that a controlled substance should be part of your treatment plan, the pharmacy will report this to the State of California’s Controlled Substance Database (CURES) and future or current medical providers will have access to this information.
Patients should be aware of the existence of the CURES database and how it is used by your provider, the Medical Board of California and other law enforcement entities. Your provider uses CURES to assure individual safety and prevent diversion of controlled substances and is required by law to check CURES in the course of treatment to assure compliance with state and federal laws. That having been said, as a patient you maintain certain critical rights when it comes to your privacy and disclosure of those confidential medical records which extend beyond prescriptions for controlled substances.
Your Rights When Your Medical Records are Requested by a Regulatory Agency or Law Enforcement
Patients are reminded that any request to release your medical records should not be taken lightly, nor agreed to without careful consideration. Should you sign a release of records Helios will in most cases be obligated to provide them to whichever individual or entity is listed on the release. Regardless of how a request is worded, patients are reminded that they have a Constitutional right to privacy and may opt to decline any and all requests to share their medical records. Patients are encouraged to consult with legal council or their provider if they have questions or concerns regarding the request.
CHANGES TO THE TERMS OF THIS NOTICE
WE CAN CHANGE THE TERMS OF THIS NOTICE, AND THE CHANGES WILL APPLY TO ALL INFORMATION WE HAVE ABOUT YOU. THE NEW NOTICE WILL BE AVAILABLE UPON REQUEST, IN OUR OFFICE, AND ON OUR WEBSITE.
• Effective July 13, 2018, Revised January 1, 2023
• Posted by Blair Dore, Director of Wellness, Privacy Officer, blair@heliospsychiatry.com, ph: 650-275-2302
• Helios Psychiatry & Wellness respects your privacy. We never market or sell personal information. We will never share any substance abuse treatment records without your written permission
NOTICE TO PATIENTS Medical doctors are licensed and regulated by the Medical Board of California. To check up on a license or to file a complaint go to www.mbc.ca.gov, email: licensecheck@mbc.ca.gov, or call (800) 633-2322
Call (650) 275-2302 or Email info@heliospsychiatry.com for more information or to make an appointment