Privacy Policy & Notice of Privacy Practices
Your privacy matters to us. This notice describes how medical information about you may be used and disclosed, and how you can get access to this information.
Effective date: [Effective Date]
This Notice of Privacy Practices (“Notice”) describes how Elysian Path ABA (“we,” “us,” or “our”) may use and disclose your protected health information (“PHI”) to carry out treatment, payment, and health care operations, and for other purposes permitted or required by law. It also describes your rights regarding your PHI. We are required by the Health Insurance Portability and Accountability Act (“HIPAA”) and applicable Nevada law to maintain the privacy of your PHI and to provide you with this Notice of our legal duties and privacy practices.
Information We Collect
We collect information you provide directly to us (for example, through our contact and client onboarding forms), such as your name, contact details, date of birth, insurance information, emergency contact, and relevant medical history. We also collect limited technical information (such as IP address) for security and to operate our website.
How We May Use and Disclose Your PHI
- Treatment: to provide, coordinate, or manage your ABA services and related care.
- Payment: to bill and obtain payment from you, an insurer, or another third party.
- Health care operations: for quality assessment, staff training, scheduling, and administrative activities.
- As required by law: when federal, state, or local law requires the use or disclosure.
Other uses and disclosures not described in this Notice will be made only with your written authorization, which you may revoke at any time as described below.
Your Rights Regarding Your PHI
- The right to inspect and request a copy of your PHI.
- The right to request an amendment to your PHI you believe is incorrect or incomplete.
- The right to request an accounting of certain disclosures of your PHI.
- The right to request restrictions on certain uses and disclosures.
- The right to request confidential communications (e.g., contacting you at a specific number).
- The right to a paper copy of this Notice upon request.
- The right to revoke a prior authorization, except to the extent we have already acted on it.
- The right to be notified following a breach of unsecured PHI.
How We Protect Your Information
Information submitted through our forms is transmitted over encrypted connections and stored encrypted at rest. Access to PHI is limited to authorized personnel, and access is logged. While we use reasonable administrative, technical, and physical safeguards, no method of transmission or storage is completely secure.
Our Responsibilities
We are required by law to maintain the privacy and security of your PHI, to notify you promptly if a breach occurs that may have compromised the privacy or security of your information, and to follow the duties and privacy practices described in this Notice.
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. The current Notice will be posted on this page with its effective date.
Contact Us / Complaints
If you have questions about this Notice, wish to exercise any of your rights, or believe your privacy rights have been violated, please contact our Privacy Officer at:
- Elysian Path ABA — [Privacy Officer Name]
- Phone: (702) 530-2905
- Email: info@elysianaba.com
- Address: 9750 W Skye Canyon Dr. Suite 160-153, Las Vegas, NV 89166
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.