Notice of Privacy Practices

Our Commitment to Your Privacy

ThriveWell Health ("we," "us," "our," or "the Practice") is dedicated to providing integrated primary care and mental health services to patients of all ages. We are required by law to maintain the privacy of your protected health information ("PHI"), to provide you with this Notice of our legal duties and privacy practices, and to notify you following a breach of unsecured PHI.

We are required to abide by the terms of this Notice while it is in effect. If we make a material change, we will post the revised Notice on our website and make copies available at our office.

1. How We May Use and Disclose Your Health Information

We may use and disclose your PHI without written authorization for:

• Treatment — coordinating your primary care and mental health/medication management, and sharing information with pharmacies, labs, or specialists involved in your care.
• Payment — billing and collecting payment, including submitting insurance claims and verifying coverage.
• Health Care Operations — quality assessment, staff training, credentialing, and business planning.

Other permitted or required uses/disclosures without authorization include: as required by law; public health activities; health oversight activities; judicial/administrative proceedings; limited law enforcement purposes; averting a serious threat to health or safety (including duty-to-warn obligations under North Dakota law); workers' compensation; coroners/medical examiners/funeral directors; organ/tissue donation; limited research; and military/national security/government purposes.

Special Protections for Mental Health and Substance Use Records

Certain information — including psychotherapy notes and, where applicable, substance use disorder treatment records protected under 42 CFR Part 2 — receives additional legal protection. In most cases we will obtain your specific written authorization before using or disclosing psychotherapy notes or substance use disorder treatment records.

Uses and Disclosures Requiring Your Written Authorization

Other than as described above, we will not use or disclose your PHI without your written authorization, including for marketing purposes, sale of your PHI, and most disclosures of psychotherapy notes. You may revoke authorization at any time, except to the extent we have already relied on it.

2. Your Rights Regarding Your Health Information

• Right to Inspect and Copy your medical and billing records (a reasonable, cost-based fee may apply).
• Right to Request Amendment if you believe information is incorrect or incomplete.
• Right to an Accounting of Disclosures made by the Practice, with certain exceptions.
• Right to Request Restrictions on how we use or disclose your PHI.
• Right to Request Confidential Communications (e.g., a specific phone number or mailing address).
• Right to a Paper Copy of this Notice at any time.
• Right to Choose Someone to Act on Your Behalf, such as a person with medical power of attorney or legal guardianship.
• Right to File a Complaint without retaliation.

To exercise any of these rights, submit a written request to our Privacy Officer using the contact information below.

3. Our Compliance and Responsibilities

We are required by law to maintain the privacy and security of your PHI, notify you promptly of any breach, and never use or share your information beyond what's described here without your written authorization. Staff and business associates who handle PHI on our behalf are required to protect it under written agreements consistent with HIPAA. We maintain administrative, physical, and technical safeguards for any electronic health records, patient portal, or online appointment systems we use.

4. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

To file a complaint with ThriveWell Health:
Privacy Officer, ThriveWell Health
3210 27th St W STE 104, Williston, ND 58801
Phone: (701) 503-3778 · Email: hello@thrivewellhealthnd.com

To file a complaint with HHS:
U.S. Department of Health and Human Services, Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
www.hhs.gov/ocr/privacy/hipaa/complaints/

5. Contact Information

Privacy Officer, ThriveWell Health
3210 27th St W STE 104, Williston, ND 58801
Phone: (701) 503-3778 · Email: hello@thrivewellhealthnd.com

Patients will be asked to sign an acknowledgment confirming receipt of this Notice at their first visit. See our Patient Acknowledgment Form.