HIPAA Notice of Privacy Practices

This notice describes the privacy practices of [LLC Legal Name]'s home care agency (care.avensahealth.com) with respect to Protected Health Information (PHI) we create or receive while providing care.

• For treatment: coordinating your care among your caregivers, care coordinator, and any physicians you authorize us to communicate with.
• For payment: billing Medicaid, insurance, or you directly for services provided.
• For health care operations: quality assessment, staff training, and compliance activities.
• As required by law: for example, mandatory reporting to CDPHE or in response to a valid legal process.

Any use beyond these categories requires your written authorization, which you may revoke at any time.

• Get a copy of your health and billing records
• Correct your health and billing records
• Request confidential communication
• Ask us to limit what we use or share
• Get a list of those we've shared your information with
• Get a copy of this privacy notice
• Choose someone to act on your behalf
• File a complaint if you believe your privacy rights have been violated

You may file a complaint with our Privacy Officer at [privacy officer contact], or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

We reserve the right to change this notice and to make the revised notice apply to health information we already have as well as any we receive in the future. The current notice is always available on this page and, on request, in writing at intake.

This notice is effective as of [effective date].