CHIME Therapy’s Notice of Privacy Practices for Members
Effective Date: January 26, 2024
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY CHIME THERAPY AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS DOCUMENT CAREFULLY.
CHIME Therapy LLC (henceforth, “CHIME Therapy”) keeps a record of medical information that you provide to us and medical information related to the health care services we provide to you. Medical information means any information that (1) identifies you and (2) relates to your past, present, or future physical or mental health, treatment, or payment for treatment. Medical information includes your medical history, diagnoses, treatments, current medical condition, and use of prescription medications.
Most CHIME Therapy clients receive therapeutic services from our network of independently contracted licensed therapists (“Providers”), in which case CHIME Therapy acts as a Business Associate under HIPAA, by providing platform and other services on behalf of a Provider, pursuant to a written agreement called a Business Associate Agreement. Some CHIME Therapy clients may receive therapeutic services directly from a CHIME Therapy employee, in which case CHIME Therapy acts in the role of a Covered Entity, under HIPAA. This Notice of Privacy Practices outlines our responsibilities, and your rights and options, when we are acting in either capacity.
If you have any questions about this Notice, please contact us using the contact information listed below.
1. Our Responsibilities
We are required by law to:
maintain the privacy and security of your medical information
assure that you are notified if a breach occurs that may have compromised the privacy or security of your medical information
follow the duties and practices described in this Notice and provide you with a copy
not sell your information without your authorization
2. Our Uses and Disclosures
Pursuant to HIPAA, CHIME Therapy typically uses or shares your medical information for the following purposes, without your written authorization:
Treatment. We use your information to provide you with mental health and related medical services, which you receive from CHIME Therapy directly or from one of our contracted Providers. For example, we may disclose your medical information to therapists and other persons who need the information to provide care to you.
Health Care Operations. We use and share your medical information to run our organization and contact you or your designated and approved contacts when necessary. These uses and disclosures help us operate the CHIME Therapy platform and improve client care. For example, we may use your medical information to review provider performance, comply with laws and regulations, or analyze information to create new models of treatment, so that we can continuously improve the delivery of health care services to you.
Bill for services. We can use and share your medical information
to bill and get payment for services, from you, or from health plans.
For example, we can use and share your payment information with payment
processors or use and share your medical information to bill and get
payment from your insurer.
We may share your medical information in other ways as permitted by HIPAA. For example, we may also use and disclose your medical information without your written authorization as follows:
Business Associates. As a Covered Entity or when acting as a Business Associate, CHIME Therapy also contracts with third parties to perform certain services for us, such as information technology or advisory and accounting services. In some cases, these third-party service providers, also called Business Associates, may need to access your medical information to perform the services. Business Associates are required by law and contract to protect your medical information, and to limit use and disclosure to the services provided on our behalf.
Disclosures to Parents or Legal Guardians. We may release a minor’s medical information to their parents or legal guardians consistent with applicable laws.
Public Health and Safety. We may share your medical information for certain situations such as reporting adverse reactions to medications; reporting suspected abuse, neglect, or violence; or preventing or reducing a serious threat to anyone’s health or safety.
Research. We may use your medical information to conduct research and/or disclose it to researchers with your authorization and/or when the research study is reviewed and approved by an Institutional Review Board before the study begins.
Comply with the Law. We will disclose your medical information when required to do so by applicable law.
Military and Veterans. If you are a member or veteran of the armed forces, we may disclose your medical information as required by military authorities.
Health Oversight Activities. We may disclose your medical information to a health oversight agency for activities authorized by law, including audits, investigations, inspections, and licensure.
Legal Activities. We may share your medical information in
response to a court or administrative order; a subpoena; a workers’
compensation claim; a law enforcement request; or in connection with
special government functions such as military, national security, and
presidential protective services. If you are or become an inmate of a
correctional institution, we may disclose your medical information to
the institution or its agents for your health and the health and safety
of others.
Uses and disclosures of medical information that are not discussed by this Notice or required by law will only be made with your written permission. CHIME Therapy will not sell your medical information to others.
If you provide us authorization to use or disclose your medical information, you may revoke that authorization in writing at any time by sending a revocation request to the address listed at the end of this Notice. If you revoke your authorization, we will no longer use or disclose your medical information about you for the reasons covered by your written authorization except to the extent that we have already acted in reliance on your authorization.
3. Your Rights
When it comes to your medical information, you have certain rights.
This section explains your rights and some of CHIME Therapy’s
responsibilities to help you.
Inspect or 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. If you
would like, we also can send this information in either paper or
electronic form to another person you identify in your request.
Some of your information is available directly to you through the Service itself. Please support@heychime.com if you need technical support to navigate these features or functions.
For more information, or to request a copy of your information, please send your request to support@musictelehealth.com.
We will provide a copy, or a summary of your health record designated record set, usually within 30 days of your request. We may charge a reasonable, cost-based fee for the costs of copying, mailing or other supplies and services associated with your request.
We may deny your request to inspect or obtain a copy in certain circumstances (e.g., we may deny access if your provider believes it will be harmful to your health or could cause a threat to others). If this occurs, you may request that the denial be reviewed, if permitted by law. If such a review is agreed upon, another licensed health care professional, chosen by CHIME Therapy, may review your request and we will comply with the outcome of that review.
Ask CHIME Therapy to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. You can request a correction for as long as the information is kept by us. Your request must be in writing and include a reason for your request.
We may say “no” to your request, if the request is not in writing or is incomplete. We may also deny your request if the information to be corrected was not created by CHIME Therapy, is no longer held by CHIME Therapy, is not part of the information you would be permitted to inspect or copy, or the information is accurate and complete. We will respond to your request within 60 days. If we say “no” to your request, you may submit a statement disagreeing with us, or you may ask that your request for correction and our denial be included anytime we share the information you requested us to change.
To request a correction, contact support@heychime.com.
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.
To request we contact you in a specific way, contact support@heychime.com.
Ask CHIME Therapy to limit what we use or share with others
You can ask us not to use or share certain health information for treatment, payment, or CHIME Therapy operations. We are not required to agree to your request, and we may say “no” if it would be harmful or compromise 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.
To request that we restrict certain information, contact us at support@heychime.com.
Get a list of those with whom we’ve shared
information
You can ask for a list (accounting) of the times we have 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 will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
To request an accounting, contact us at support@heychime.com.
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. CHIME Therapy 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 at support@heychime.com.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:
Sending a letter: 200 Independence Avenue, S.W., Washington, D.C. 20201
Calling: 1-877-696-6775
Visiting: www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
4. 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
In the following cases we never share your protected health information unless you give us written permission:
Marketing purposes
Sharing of medical information
CHIME Therapy does not sell or rent our clients’ names or addresses to any organization outside of CHIME Therapy.
5. Changes to the Terms of This Notice
CHIME Therapy 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 on our web site at https://www.musictelehealth.com/privacy.
6. Contact Information
If you want to file a complaint, express concerns, or further inquire about CHIME Therapy’s use or disclosure of health information, please contact the CHIME Therapy Privacy Officer by sending an email to support@heychime.com.
This document was last updated on January 26, 2024. CHIME Therapy’s policies may be created, eliminated, changed or amended from time to time, and at any time, at the sole discretion of CHIME Therapy.