HIPAA Notice of privacy practices

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.

We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information.

At Ardon Health, we respect the privacy of your protected health information and will maintain its confidentiality in a responsible and professional manner. Protected health information includes any information related to your healthcare that can identify you as the recipient of the healthcare services. We are required by law to provide you with this notice and abide by its terms.

This notice explains how we gather and use information about you and when we can share information with others. It also describes your rights as our valued client and how you can exercise these rights.

We collect information from enrollment forms. Information gathered includes: client name, address and Social Security number; general health status; employment details; and other information relevant to coverage. We also collect information from healthcare coverage transactions with your health plan. This information includes claims, service authorization requests, deductible status and copayments. While most information we collect is in writing, we may also gather information in person, by telephone or electronically.

We ensure the security of your information through physical, technical, and procedural safeguards. All information collected is treated in a confidential and secure manner whether you are a prospective, current, or former client.

In the first situation, we must disclose your information to:

• You or your personal representative. When you (or a personal representative you have authorized in writing to represent you) specifically request access to or a summary of disclosures of your protected health information, we are required by law to provide that information to you or your representative. 

• The U.S. Department of Health & Human Services (HHS). When HHS is investigating complaints or otherwise enforcing compliance with federal privacy laws, we are legally required to cooperate with HHS’s efforts. This cooperation could involve disclosing protected health information. Remember that all government agencies, including HHS, are required by law to protect the privacy of any protected health information they may receive.

Privacy laws permit the following uses or disclosures of your health information without your authorization:

• Treatment. We can use and disclose health information about you to provide you with pharmacy care or other medical treatment or services. For example, information related to your treatment may be communicated with and obtained by a healthcare provider, such as a pharmacist, nurse or other person providing health services to you, and will be recorded in your medical record. The sharing of this information is necessary for healthcare providers to determine what treatment you should receive. Other examples include:
   
  –Prescription reminders. We may use health information about you to provide you with updates about your prescriptions.– Alternative treatments. We may use health information about you to provide you with information about other treatments or additional health-related benefits, and services that may be of interest to you.– Future communications. We may communicate with you via newsletters, mailings, the My Ardon Portal (if you opt in), or other means regarding treatment options, health-related information, disease-management programs, wellness programs, or other community-based initiatives or activities in which we are participating.
  
• Payment. We may disclose health information about you for payment-related purposes. For example, we may contact your insurer, payer or other entity for purposes of receiving payment for treatment and services that you receive or to determine whether the entity will pay for the particular product or service. The billing information may identify you, your diagnosis, and treatment or supplies used in the course of your treatment.
• Healthcare operations. We may use and disclose health information about you for administrative and operational purposes. For example, members of the risk management or quality improvement teams may use health information about you to assess the care and outcomes in your case and others like it. The results will be used internally to continually improve the quality of care for all patients.

We will not use or disclose your protected health information unless we are allowed or required by law to do so. We may make the following additional types of disclosures:

• To individuals involved in your care or payment for your care. We may disclose to a family member, other relative, close personal friend, or any other person whom you designate, health information about you directly relevant to that person’s involvement in your care or payment related to your care. We will, to the extent possible, ensure that you have agreed to this. 
• To business associates. We provide some services through contracts with business associates, such as accountants, consultants and attorneys, so they can perform the tasks we have assigned to them. To protect your health information, we require business associates to appropriately safeguard health information about you.
• As required by law. We may use and disclose health information about you as required by federal, state or local law. For example, we may disclose health information for the following purposes: – To respond to judicial or administrative proceedings pursuant to legal authority – To respond to appropriate authorities, if we believe you are a victim of abuse or neglect, domestic violence or other crimes – To assist law enforcement officials in their law enforcement duties, under certain circumstances and specific conditions
• For public health activities. We may use or disclose health information about you for public health activities, such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability, or for other health oversight activities.
• To public health authorities. We may use or disclose health information about you to authorized public health agencies. For instance, we may report concerns to the Food and Drug Administration regarding prescription drug or medical device problems.
• For research. We may use or disclose health information about you to researchers if an institutional review board or privacy board has reviewed and approved the research proposal and established protocols to ensure the privacy of your health information.
• To reduce health or safety risk. We may use or disclose health information about you to appropriate agencies if we believe there is a serious health or safety threat to you or others.
• To health oversight agencies. We may use or disclose your health information as required by activities authorized by law, such as audits, criminal investigations, or licensure or disciplinary actions.
• To law enforcement agencies. We may use or disclose health information about you to law enforcement agencies attempting to identify or locate a suspect, fugitive, material witness, crime victim, or missing person.
• In communicating information not personally identifiable. We may use or disclose health information about you in ways that do not personally identify you or allow others to discover who you are.
• If we receive or maintain any information about you from a substance use disorder treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the Part 2 Program record for purposes of treatment, payment or health care operations. In that case, we may use and disclose your Part 2 Program record for treatment, payment and health care operations purposes as described in this notice. If we receive or maintain your Part 2 Program record through specific consent you provide to us or another third party. In that case, we will use and disclose your Part 2 Program record only as expressly permitted by you in your consent as provided to us. In no event will we use or disclose your Part 2 Program record, or testimony that describes the information contained in your Part 2 Program record, in any civil, criminal, administrative, or legislative proceedings by any federal, state, or local authority, against you, unless authorized by your consent or the order of a court after it provides you notice of the court order.

Here are a few additional types of disclosures for which we may use or disclose your protected health information:

• A court or administrative agency in response to a search warrant, subpoena or other lawful process
• Coroners, medical examiners and organ procurement entities, as well as for research in limited cases
• Military authorities and authorized federal officials for intelligence, counterintelligence and other national security activities
• Workers’ compensation or other similar programs, to the extent necessary to comply with related laws
• Public or private entities authorized by law to assist in disaster relief efforts

Your authorization is required for uses and disclosures other than those allowed or required by law. These uses and disclosures requiring authorization include but are not limited to:

• Most uses and disclosures of psychotherapy notes.
• Uses and disclosures of certain records that have additional protections under state or federal law, such as those containing HIV test results, genetic information, or information about sexually transmitted diseases or substance abuse.
• Uses and disclosures of your protected health information for marketing purposes.
• Other uses and disclosures of health information about you, not described above, which will be made only with your written authorization. If you provide authorization for the use and disclosure of your information and later change your mind, you may revoke the authorization at any time. Your request to revoke authorization must be in writing, and the revocation will not cover any uses or disclosures we may have made before you submitted your request to revoke.

Your rights include the right to:

• Request that we not use or disclose your protected health information for treatment, payment or healthcare operations, or to persons involved in your care except when specifically authorized by you, when required by law or in an emergency. The request must be made in writing. While we will consider your request for restrictions, we are not required to agree to these restrictions.
• Request that your protected health information be communicated to you in a confidential manner, such as sending mail to an address other than your home. The request must be made in writing. We will accommodate reasonable requests.
• In most cases, inspect and obtain a copy of protected health information records that we use to make decisions about your care. Your request must be made in writing. We may charge a reasonable fee for copying and postage.
• Request that we amend the records if you believe that the protected health information in your record is incorrect or if important information is missing. Your request must be in writing and must include the basis for your request. We may deny your request if the information was not created by us, if it is not maintained by us, or if we determine that the record is accurate.
• Receive notifications of a breach of your unsecured protected health information.
• Receive an accounting of certain disclosures of your information made by us during the six years prior to your request. The accounting will not include disclosures that were made:
   
  – For treatment, payment and healthcare operations purposes– To you– Incident to a use or disclosure otherwise permitted– Pursuant to your authorization– To persons involved in your care– For national security or intelligence purposes– To correctional institutions or law enforcement agencies– As part of a limited data set for research, public health or healthcare operations purposes– Prior to April 14, 2003

 
We will provide one accounting upon request every 12 months at no charge. We may charge a fee for an additional accounting within 12 months. We will inform you in advance of the fee and allow you to withdraw or modify your request.

If you would like an additional copy of this notice or have questions, please call the Ardon Health Privacy Office at 503-444-6503 or 855-425-4101 ext. 6503, Monday through Friday, from 8:30 a.m. to 5:00 p.m. Pacific time.

If you believe your privacy rights have been violated, you can send a written complaint to:

Ardon Health
Attn: Privacy Office
11835 NE Glenn Widing Drive
Portland, OR 97220

You also can file a written complaint with the Department of Health and Human Services (HHS), Office for Civil Rights (OCR). Visit hhs.gov/ocr to find the contact information. You also can contact our office for more specific information.

We will not take any action against you for filing a complaint.

This notice was effective as of August 1, 2025. We reserve the right to change the terms of this notice and to make the new notice effective for all protected health information we maintain. If revised, we will provide notification to you by mail or electronically, if you have agreed to receive an electronic copy. We also will post an updated version of the notice to our website at ardonhealth.com.

Ardon Health will abide by the terms of the notice that is then in effect.