HIPAA NOTICE OF PRIVACY PRACTICES
Notice of Privacy Practices for Protected Health Information
CogniVita Center for Neuropsychology
Effective Date: December 1, 2025
THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
CogniVita Center for Neuropsychology (“CogniVita,” “we,” “us,” or “our”) is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this Notice of Privacy Practices, and to abide by the terms of this Notice.
I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
We may use or disclose your PHI for treatment, payment, and health care operations without your written authorization.
• Treatment: Providing, coordinating, or managing your care, including consultation with other licensed health care providers.
• Payment: Activities undertaken to obtain payment for services, including billing insurance or determining coverage.
• Health Care Operations: Practice operations such as quality assurance, training, audits, and administrative services.
II. Other Uses and Disclosures Requiring Authorization
We will obtain your written authorization before using or disclosing PHI for purposes outside treatment, payment, or health care operations. We also require authorization to release psychotherapy notes, which are maintained separately and receive heightened protection under HIPAA.
You may revoke an authorization in writing at any time, except to the extent that we have relied on it or where revocation is not permitted by law.
III. Uses and Disclosures Without Authorization
We may disclose PHI without authorization in the following circumstances:
• Abuse or Neglect: As required by Florida law, we must report suspected child abuse, neglect, or exploitation, as well as abuse or exploitation of vulnerable adults.
• Health Oversight Activities: To oversight agencies for activities such as audits, investigations, or licensure actions.
• Judicial and Administrative Proceedings: As required by a court order, subpoena, or other lawful process.
• Serious Threat to Health or Safety: When necessary to prevent a serious and imminent threat to you or others.
• Workers’ Compensation: As authorized by law for workers’ compensation or similar programs.
IV. Telehealth and Interstate Practice
CogniVita provides services in person and via secure telehealth platforms. PHI created or transmitted through telehealth is protected under HIPAA. Services may be provided across state lines in accordance with applicable laws, including participation in PSYPACT where permitted.
V. Your Rights
You have the right to:
• Request restrictions on certain uses or disclosures (we are not required to agree).
• Request confidential communications.
• Inspect and obtain copies of your PHI.
• Request amendments to your PHI.
• Receive an accounting of disclosures.
• Obtain a paper copy of this Notice.
VI. Our Duties
We are required by law to maintain the privacy of your PHI and to notify you following a breach of unsecured PHI. We reserve the right to change this Notice and make the revised Notice effective for all PHI we maintain.
VII. Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
CogniVita Center for Neuropsychology
13001 Founders Square Dr, Ste 200
Orlando, FL 32828
Phone: (321) 461-3202
Fax: (321) 204-6855
Email: admin@cognivitapsych.com
You may also file a complaint with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
