Notice of Privacy Practices (HIPAA)

Effective Date: 02-18-2026

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.

Altera Health P.C., operating under the Top Tier Psychiatry name and its network of locally branded psychiatric practices, is 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 with respect to your PHI, and to abide by the terms of the Notice currently in effect.

This Notice applies to all of the medical records and other PHI generated or maintained by Top Tier Psychiatry and its locally branded practices, including but not limited to records created by your provider, information received from other healthcare providers, billing and insurance records, appointment and scheduling records, and clinical documentation generated through technology-assisted tools.

How We May Use and Disclose Your Protected Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, and manage your psychiatric care. This includes sharing information among your treatment team, consulting with other healthcare providers, coordinating prescription medications (including controlled substances), facilitating pharmacogenomic testing, and generating clinical documentation through technology-assisted tools. Any documentation generated with AI assistance is reviewed by your provider and becomes part of your medical record.

Payment

We may use and disclose your PHI to bill and collect payment for the services we provide. This includes verifying insurance coverage, submitting claims, communicating with your insurance company, and collecting copayments, deductibles, and outstanding balances.

Healthcare Operations

We may use and disclose your PHI for quality assessment, clinical auditing, provider credentialing, business planning, compliance activities, and other activities necessary to run our practice.

Appointment Reminders and Health-Related Communications

We may contact you with appointment reminders, treatment follow-ups, care coordination messages, and other health-related information via telephone, email, SMS/MMS (if opted in), mail, or other methods.

As Required by Law

We will use and disclose your PHI when required by federal, state, or local law.

Public Health Activities

We may disclose your PHI to public health authorities for preventing or controlling disease, reporting adverse medication reactions, and notifying appropriate parties regarding communicable diseases.

Abuse, Neglect, or Domestic Violence

If we reasonably believe you are a victim of abuse, neglect, or domestic violence, we may disclose your PHI to the appropriate government authority as required by law.

Health Oversight Activities

We may disclose your PHI to health oversight agencies for audits, investigations, inspections, and licensure actions.

Judicial and Administrative Proceedings

We may disclose your PHI in response to a court order, subpoena, or other lawful process.

Law Enforcement

We may disclose your PHI to law enforcement under limited circumstances including court orders, to identify suspects or missing persons, or regarding deaths believed to involve criminal conduct.

Serious Threat to Health or Safety

We may use and disclose your PHI when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Specialized Government Functions

We may disclose your PHI for military activities, national security, and protective services.

Workers' Compensation

We may disclose your PHI as necessary to comply with workers' compensation laws.

Uses and Disclosures Requiring Your Written Authorization

• Psychotherapy Notes: Uses of psychotherapy notes (if maintained separately) require your authorization, except for limited purposes.
• Marketing: We will not use your PHI for marketing without your written authorization.
• Sale of PHI: We will never sell your PHI.
• Other Uses: Any uses not described in this Notice require your written authorization. You may revoke any authorization at any time in writing.

Your Rights Regarding Your Protected Health Information

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your medical record and billing records. Submit a written request. We may charge a reasonable fee for copies. We will respond within thirty (30) days.

Right to Amend

If you believe information in your record is incorrect, you may request an amendment in writing. We will respond within sixty (60) days.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made (excluding treatment, payment, and operations). The first request in a twelve-month period is free.

Right to Request Restrictions

You may request restrictions on certain uses of your PHI. We must agree to restrict disclosures to a health plan if you paid out of pocket in full.

Right to Request Confidential Communications

You may request that we communicate with you using a particular method or at a certain location. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice at any time.

Right to Be Notified of a Breach

You have the right to be notified in the event of a breach of your unsecured PHI.

Our Duties

We are required by law to: maintain the privacy of your PHI; provide you with this Notice; abide by its terms; and notify you of breaches. We may change this Notice and will post updates on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll-Free: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.

Minors and Guardians

For patients under eighteen (18) years of age, the parent or legal guardian who consented to treatment is considered the personal representative of the minor for HIPAA purposes and may exercise the minor's rights under this Notice, including the right to access, amend, and request restrictions on the minor's protected health information.

We will share your child's health information with you as the parent or legal guardian, except where state law provides confidentiality protections to the minor (for example, certain states protect the confidentiality of adolescent behavioral health or substance abuse records). Your provider may exercise clinical judgment about what information to share with a parent or guardian.

How we communicate about your child's care:

• Billing and financial notifications (including bills, charges, payment receipts, no-show fees, and late cancellation fees) are sent to the parent or legal guardian only.
• Appointment reminders and care-related notifications (including scheduling confirmations, intake links, and follow-up reminders) are sent to both the parent or legal guardian and the minor patient when separate contact information is on file.

The parent or legal guardian is financially responsible for all charges related to the minor's care, including copayments, deductibles, coinsurance, no-show fees, and late cancellation fees.

Contact Information

Altera Health P.C., operating as Top Tier Psychiatry
HIPAA Privacy Officer: Daniel
Mailing Address: P.O. Box 8013, Greensboro, NC 27419
Email: info@toptierpsych.com
Phone: (725) 272-2411
Website: toptierpsych.com