HIPAA
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.
Effective / last updated: September 10, 2026. You may ask for a paper copy at any time.
Our duties
Holland Behavioral Health and Kelly Holland, APRN, PMHNP (the “Practice”) must keep protected health information (PHI) private, give you this notice, notify you of a breach of unsecured PHI, and follow the notice in effect. We may change this notice and apply the new version to all PHI we keep. The current copy is at our Lexington office and on our website. This notice covers office, Kentucky telehealth, and concierge care, plus vendors who handle PHI for us under business associate
agreements.
How we use and share your information
Treatment. To evaluate, treat, prescribe, manage medication, coordinate care, and refer you when needed.
Payment. To check coverage, bill insurance or you, get authorizations, and respond to payer reviews. If you pay a service in full out of pocket, you may ask us not to
tell your health plan about that service unless the law requires it.
Health care operations. Quality, compliance, licensing, appointment management, and running the practice.
Other uses allowed by law without your written OK may include: a real emergency; a valid court order or other required legal process; a serious and imminent threat
to you or someone else; required reports of child or elder abuse or neglect; a crime at our office or against our staff; public health or health-oversight reviews; health
information exchanges / TEFCA when permitted; limited research using de-identified or preparatory information; and appointment reminders. We share only what is
needed. We do not sell your PHI.
Written authorization is required for most other uses, including most psychotherapy notes, marketing that HIPAA treats as marketing, and any sale of PHI. Extra rules
apply to substance use records under 42 C.F.R. Part 2 and other highly confidential information. You may revoke an authorization in writing, except where we already
relied on it.
Your rights
Ask in writing (email, mail, or phone below). You may: look at or get a copy of your record (a reasonable copy fee may apply); ask us to fix information you believe is
wrong; get a list of certain disclosures; ask us to limit how we use or share information (we must agree only in the self-pay situation described above, unless the law
requires a disclosure); ask us to contact you in a particular way or place; and, if Part 2 applies, request an intermediary disclosure list as those rules allow.
Complaints. You may complain to us or to the U.S. Department of Health and Human Services, Office for Civil Rights (hhs.gov/hipaa). We will not retaliate.
Email, text, and emergencies
Regular email and text are not fully secure. Do not use them for emergencies. Call 911 or go to an emergency department if you are in immediate danger. For 24-hour
support, call or text 988. Messages may be placed in your record.
Privacy Officer
Kelly Holland, APRN, PMHNP · Holland Behavioral Health · 2355 Huguenard Drive, Suite 120, Lexington, KY 40503 · (859) 753-2927 ·
privacy@hollandbehavioralhealth.com
Where Kentucky law is more protective of your information and is not preempted, we follow the more protective rule.