Notice of Privacy Practices

1. Who We Are

Parker Neuroscience, LLC is an independent interventional psychiatry practice located at 17940 Welch Plaza, Omaha, NE 68135. Services include IV ketamine therapy, intranasal esketamine (Spravato), medication management, and integrated behavioral health support. Lisa Parker, DNP, APRN, NP is the sole licensed clinical provider and Privacy Officer.

2. Your Protected Health Information

Protected health information (PHI) includes any individually identifiable health information we create, receive, maintain, or transmit in connection with your care. This includes medical records, billing records, mental health records, and any other information relating to your physical or mental health, treatment, or payment for care.

Psychotherapy notes are afforded additional protections under HIPAA and Nebraska law and will not be disclosed without your specific written authorization except as required by law.

3. How We May Use and Disclose Your PHI

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care and related services. For example, we may share information with other providers involved in your treatment, such as referring physicians, therapists, pharmacies, or specialists.

Payment

We may use and disclose your PHI to obtain payment for services rendered. This includes submitting claims to insurance carriers, verifying coverage, and billing you directly for outstanding balances. Parker Neuroscience operates primarily on a fee-for-service and self-pay basis; insurance participation status may vary.

Health Care Operations

We may use and disclose your PHI for operational purposes, including quality assessment, staff training, compliance reviews, and accreditation activities. These uses support the delivery of quality care and efficient practice management.

Other Permitted Uses and Disclosures

Without your written authorization, we may also use or disclose your PHI in the following circumstances:

• As required by federal, state, or local law
• For public health activities (reporting communicable diseases, adverse events, etc.)
• To report abuse, neglect, or domestic violence to authorized government agencies
• For health oversight activities by government agencies
• In response to a court order, subpoena, or other lawful process
• For law enforcement purposes as permitted or required by law
• To coroners, medical examiners, and funeral directors as necessary
• For organ and tissue donation purposes
• For certain research activities with appropriate safeguards
• To avert a serious threat to health or safety
• For specialized government functions (military, national security, etc.)
• For workers' compensation programs as authorized by law
• To business associates under a signed Business Associate Agreement (BAA)

4. Mental Health Records

Mental health records, including records of psychiatric treatment, psychotherapy, and substance use treatment, are protected by additional state and federal laws. In Nebraska, mental health records require your specific written authorization before disclosure except in limited circumstances such as imminent danger to yourself or others, mandatory reporting obligations, or court order.

Psychotherapy notes (process notes) maintained separately from the medical record receive the highest level of protection and require your specific written authorization in virtually all circumstances.

5. Uses Requiring Your Written Authorization

Most uses and disclosures of your PHI beyond treatment, payment, and operations require your written authorization. You may revoke any authorization at any time in writing, except where we have already acted in reliance on that authorization. Authorization is required for:

• Most disclosures of psychotherapy notes
• Use or disclosure of PHI for marketing purposes
• Sale of PHI
• Disclosure to family members or friends (unless you are present and consent)
• Release of records to attorneys, employers, or other third parties
• Any other use or disclosure not described in this notice

6. Your Rights Regarding Your PHI

Right to Access Your Records

You have the right to inspect and obtain a copy of your PHI maintained in our designated record set, with limited exceptions. Requests must be submitted in writing. We will respond within 30 days. We may charge a reasonable cost-based fee for copies.

Right to Amend Your Records

You have the right to request an amendment to your PHI if you believe it is inaccurate or incomplete. We may deny the request under certain circumstances and will provide written explanation if we do so.

Right to an Accounting of Disclosures

You have the right to request a list of disclosures of your PHI made for purposes other than treatment, payment, and operations. This right applies to disclosures made within the six years prior to your request.

Right to Request Restrictions

You may request that we restrict certain uses or disclosures of your PHI. We are not required to agree to most restrictions, but if we do agree, we will comply with the restriction unless the information is needed to provide emergency treatment. We are required to agree to restrict disclosure to a health plan for a service you paid for in full out of pocket.

Right to Confidential Communications

You have the right to request that we communicate with you in a specific way or at a specific location. We will accommodate reasonable requests. For example, you may ask us to contact you only at a particular phone number or mailing address.

Right to Receive a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice of Privacy Practices upon request, even if you received this notice electronically.

Right to Be Notified of a Breach

You have the right to be notified in the event of a breach of your unsecured PHI. Parker Neuroscience will notify affected individuals, HHS, and when required, the media, in accordance with HIPAA Breach Notification Rules.

7. Electronic Health Records and Security

Parker Neuroscience uses OptiMantra, a HIPAA-compliant electronic health record (EHR) platform, for clinical documentation, scheduling, and billing. All electronic PHI is stored and transmitted using industry-standard encryption. Stripe Standard is used for payment processing; no payment card data is stored on our systems. Business Associate Agreements (BAAs) are maintained with all relevant vendors.

8. Our Duties

Parker Neuroscience, LLC is required by law to:

• Maintain the privacy of your PHI
• Provide you with this notice of our legal duties and privacy practices
• Notify you following a breach of your unsecured PHI
• Abide by the terms of the notice currently in effect

We reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI we maintain. Updated versions will be available in our office and on our website at parkerneuroscience.com.

9. Complaints

If you believe your privacy rights have been violated, you may file a complaint with Parker Neuroscience, LLC or with the Secretary of the U.S. Department of Health and Human Services Office for Civil Rights. Complaints to HHS may be filed at:

You will not be retaliated against for filing a complaint.

10. Contact the Privacy Officer

For questions about this notice, to exercise your rights, or to file a complaint with our practice, please contact: