Notice of Privacy Practices

Who We Are

This Notice of Privacy Practices applies to Agni Health, a telehealth medical practice operated by Sohan Japa MD LLC ("we," "us," or "our"), located at 447 Sutter St Ste 506 - 1024, San Francisco, CA 94108. We are a covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and are required by law to maintain the privacy of your protected health information (PHI), provide you with notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.

How We May Use and Disclose Your Health Information

The following describes the ways we may use and disclose health information that identifies you. Not every use or disclosure will be listed, but all of the ways we are permitted to use and disclose information will fall within one of these categories.

Treatment

We may use your health information to provide, coordinate, or manage your medical care. For example, a physician treating you may share information with other health professionals who are providing services to you or who may be treating you in the future.

Payment

We may use and disclose your health information to process payment for services, including billing you directly or processing payment through the platform you used to enroll.

Health Care Operations

We may use and disclose your health information in connection with our health care operations. Health care operations include quality assessment and improvement activities, reviewing and evaluating provider performance, training, licensing, and other business activities. We may share your information with business associates (e.g., electronic health record vendors, scheduling platforms) who assist us under written agreements requiring them to protect your information. We limit use and disclosure of your protected health information to the minimum necessary to accomplish the intended purpose.

Other Permitted Uses and Disclosures

• As required by law (e.g., court orders, subpoenas)
• Public health activities (e.g., reporting communicable diseases)
• Health oversight activities (e.g., audits, investigations)
• To avert a serious threat to health or safety
• Workers' compensation as authorized by and to the extent necessary to comply with laws
• Law enforcement purposes under specific circumstances

Uses and Disclosures Requiring Your Authorization

Other uses and disclosures of your health information not described in this Notice will be made only with your written authorization, including:

• Most uses and disclosures of psychotherapy notes
• Uses and disclosures for marketing purposes
• Disclosures that constitute a sale of your health information

You may revoke any authorization you give us at any time in writing, except to the extent that we have already taken action in reliance on your authorization.

Your Rights Regarding Your Health Information

You have the following rights with respect to your protected health information:

Right to Inspect and Copy

You have the right to inspect and obtain a copy of your health information that we maintain in a designated record set, including the right to receive an electronic copy in the format you request if readily producible. We will respond to your request within 30 days. We may charge a reasonable, cost-based fee for copies. We may deny your request in limited circumstances.

Right to Amend

You have the right to request that we amend your health information if you believe it is inaccurate or incomplete. We may deny your request under certain circumstances.

Right to an Accounting of Disclosures

You have the right to request a list of the disclosures we have made of your health information for purposes other than treatment, payment, health care operations, and certain other activities.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or health care operations. We are not required to agree to your request except in limited circumstances required by law.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health information in a certain way or at a certain location.

Right to Breach Notification

You have the right to be notified within 60 days of the discovery of any breach of your unsecured protected health information.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically. Contact us at the address below to request a copy.

Our Duties

We are required by law to maintain the privacy of your protected health information, to provide you with notice of our legal duties and privacy practices with respect to health information, and to notify you following a breach of your unsecured protected health information. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all health information we maintain. We will post the current Notice on our website at agnihealth.co/privacy and will provide a copy upon request.

State Law Protections

Patients in California have additional rights under the Confidentiality of Medical Information Act (CMIA). California law, including SB 107, provides heightened protections for reproductive health information and may restrict certain uses and disclosures beyond what HIPAA requires. We comply with applicable state privacy laws in all states where we provide services.

Deceased Patients

Protected health information of deceased individuals remains protected for 50 years following the date of death.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

To file a complaint with us, contact us at: privacy@agnihealth.co

To file a complaint with the federal government: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201 | 1-877-696-6775 | hhs.gov/ocr/privacy/hipaa/complaints

Contact Us

For questions about this Notice or to exercise your rights, contact our Privacy Officer: