Privacy Policy

Your Information. Your Rights. Our Responsibilities.

This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully. 
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We (Yelison Health LLC) do not share protected health information (PHI) about you without your written consent.  PHI is health information that includes your name, member number or other identifiers, and is used or shared Yelison Health LLC. We use your information to carry out treatment, payment, and health care operations, and may share your information as allowed and required by law. We have the duty to keep your health information private and to follow the terms of this Notice. The effective date of this Notice is September 1st, 2025.

Who We Are and Where We Work

Yelison Health LLC (“Yelison,” “we,” “our,” “us”) is a self‑pay psychology practice based in Dayton, Ohio. We serve clients physically located in Ohio and PSYPACT states or territories. Services are delivered in-person and only through secure, HIPAA‑compliant platforms for scheduling, billing, video sessions, email, and text messaging.

Our Uses and Disclosures

How Yelison Health LLC May Use or Disclose Your Health Information

Federal rules let health‑care providers use or share PHI without written authorization when doing their own treatment, payment, or health‑care operations. We typically use or share your health information in the following ways. 

• We can use your health information and share it with other professionals who are treating you, consulting with clinicians, or making a referral.

• We can use and share your health information to run our practice, improve your care, complying with audits, training our staff, and contact you when necessary. 

• We can use and share your health information to send invoices to you, bill and receive payment from health plans or other entities, process your credit-card payment, or verify out-of-network benefits with health plans. 

• We may use and disclose medical information to contact and remind you about appointments.  If you are not home, we may leave this information on your answering machine

How Else Can We Use Or Share Your Health Information Without Getting Written Authorization (Approval) From You?

Help with public health and safety issues 

• Reporting suspected child, elder, or dependent-adult abuse, neglect, or domestic violence.

• Preventing or reducing a serious threat to you or anyone’s health or safety 

• Helping public health agencies to prevent and control disease

 
Comply with the law 
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law. 
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Judicial and Administrative Proceedings

• We may, and are sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order.  We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.

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Research
We may disclose your health information to researchers conducting research with respect to which your written authorization is not required in compliance with governing law.

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Workers’ compensation, law enforcement, and other government requests.
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• We may disclose your health information as necessary to comply with workers’ compensation laws.  For example, to the extent your care is covered by workers' compensation, we will make periodic reports to your employer about your condition.  We are also required by law to report cases of occupational injury or occupational illness to the employer or workers' compensation insurer.

• We may, and are sometimes required by law, to disclose your health information law enforcement purposes or with a law enforcement official.

• We may, and are sometimes required by law, to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by law.

• We may disclose your health information for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.

Psychotherapy Notes
  

• We will not use or disclose your psychotherapy notes without your prior written authorization except for the following: 1) use by the originator of the notes for your treatment, 2) for training our staff, students and other trainees, 3) to defend ourselves if you sue us or bring some other legal proceeding, 4) if the law requires us to disclose the information to you or the Secretary of HHS or for some other reason, 5) in response to health oversight activities concerning your psychotherapist, 6) to avert a serious and imminent threat to health or safety, or 7) to the coroner or medical examiner after you die. To the extent you revoke an authorization to use or disclose your psychotherapy notes, we will stop using or disclosing these notes.

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Marketing
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• We will not use or disclose your medical information for marketing purposes or accept any payment for other marketing communications without your prior written authorization

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Sale of Health Information
 

• We will not sell your health information without your prior written authorization. The authorization will disclose that we will receive compensation for your health information if you authorize us to sell it, and we will stop any future sales of your information to the extent that you revoke that authorization.

 
Our Responsibilities
 

• We are required by law to maintain the privacy and security of your protected health information. 

• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in this notice and give you a copy of it. 

• Any use or disclosure not listed in this notice needs your written authorization. You may revoke an authorization at any time in writing, and we will stop future uses.

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Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. 
Right to Inspect and Copy electronic or paper copy of your PHI record 

• You can ask to see or receive an electronic or paper copy of your PHI record and other health information including billing records we have about you. You will need to make your request in writing. 

• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee which covers our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an explanation or summary.

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Right to Amend or Supplement
 
You can ask us to correct health information about you that you think is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete.  We will discuss with you the amendment process upon your request. 

• We may say deny your request, but we’ll tell you why in writing within 60 days. If we deny your request, you may submit a written statement of your disagreement with that decision, and we may, in turn, prepare a written rebuttal. All information related to any request to amend will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.

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Right to Request Confidential Communications
 

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. 

• We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.

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Right to Request Special Privacy Protections

You have the right to request restrictions on certain uses and disclosures of your health information by a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed.  If you tell us not to disclose information to your commercial health plan concerning health care items or services for which you paid for in full out-of-pocket, we will abide by your request, unless we must disclose the information for treatment or legal reasons. 

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say deny your request if it would affect your care. 

• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will abide by your request unless a law requires us to share that information. We reserve the right to accept or reject any other request, and will notify you of our decision.

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Right to an Accounting of Disclosures
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• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. 

• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

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Right to a Paper or Electronic Copy of this Notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. 

• We will make sure the person has this authority and can act for you before we take any action.

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Complaints: File a complaint if you feel your rights are violated

• ​You can complain if you feel we have violated your rights by contacting us using the information below. 

• You can file a complaint with the Secretary of U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to: U.S. Department of Health and Human Services at Office for Civil Rights, U. S. Department of Health and Human Services, 233 N. Michigan Ave., Suite 240, Chicago, IL 60601, in writing within 180 days of a violation of your rights.  We will not retaliate against you for filing a complaint.

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Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Privacy Officer

Questions or concerns about the privacy policies may be sent to the Yelison Health Privacy Officer at
 
Phone: 937.938.0333  or Email: info@yelison.com