Long Island Neuropsychological Services, PLLC
Effective date: November 14, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND PSYCHOLOGICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this notice, please contact our Privacy Officer using the information at the end of this notice.
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.
Get a copy of your health and billing records
You can ask to see or get a copy of your health and billing records and other health information we have about you, in paper or electronic form. Ask us how to do this. We will provide a copy or a summary of your information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. To protect test security and comply with professional standards, raw test materials (test forms and protocols) may be released only to another qualified professional, as permitted by law.
Ask us to correct your records
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say "no" to your request, but we will tell you why in writing within 60 days.
Request confidential communications
You can ask us to contact you in a specific way (for example, a home or office phone) or to send mail to a different address. We will say "yes" to all reasonable requests.
Ask us to limit what we use or share
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 "no" 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 say "yes" unless a law requires us to share that information.
Get a list of those with whom we've shared information
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 will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy 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.
Choose someone to act for you
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. For children, a parent or legal guardian generally exercises these rights. We will make sure the person has this authority and can act for you before we take any action.
Be notified of a breach
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
File a complaint if you feel your rights are violated
You can complain if you feel we have violated your rights by contacting our Privacy Officer using the information at the end of this notice. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
Our Uses and Disclosures
We typically use or share your health information in the following ways.
Treat you
We can use your health information and share it with other professionals who are treating you. Example: With your authorization, we send a copy of your evaluation report to the physician who referred you.
Run our practice
We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to schedule appointments and to review the quality of our services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities, such as NYSHIP, No-Fault carriers, or Workers' Compensation carriers. Example: We give information about you to your health insurance plan so it will pay for your services.
How Else Can We Use or Share Your Health Information?
We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
- Help with public health and safety issues, such as reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
- Do research, under conditions required by law.
- Comply with the law, including sharing information with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
- Respond to organ and tissue donation requests and work with a medical examiner or funeral director.
- Address workers' compensation, law enforcement, and other government requests, including workers' compensation claims, law enforcement purposes or with a law enforcement official, health oversight agencies for activities authorized by law, and special government functions such as military, national security, and presidential protective services.
- Respond to lawsuits and legal actions, in response to a court or administrative order, or in response to a subpoena, as permitted by law.
Independent medical examinations
When we perform an independent medical examination (IME) at the request of a third party, such as an insurance carrier, employer, or attorney, the results are provided to the party that requested the examination, as permitted by law.
Substance use disorder records
If we receive or maintain records of substance use disorder treatment that are protected by federal law (42 C.F.R. Part 2), we will not use or share those records in a civil, criminal, administrative, or legislative proceeding against you unless you give written consent or a court order is issued after you have been given notice and an opportunity to be heard, as required by law.
Stricter New York State laws
New York State law provides additional protection for certain types of information, including HIV/AIDS-related information, genetic testing information, and certain mental health information. When New York law is more protective of your privacy than federal law, we will follow New York law.
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.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information, see the U.S. Department of Health and Human Services' page on your rights under HIPAA.
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 offices, and on our website.
Contact Our Privacy Officer
Susan Plate-Granieri, Privacy Officer
Long Island Neuropsychological Services, PLLC
111 Smithtown Bypass, Suite 223, Hauppauge, NY 11788
Phone: 631-676-1962
This notice applies to Long Island Neuropsychological Services, PLLC and its offices in Hauppauge and Garden City, New York.