Last updated: April 9, 2025 

Laws govern how E. Strother, NP in Family Health and Psychiatry PLLC, doing business as Top Tier Health and Wellness Group, A New York Professional Limited Liability Company, (collectively 'we'/'us') can use and disclose health information that 'individually identifies' you. We call this information 'protected health information' or 'PHI'. We collect PHI when you use our Website and when you communicate with us.

This Privacy Policy helps you understand a) how we'll use and share your PHI, b) what rights you have over your PHI and how to exercise your rights, c) what to do if you think we're not complying with our legal obligations, and d) what other information we collect and share when you use the Top Tier Health and Wellness Group website.

We are required by law to: make sure that health information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to your health information; notify you following a breach of your unsecured protected health information; and follow the terms of the notice that are currently in effect.

If you have any questions, please send us a message through the Website or call us at 914-512-8059 during business hours, Monday to Friday. Our normal business hours are 8:00am to 5:00pm Eastern Time Monday to Friday.

We use and disclose your PHI for the purposes of providing services, quality care, to run our healthcare operations, to take payment and to comply with regulations. We implement a range of technical, administrative and physical safeguards to protect your PHI.

Top Tier Health and Wellness Group will use your Health Information to: 

Collect Payment:

• In order to submit claims to insurance companies for reimbursement for services provided by Top Tier Health and Wellness Group, we must provide them with your health information, including diagnosis, to ensure proper payment. 
• We contract with billing companies to submit claims to insurance companies on our behalf, therefore, your health information, including diagnosis, may be shared with our contracted billing company to submit your claim to insurance. 
• We share your PHI and card details with our trusted online payment processors. If you choose to save your payment details to make future payments easier, our trusted payment provider will store them safely on our behalf.

Provide Treatment:

• If your provider cannot prescribe medications but would like to refer you to another provider within your network or area, we will use your health information for the referral to help expedite your care and ensure that we are referring you to a provider that is capable of caring for your needs. 
• We share your PHI with the pharmacy if we give you a prescription and with intermediaries who enable us to send prescriptions electronically. If you request that we organize for a partner mail order pharmacy to deliver your medicines, then we will share your PHI with and send your prescription to one or more mail order pharmacies so that there is flexibility in terms of which pharmacy mails your first delivery and which pharmacy mails any subsequent deliveries.
• If we order laboratory tests for you then we share your PHI with the lab company that runs the tests. If a laboratory test we order for you finds a 'reportable' infection we may be required by law to share your PHI to your county health department.
• Our providers will keep “Psychotherapy notes” as that term is defined in ​​45 CFR § 164.501 confidential, and any use or disclosure of such notes requires your 

                 Authorization unless the use or disclosure is:

• For Top Tier Health and Wellness Group’s use in treating you
• For Top Tier Health and Wellness Group’s use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
• For Top Tier Health and Wellness Group’s use in defense of legal proceedings instituted by you.
• For use by the Secretary of Health and Human Services to investigate Top Tier Health and Wellness Group’s compliance with HIPAA.
• Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. 
• Required by a Coroner who is performing duties authorized by law.
• Requires to help avert a serious threat to the health and safety of others.

Internally: 

• We may share your health information with medical staff who help ensure that we are providing a service that meets the appropriate and best standard of care.

With Organizations: 

• We may share your PHI with organizations that help us run and maintain the technology and security infrastructure that supports the Client Portal, Electronic Health Record, Website and the care we provide.
• We may share your PHI with a third party if we merge, are acquired or undergo an asset sale. Wherever possible we strive to make sure that any third parties with whom we share your PHI are legally bound by the restrictions of this Privacy Policy.

Email address.

• We will send you a range of different emails, including but not limited to; status of your request for a prescription or laboratory tests, alerts that there is a message waiting for you in the Client portal, appointment confirmations & reminders, feedback and experience emails, notifications that you are due for a refill, to create an online account and marketing emails. Top Tier Health and Wellness Group will also share your email and first name to third party email platforms managed by Lavender, in order to send you these notifications.

Telephone Number.

• We will use your telephone number to call you if we have any questions about your health information or upcoming appointments, to leave a voice message if you do not answer when called and to ask for feedback on your experience with our services. We will also use your telephone number to send you SMS/Text message notifications for appointment reminders or to update you on the status of your visit.

Marketing

As a psychiatry practice, Top Tier Health and Wellness Group will not use or disclose or sell your PHI for marketing purposes.

We store information you provide us with whether you complete a visit or whether you do not complete a visit. We take the same precautions over your data regardless of whether you complete a visit.

We do not record video visits between our patients and our nurse practitioners. We may, however, capture a still image from the video and store that image in your medical record.

We may use your PHI to tell you about health-related products and services.

We are generally unable to delete information from your medical record. At your request we can de-activate your secure account so that you and others can no longer access it with your username and password.

Separate from the health information we collect, we collect technical information about how you use our Website. We use this information to help us improve the overall quality of the Website, improve the service we provide, and improve our advertising and marketing campaigns.

Technical information we collect and may share with Facebook, Google, and Microsoft (Bing Ads) includes information about your mobile device or computer, including but not limited to unique device identifiers and the operating system and browser you use, and information about when and how you use the Website, including specific pages you visit, and information about your general location when you use the Website, including but not limited to your internet protocol address and MAC address. Facebook, Google, and Microsoft are not bound by the terms of this Privacy Policy as to how they use technical information about you but are instead bound by the Facebook, Google Analytics, and Microsoft Bing Ads Terms of Use and Privacy Policies that are available on their respective websites.

We use 3rd party vendor re-marketing tracking cookies, including the Google Adwords and Facebook tracking cookies. This means we will continue to show ads to you across the internet. The third-party vendors will place cookies on web browsers in order to serve ads based on past visits to our website. Third party vendors, including Google and Facebook, use cookies to serve ads based on a user’s prior visits to your website. This allows us to make special offers and continue to market our services to those who have shown interest in our service.

We do not respond to 'do not track' signals in your browser.

The emails we send you are not secure because they are unencrypted. Other people may be able to read and forward the emails we send you and the emails you send us. Emails we send you may include a wide range of identifiers that include but aren't limited to your name, your email address, your visit number, your patient number, the date you used our service etc.

When you create an account on the Client Portal we ask you to give us your email address. We send an email to the email address you give us. If you give us an incorrect email address we will unknowingly send an email to the wrong person.

The SMS/text messages we send you are not secure because they are unencrypted. Other people may be able to read and SMS/text messages we send you and any SMS/text messages you send us.

SMS/text messages we send you will include your telephone number. It will be clear that SMS/text messages we send you have come from Top Tier Health and Wellness Group.

When you use the Client Portal or Website there is a risk that your PHI will be stored unencrypted on your mobile. We take a variety of technical safeguards to make sure that your PHI does not leak onto your mobile but we cannot guarantee that these safeguards work.

We take a number of administrative, technical and physical safeguards to look after the PHI that we hold electronically on our servers. But despite these safeguards, no system is full-proof and we cannot guarantee that our systems and your PHI will not be hacked or otherwise compromised by unauthorized third parties.

• Emergencies. Sufficient information may be shared to address an immediate emergency you are facing.
• Judicial and Administrative Proceedings. We may disclose your personal health information in the course of a judicial or administrative proceeding in response to a valid court order or other lawful process, including if you were to make a claim for Workers Compensation.
• Public Health Activities. If we felt you were an immediate danger to yourself or others, we may disclose health information about you to the authorities, as well as alert any other person who may be in danger.
• Child/Elder Abuse. We may disclose health information about you related to the suspicion of child and/or elder abuse or neglect.
• Criminal Activity or Danger to Others. We may disclose health information if a crime is committed on our premises or against our personnel, or if we believe there is someone who is in immediate danger.
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Right to inspect and obtain a copy of your medical record. We are allowed to charge you a fee if we think it's appropriate.

Right to request that we limit how we use and share your PHI. There may be occasions when we cannot agree to your request.

Right to request that we amend or update information held in your medical record. There may be occasions when we cannot agree to your request.

Right to request how we send you PHI. The electronic nature of our service limits our ability to agree to such requests, but we will be transparent as to what our systems can and cannot facilitate.

Right to an accounting of the disclosure of your PHI. You are entitled to one 'disclosure accounting' in a 12 month period at no charge. An accounting does not include disclosures to carry out treatment, healthcare operations or payment. We are allowed to charge a fee for any additional accounting in a 12 month period.

Right to a paper copy of this Privacy Policy. The electronic nature of our service limits our ability to agree to such requests.

How to contact Top Tier Health and Wellness Group to Use your Rights

Please write to us at: Top Tier Health and Wellness Group, 1767 Central Park Ave, Suite 308, Yonkers, NY 10710.

How to complain

To submit a complaint to Top Tier Health and Wellness Group you must submit your complaint in writing and via email to:

Top Tier Health and Wellness Group, 1767 Central Park Ave, Suite 308, Yonkers, NY 10710 Email:  connect@toptierhwgroup.com

In addition you can complain to:

Secretary of the U.S. Department of Health and Human Services

Office of Civil Rights

Attention: Regional Manager

50 United Nations Plaza, Room 322

San Francisco, California 94102

For additional information, call (800) 368-1019

or

U.S Office of Civil Rights (866) 627-7748 (Voice) or (866) 788-4989 (TTY)

No retaliation

We will not retaliate against you for filing a complaint.

Effective date

This Notice is effective dated

April 9, 2025

Changes to this Notice

If we change the terms of this Privacy Policy then we will post the new Privacy Policy on our Website. Any new Privacy Policy will apply to all PHI that we maintain, including PHI that was created prior to the change.