HIPAA Notice of Privacy Practices​

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This Notice of Privacy Practices explains how we may use and disclose your protected health information (PHI) to carry out treatment, payment, and healthcare operations, and for other purposes permitted or required by law. It also describes your rights to access and control your PHI.

Protected health information refers to information about you, including demographic details, that may identify you and that relates to your past, present, or future physical or mental health condition and related healthcare services.

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I. Uses and Disclosures of Protected Health Information

Your protected health information may be used and disclosed by your physician, our office staff, and others outside of our office who are involved in your care and treatment. Such use or disclosure may occur for the purpose of providing healthcare services to you, paying your healthcare bills, supporting the operations of the physician’s practice, or for any other use required by law.

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Treatment:

 

We will use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This may include coordination with third parties. For example, your PHI may be disclosed to a physician to whom you have been referred, ensuring that provider has the information necessary to diagnose or treat you.

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Payment:

 

Your PHI will be used as needed to obtain payment for healthcare services. For example, your health plan may require relevant PHI to authorize treatment.

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Healthcare Operations:

 

We may use or disclose your PHI as needed to support the business activities of the practice. These activities may include quality assessment, staff review, training of Licensed Professional Counselor Interns, and licensing requirements. For example, we may call your name in the waiting room when your provider is ready to see you or contact you to remind you of appointments.

We may also use or disclose your PHI without authorization in certain situations required by law, including but not limited to:

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-Public health issues or communicable diseases

-Health oversight activities

-Suspected abuse or neglect

-Food and Drug Administration requirements

-Legal proceedings

-Law enforcement requests

-Coroners, funeral directors, and organ donation processes

-Research purposes (when approved)

-Criminal activity

-Military and national security activities

-Workers’ compensation claims

-Inmate healthcare services

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Under the law, we must also make disclosures to you upon request and, when required, to the Department of Health and Human Services for compliance investigations under Section 164.500.

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Other Uses and Disclosures:

 

Any other uses or disclosures of your PHI will be made only with your authorization or opportunity to object, unless otherwise required by law. You may revoke any authorization in writing at any time, except to the extent that action has already been taken in reliance on that authorization.

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II. Your Rights
You have the following rights regarding your protected health information:

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Right to Inspect and Copy:

You may request to inspect and receive copies of your PHI. Requests must be submitted in writing. Under federal law, you may not access psychotherapy notes; information prepared in anticipation of a legal proceeding; or PHI otherwise restricted by law.

 

Right to Request Restrictions:

You may request restrictions on the use or disclosure of your PHI for treatment, payment, or operations. You may also request that your PHI not be disclosed to family or friends. Requests must specify the restriction and to whom it applies. Please note providers are not required to agree to restrictions if they believe it is not in your best interest.

 

Right to Confidential Communications:

You may request that communications be sent to you by alternative means or at an alternative location.

 

Right to Amend:

You may request amendments to your PHI if you believe it is incorrect or incomplete. If denied, you have the right to submit a statement of disagreement, and we may prepare a rebuttal which will be shared with you.

 

Right to an Accounting of Disclosures:

You may request a list of certain disclosures of your PHI made by our practice.

 

Right to a Paper Copy:

You are entitled to a paper copy of this notice at any time.

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We reserve the right to modify this Notice. Changes will be posted in our waiting areas, and you have the right to object to changes as outlined in this notice.

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III. Complaints

If you believe your privacy rights have been violated, you may file a complaint:

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With our office staff at 240-280-3245 

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

We will not retaliate against you for filing a complaint.