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Notice of Privacy Practices

Last updated: May 2024

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THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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I. REGARDING HEALTH INFORMATION: Crescent Healing Counseling, PLLC understands that health information about you and your health care is personal. Your clinician is committed to protecting health information about you. Your clinician creates a record of the care and services you receive. This record is needed to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which your clinician may use and disclose health information about you. This notice also describes your rights to the health information your clinician keeps about you, and describes certain obligations your clinician and this practice have regarding the use and disclosure of your health information. Your clinician and this practice are required by law to:

·       Make sure that protected health information (“PHI”) that identifies you is kept private.

·       Give you this notice of your clinician’s and this practices’s legal duties and privacy practices with respect to health information.

·       Follow the terms of the notice that is currently in effect.

·       The practice can change the terms of this Notice, and such changes will apply to all information your clinician has about you. The new Notice will be available upon request, in the office, and on the practice’s website at www.crescenthealingcounseling.com.

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II. USE AND DISCLOSURE OF HEALTH INFORMATION ABOUT YOU: The following categories describe different ways that your clinician and this practice may use and disclose health information. For each category of uses or disclosures your clinician will explain and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways your clinician and this practice are permitted to use and disclose information will fall within one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. Your clinician may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, your clinician and this practice may disclose health information in response to a court or administrative order. Your clinician or this practice may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

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III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

1.     Psychotherapy Notes. Your clinician keeps “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is: a. For your clinician’s use in treating you. b. For your clinician’s use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy. c. For your clinician’s use in defending themselves in legal proceedings instituted by you. d. For use by the Secretary of Health and Human Services to investigate your clinician’s compliance with HIPAA. e. Required by law and the use or disclosure is limited to the requirements of such law. f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. g. Required by a coroner who is performing duties authorized by law. h. Required to help avert a serious threat to the health and safety of others.

2.     Marketing Purposes. As a psychotherapist, your clinician will not use or disclose your PHI for marketing purposes.

3.     Sale of PHI. As a psychotherapist, your clinician will not sell your PHI in the regular course of business.

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IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, your clinician and this practice can use and disclose your PHI without your Authorization for the following reasons:

1.     When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

2.     For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

3.     For health oversight activities, including audits and investigations.

4.     For judicial and administrative proceedings, including responding to a court or administrative order, although your clinician’s and this practice’s preference is to obtain an Authorization from you before doing so.

5.     For law enforcement purposes, including reporting crimes occurring on the practice’s premises.

6.     To coroners or medical examiners, when such individuals are performing duties authorized by law.

7.     For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

8.     Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.

9.     For workers’ compensation purposes. Although your clinician’s and this practice’s preference is to obtain an Authorization from you, your clinician may provide your PHI in order to comply with workers’ compensation laws. 10 Appointment reminders and health related benefits or services. Your clinician may use and disclose your PHI to contact you to remind you that you have an appointment with your clinician. Your clinician may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that your clinician offers.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

1.     Disclosures to family, friends, or others. Your clinician may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

 

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1.     The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask your clinician not to use or disclose certain PHI for treatment, payment, or health care operations purposes. Your clinician and this practice are not required to agree to your request, and your clinician or this practice may say “no” if your clinician or this practice believes it would affect your health care.

2.     The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

3.     The Right to Choose How Your Clinician Sends PHI to You. You have the right to ask your clinician or this practice to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and your clinician and this practice will agree to all reasonable requests.

4.     The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that your clinician or this practice may have about you. Your clinician or this practice will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and your clinician or this practice may charge a reasonable, cost based fee for doing so.

5.     The Right to Get a List of the Disclosures Your Clinician Or This Practice Have Made. You have the right to request a list of instances in which your clinician or this practice have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided your clinician or this practice with an Authorization. Your clinician or this practice will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list your clinician or this practice will give you will include disclosures made in the last six years unless you request a shorter time. Your clinician or this practice will provide the list to you at no charge, but if you make more than one request in the same year, your clinician or this practice will charge you a reasonable cost based fee for each additional request.

6.     The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that your clinician or this practice correct the existing information or add the missing information. Your clinician or this practice may say “no” to your request, but your clinician or this practice will tell you why in writing within 60 days of receiving your request.

7.     The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.

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Acknowledgement of Receipt of Privacy Notice

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information.

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