HIPAA NOTICE OF PRIVACY PRACTICES
This Notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
The terms of this Notice of Privacy Practices applies to Richer Soil Counseling, LLC. We are required by law to maintain the privacy of protected health information (“PHI”) and to provide patients with notice of our legal duties and privacy practices with respect to protecting your PHI. We are required to abide by the terms of this Notice of privacy practices (“Notice”) (or other notice in effect at the time of the use or disclosure). We reserve the right to change the terms of this notice as necessary and to make the new Notice effective for all PHI maintained by us. If we change this Notice, we will post the new notice on our website or you can request a copy.
We keep a record of the therapy services we provide you. You may ask your therapist to see your record and you make ask us to make corrections to the record. We will not disclose your record to others unless you direct us to do so - and sign the appropriate release of information - or unless we are compelled by law.
Except for the allowed and required uses and disclosures described in this Notice, we will use and disclose your health information only with written authorization from you.You may revoke your written authorization at any time in writing. This will not apply to uses and disclosures we have already acted upon based on your initial authorization.
We use and disclose your PHI to provide treatment and other services to you–for example, to provide our services or to consult with specialists about your healthcare. We may use your information to direct or recommend alternative treatments, therapies, health care providers, or settings of care to you or to describe a health-related product or service. We may also disclose PHI to other providers involved in your treatment.
We may use and disclose of your PHI as necessary for payment purposes. For example, we may forward information regarding services provided to your insurance company to arrange payment for the services provided to you or we may use your information to prepare a bill to send to you or to the person responsible for your payment.
We may use and disclose your PHI for our health care operations, which include internal administration and planning and various activities that improve the quality and cost-effectiveness of the care that we deliver to you.
With your approval, we may from time to time disclose your PHI to designated family, friends and others who are involved in your care or in payment of your care in order to facilitate that person’s involvement in caring for you or paying for your care. If you are unavailable, incapacitated, or facing an emergency medical situation and we determine that a limited disclosure may be in your best interest, we may share limited PHI with such individuals without your approval.
Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as billing, accounting, etc. At times, it may be necessary for us to provide your PHI to one or more of these outside persons or organizations who assist us with our health care operations. In all cases, we require these business associates to appropriately safeguard the privacy of your PHI.
We are permitted or required by law to make certain other uses and disclosures of your PHI without your consent or authorization.
• We may use and disclose your PHI when required to do so by any applicable federal, state or local law;
• We may release your PHI as required by law if we suspect child or elder abuse or neglect;
• We may release your PHI if you threaten to hurt or kill another person;
• We may release your PHI if you threaten to hurt or kill yourself.
You have the right to copy and/or inspect much of the PHI that we retain on your behalf. All requests for access must be made in writing and signed by you or your representative. If we maintain your PHI in electronic form, you may request to receive a copy in electronic form. There is a copying fee of $.10 per page.
You have the right to request in writing that PHI that we maintain about you be amended or corrected. We are not obligated to make all requested amendments but will give each request careful consideration. All amendment requests, in order to be considered by us, must be in writing, signed by you or your representative and must state the reasons for the amendment/correction request. If we make an amendment or correction you request, we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary.
You have the right to receive an accounting of certain disclosures made by us of your PHI. Requests must be made in writing and signed by you or your representative.
You have the right to request restrictions on certain of our uses and disclosures of your PHI for treatment, payment, or health care operations. We are not required to agree to your restriction request but will attempt to accommodate reasonable requests when appropriate and we retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction. Notwithstanding the foregoing, we must agree to your request to restrict disclosure of your PHI to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law, the disclosure is not otherwise required by law, and the PHI pertains solely to a health care item or service for which you or another person other than the health plan has paid us in full.
You have the right to ask to receive confidential communications by asking us to send information by alternative means or at alternative locations — for example, to another address instead of your home address. You must make a written request to receive confidential communications or to cancel or change an earlier request.
We safeguard your PHI throughout our collection, use, and disclosure of that PHI in a manner consistent with applicable laws and regulations. Your PHI will be retained by in accordance with applicable laws and regulations, and then will be disposed of securely.
In the event of a breach of the security of your PHI, we will provide you with a notification about the breach, including what steps we have taken in response to the breach and what you may do to reduce the risk of harm from the breach.
If you believe your privacy rights have been violated, you can file a complaint with us. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services in Washington D.C. in writing within 180 days of a violation of your rights. There will be no retaliation for filing a complaint.
If you have questions or need further assistance regarding this Notice, you may contact us:
By phone: 508-928-7555
By email: email@example.com
As a client of Richer Soil Counseling, you retain the right to obtain a paper copy of this Notice of Privacy Practices, even if you have requested such copy by email or other electronic means.
This Notice of Privacy Practices is effective March 2, 2019.
The roots of all goodness lie in the soil of appreciation for goodness.
~ Dalai Lama