NOTICE OF PRIVACY PRACTICE
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.
Why are we providing you with this notice? We are required by a federal law known as the Health Insurance Portability and Accountability Act (HIPPA) to give this noce. This noce will provide information about how we may use and disclose health information about you. It will also describe your rights and our personal obligations regarding the use and disclosure of that information.
Personal health information. This noce applies to the information and records we have about your mental health, health status, and the mental health care services you receive from Insight Counseling & Therapy. This information is related to the counseling services you receive from us and the records pertaining to counseling.
How we may use and disclose the health information about you:
For Treatment: We may use or disclose health information about you to facilitate counseling and other health treatment. For example, your counselor may disclose information about you to another professional counselor in the agency so that the counselor can determine the most appropriate care for you.
For Payment: We may use and disclose health information about you so that we can be paid by you, your insurance company and/or another party. For example we may need to give your insurance company information about our services to you so the company will pay us for services.
For Agency Operations: We may use and disclose health information about you in order to run our office and make sure that you and our other clients receive quality care. For example, we may use your information to contact you to remind you of your appointments. Please notify us in writing if you do NOT want us to contact you to remind you of your appointments. Special Situations: We may use or disclose your health information without your permission for several reasons including:
● Disclosing your health information when we believe that disclosure is necessary to prevent a serious threat to your health and safety or the health and safety of another person.
● Disclosing your health information as required by federal, state or local law.
● Disclosing your health information as required by law to prevent injury, suspected abuse, or neglect.
● Disclosing your health information in response to a court order, subpoena, warrant, summons, or similar process. Other Uses and Disclosures of Health Information: Except where otherwise required or authorized by law, we will not use or disclose your health information for any purpose without your written authorization. If you authorize us to use or disclose health information about you, you may revoke your authorization in writing, at any me. If you revoke your authorization, we will no longer use or disclose your health information for the reasons covered by your written authorization, but we cannot take back any uses or disclosures we have already made with your permission.
Your rights regarding your health information: You have the following rights with regard to your health information:
● You may inspect and copy your health information, with certain exceptions.
● If you believe that the health information we have about you is incorrect or incomplete, you may ask us to amend the information.
● You may obtain an accounting of our disclosures of your health information. This is a list of all of your disclosures of your health information for purposes other than treatment, payment and health care operations.
● You have the right to request that we restrict or limit our use or disclosure of your health information to only treatment, payment or health care operations. We are not required to comply with your request.
● You may request that we communicate with you about your health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
● You have the right to receive a paper copy of this noce.
If you want to exercise any of these rights, please contact the director of Insight Counseling & Therapy, Becky J. Wolery, in writing where you are receiving counseling.
Changes to this notice.
We have the right to change this noce. If we do so, the new noce will apply to the health information we may already have about you and to the health information that we receive in the future. We are required to abide by the most current noce that is in effect. We will post a summary of the most current noce in our office. You are entitled to receive a copy of the most current noce.
If you believe that your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with Insight Counseling and Therapy please contact Becky J Wolery at 208-405-0020 or email her at: firstname.lastname@example.org (You will not be penalized for filing a complaint.) This Notice is effective as of Aug, 2022.