NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MENTAL HEALTH AND OTHER APPLICABLE MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED – AS WELL AS HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Commitment to Privacy
Impower Healing Holistic Counseling and Wellness (hereafter referred to as “this practice”) is dedicated to maintaining the privacy of your health information. Your health record is further protected under a federal law known as the Health Insurance Portability and Accountability Act (HIPAA) which requires that we give notice about how medical information about you may be used and disclosed, and how you can get access to this information.
Notice of Privacy Practices
Your health (aka medical) record contains information about you and your health that a provider creates to provide you with quality care and to fulfill certain legal requirements. When this information identifies you and information about your past, present and future mental or medical health and/or care, it is considered protected health information or “PHI."
Permitted Uses & Disclosures of Your Information
This practice may use and disclose information for the following purposes:
1) Treatment: PHI may be used and disclosed by those who are involved in your care so that they can provide, manage or coordinate your health care and related services. This includes (but is not limited to) referrals and consultation with clinical supervisors or other health care professionals.
2) Payment: Your PMI may be used as needed to determine your eligibility for health plan and insurance coverage and to provide information necessary to submit bills to insurance or to a third party responsible for payment of services provided to you.
3) Healthcare Operations: This practice may use or disclose, as needed, your PHI to run our business. This includes, but is not limited to, administrative, financial, legal and quality improvement activities. Third party businesses we contract with (such as electronic health records) will have a written contract that requires it to safeguard the privacy of your PHI.
4) Communication with you. This includes appointment reminders, treatment alternatives or share services that might be of interest to you.
Disclosing Information Without Consent
There are times when local, state or federal law may require us to use or share your information, including but not limited to:
• A serious threat to your or other’s health and safety or to the public.
• Suspected abuse or neglect of children, elders or people with special needs. We will only share information with persons/organizations who are able to help prevent or reduce the threat.
• Help with public health and health oversite activities.
• Research purposes
• Address worker’s compensation, law enforcement and other governmental requests.
• When we are required to do so by lawsuits and other legal or court proceedings.
• Special government functions including military, intelligence, or ensuring the safety of those housed in correctional institutions.
• In general, we will make efforts to use, disclose, or request the minimum necessary PHI to accomplish the intended purpose except in the cases of disclosure to you, with authorization, or investigations.
Information You Have Choices About The Way It Is Used & Shared
If you have a clear preference for how we share your information in these situations, let us know and we will do our best to fulfill your wishes. In cases of imminent threat to health or safety, or a situation where you are unable to respond we may go ahead and share your information if we feel it is in your best interest to lessen harm.
This practice 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.
• Share PHI with public or private entities authorized by law to assist in disaster relief efforts.
• Raise funds (you may ask to step receiving this information).
We will never share your information unless you give us written permission for: Marketing purposes
Your Rights Regarding Your Health Information
You have the right to:
1. Request confidential communication. You can ask us to communicate with you in a particular way or at a certain place that is more private for you. For example, you can ask us to call you at home, and not at work, to schedule or cancel an appointment.
2. Ask us to limit what we tell people involved in your care or the payment for your care, such as family members and friends.
3. Look at the health information we have about you, such as your medical and billing records. You can get a copy of these records, but we may charge you for it.
4. Ask us to make additions or corrections to your record if you believe that the information in your records is incorrect or missing something important. You have to make this request in writing and tell us your reasons for wanting to make the changes.
5. Choose someone to act for you: for example, someone who you have given medical power of attorney or who is a legal guardian.
6. Get a list of those with whom we’ve shared your information in the last 6 years.
7. You have the right to a copy of this notice.
8. File a complaint if you believe your privacy rights have been violated. You can file a complaint with our privacy officer (Tabitha Marsh, DACM, Professional Counselor Associate) and with the Secretary of the U.S. Department of Health and Human Services. All complaints must be in writing. Filing a complaint will not change the health care we provide to you in any way. Also, you may have other rights that are granted to you by the laws of our state, and these may be the same as or different from the rights described above. We will be happy to discuss these situations with you or any questions regarding this notice or our health information privacy policies.
Last updated: 9/22/2024
Mobile SMS privacy policy: As a current or prospective client, you understand that you can text us to STOP at any time to opt out of receiving SMS text messages from us. You can text us HELP at any time to receive help.
Your mobile information will not be shared with any third parties/affiliate for marketing/promotional purposes.
All policies are followed as per CTIA guidelines 5.2.1. At any time, if you want your information to be removed from our list, you can contact us via our email address or regular mail (with the exception of patient records which are a part of the medical file).