HEALTH INSURANCE PORTABILITY and ACCOUNTABITLITY ACT [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 CAREFULLY.
Definitions of terms:
When we say “you” in this Notice we refer to the patient or research participant who is the subject of the medical information. When we say “we”, “our”, “us”, “TEMPLE COUNSELING, LLC. ,”, or “Temple Counseling, LLC. ” we refer to one or more of the TEMPLE COUNSELING, LLC. organizations. When we say “medical information”, or “health care information”, we include information that identifies you and tells about your past, present, or future physical or mental health condition and the provision of the health care provided to you.
Safeguarding your protected Health Care Information:
Temple Counseling, LLC. (TEMPLE COUNSELING, LLC.) is committed to protecting your health care information. In order to provide treatment, TEMPLE COUNSELING, LLC. will ask for certain health information and the health information will be put into your medical record. The medical record usually contains your symptoms, examination and test results, diagnosis, and treatment records provided by your therapist and or psychiatrist. That information, referred to as your health medical record, and legally regulated as health information may be used for a variety of purposes. TEMPLE COUNSELING, LLC. is required to follow the privacy practices described in this Notice, although TEMPLE COUNSELING, LLC. reserves the right to change our privacy practices and the terms of the Notice at any time. A new copy of the notice will be provided upon your request from TEMPLE COUNSELING, LLC .
How TEMPLE COUNSELING, LLC. may use your Protected Health Care Information:
TEMPLE COUNSELING, LLC. employees will only use your health care information for purposes related to your treatment. For uses beyond what TEMPLE COUNSELING, LLC. normally does, TEMPLE COUNSELING, LLC. must have your written authorization unless the law permits or requires it. The following are some examples of our possible uses and disclosures of your health care information.
Uses and disclosures relating to treatment, payment, or health care operations:
For Treatment: TEMPLE COUNSELING, LLC. may use or share your health care information to approve or deny treatment and to determine if your medical treatment is appropriate. For example, TEMPLE COUNSELING, LLC. providers may need to review your treatment plan with your health care provider for medical necessity and coordination of care. We may disclose medical information about you to doctors, nurses, therapists, students, or other persons involved in your health care treatment.
Payment: TEMPLE COUNSELING, LLC. may use and share your health information in order to bill and collect payment for your health care services and to determine your eligibility to participate in our services. For example, your health care provider may send claims for payment of medical services rendered for you, in order to receive payment or to reimburse you for services.
Health Care Operations: TEMPLE COUNSELING, LLC. may use and share your health care information to evaluate the quality of services provided, or to our state and federal auditors. Your medical information also may be used or disclosed to comply with law and regulation, accreditation purposes, patients’ claims, grievances or lawsuits, health care contracting relating to our operations, legal services, business planning and development, business management and administration, the sale of all or parts of TEMPLE COUNSELING, LLC. to another organization, underwriting and other insurance activities to operate the TEMPLE COUNSELING, LLC. organization.
Other uses and disclosures of health care information required or allowed by law:
Appointment reminders: We may contact you to remind you that you have an appointment with a provider.
Treatment Alternatives: We may contact you to tell you about or recommend possible treatment options or alternatives that may interest you.
Health-related benefits and services: We may contact you about benefits or other services we provide.
Information purposes: Unless you provide us with alternative instructions, TEMPLE COUNSELING, LLC. may send appointment reminders and other program materials to your home.
Required by law: We will disclose medical information about you when required to do so by federal or state law.
Public health disclosures: TEMPLE COUNSELING, LLC. may disclose medical information about you for public-health purposes. These purposes generally include the following:
*Preventing or controlling disease (such as cancer or tuberculosis), injury or disability; *reporting vital events such as births and deaths;
*reporting child abuse or neglect; *notifying a person who may have been exposed to a disease or may be at risk of contracting or spreading disease or condition; *notifying a person who may have been exposed to a disease or may be at risk of contracting or spreading disease or condition;
*notifying a person who may have been exposed to a disease or may be at risk of contracting or spreading disease or condition; *notifying the appropriate government authority as authorized or required by law if we believe a patient has been the victim of physical or sexual abuse, neglect or domestic violence.
Health oversight activities: TEMPLE COUNSELING, LLC. may disclose your health care information to other divisions in the department and other agencies for oversight activities required by law. Examples of these activities are audits, inspection, investigations and licensure.
Coroners, Medical Examiners, Funeral Directors and Organ Donations: In most circumstances TEMPLE COUNSELING, LLC. may disclose health care information relating to a death to, coroners, medical examiners, or funeral directors, and to authorized organizations relating to organ, eye, or tissue donations or transplants.
Research Purposes: In certain circumstances, and under supervision of our Institutional Review Board or other designated privacy board, TEMPLE COUNSELING, LLC. may disclose health care information to assist in medical research. Your medical information may be important to further research efforts and the development of new knowledge.
Avert threat to health or safety: In order to avoid a serious threat to health or safety, TEMPLE COUNSELING, LLC. may disclose health information as necessary to law enforcement or other persons who can reasonably prevent or lesson a serious and imminent threat to your health and safety of the public or another person.
Protective services for the U.S. President and others: As authorized or required by law, we may disclose medical information about you to authorized federal officials so they may conduct special investigations or provide protection to the U.S. President, other authorized persons or foreign heads of state.
Military: If you are a member of the armed forces, we may release medical information about you to military authorities as authorized or required to by law.
Families, friends or others included in your care: Unless you say no, TEMPLE COUNSELING, LLC. may release your medical information to anyone involved in your medical care or payment of your care. Such people include family members, friends, or any individual you identify. TEMPLE COUNSELING, LLC. may also share health information with people to notify them about your location, general condition or death.
Workers Compensation: TEMPLE COUNSELING, LLC. may disclose health care information to workers compensation programs that provide benefits for work-related injuries or illnesses without regard to your fault. These programs provide benefits for work-related injuries or illness.
Patient Directories: The health care plan under which you are enrolled does not maintain a directory for disclosures to callers or visitors who ask for you by name. Your name will not be identified to an unknown caller or visitor without authorization from you.
Legal proceedings, lawsuits and other legal actions: We may disclose medical information to courts, attorneys and court employees when we get a court order, subpoena, discovery request, warrant, summons or other lawful instructions from those courts or public bodies and in the course of certain other lawful, judicial or administrative proceedings or to defend ourselves against a lawsuit brought against us.
Law Enforcement: If asked to do so by law enforcement, and as authorized or required by law, we may release medical information:
* to identify or locate a suspect, fugitive, material witness or missing person;
* about a suspended victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
* about a death suspected to be the result of criminal conduct;
* about criminal conduct at TEMPLE COUNSELING, LLC.
* in case of a medical emergency, to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Other uses of medical information:
Other uses and disclosures of medical information not covered by this Notice will be made only with your written authorization. If you provide us authorization (permission) to use or disclose medical information about you, you may revoke (withdraw) that authorization (permission), in writing, at any time.
Your rights regarding medical information about you:
Right to request restrictions: You can request a restrictions or limitation on the health care information Temple Counseling, LLC. uses or discloses about you. Temple Counseling, LLC. will accommodate your request if possible, but it is not legally required to agree to the requested restriction. If Temple Counseling, LLC. agrees to a restriction, Temple Counseling, LLC. will follow it, except in emergency situations.
Right to request Confidential Communications: You can request that TEMPLE COUNSELING, LLC. communicate w/you about medical matters in a certain way or a certain location.
Right to request a disclosure: You have the right to request that we disclose your medical information for reason not provided in this Notice. For example, you may want your lawyer to have a copy of your medical records.
Right to Inspect and Copy: With certain exceptions (such as psychotherapy notes, information collected for certain legal proceedings, and medical information restricted by law) you have a right to see your health care information upon written request. If you want copies of your health information, you may be charged a fee for copying, depending on your circumstances. You have a right to choose what portions of your information you want to have copied, and to have prior information to the cost of copying.
Right to request Amendment: You may request in writing that TEMPLE COUNSELING, LLC. correct or add to your health record. TEMPLE COUNSELING, LLC. may deny the request if TEMPLE COUNSELING, LLC. determines that the health information is 1) correct and complete; 2) not created by us and/ or nor part of our records; 3) not permitted to be disclosed. If TEMPLE COUNSELING, LLC. approves the request for amendment, TEMPLE COUNSELING, LLC. will change the health information and inform you, and will inform others that need to know about the change in your health care information.
Right to an accounting of disclosures: You can request a list of disclosures made of your health information six years prior to your request. Exceptions are health information that has been used for treatment, payment, and operations. In addition, TEMPLE COUNSELING, LLC. does not have to list disclosures made to you, based on your written authorization, provided for national security, to law enforcement officials or correctional facilities. There will be no charge for up to one aforementioned list each year.
Right to paper copy of this notice: You have the right to receive a paper copy of this Notice and/or electronic copy by email upon request.