Protecting the Privacy of Your Health Information
As required by HIPPA law, this notice is to inform you of your rights and our obligations regarding your confidential Protected Health Information (PHI) and how it may be used, disclosed and accessed.
Whole Health Plus maintains confidential records of our counseling sessions including all communication and consultations. With written request, you have a right to access, inspect, copy and request your records with some exceptions. In marriage and/or family counseling, you can only request records with written permission from your partner or other adult family members. If you think any part of the record is incomplete or incorrect, you have the right to ask us to amend your record.
HOW YOUR HEALTH INFORMATION MAY BE USED:
Your PHI record is protected by privacy laws but can be released in 2 ways.
- PHI can be released by your written permission, which can be revoked at any time upon written request and expires after 90 days of closing your case.
The following are 3 examples of authorized permission:
For Payment: You can give authorization for us to disclose and give information to an insurance company or other third party to obtain reimbursement or determine eligibility or coverage. For example, we may need to give your third party information about your diagnosis, treatment plan and prognosis in order to pay for services rendered.
For Benefits: (such as Disability or Worker’s Compensation): If you are eligible and wish to file for disability or worker’s comp. you may want to give authorization for Danelle to help provide any information relating to your diagnosis and treatment to the state or your employer’s insurance carrier.
For Quality Care & Treatment: It can often benefit you to give authorization for us to consult with and disclose information to another agency, service provider, family member or health care professional to help provide quality and continuity of care. (i.e. doctors, clergy, schools, community agencies, hospitals, referrals, trusted supports, etc.) Danelle also consults with competent, experienced supervisors and other professionals to discuss best practices and better treatment ideas to improve quality of care. Last names or identifiers are not disclosed to maintain anonymity and privacy.
- PHI can be released without your permission or authorization. Although there are seldom breaks in confidentiality, it is your right to know of the exceptions to privacy laws such as:
- If you discuss a plan or intent to hurt yourself or someone else.
- If there is a reasonable suspicion of abuse/neglect against a minor child, elderly person (65 or older) or a dependent, disabled or vulnerable adult. Danelle Holbrook, by law is a mandated reporter of child, disabled and elder abuse. If child, disabled or elder abuse or neglect is suspected or reported, personal information will be disclosed to the proper authorities.
- If disclosure is necessary to protect against a serious threat to the health and safety of you or another person such as fire or emergency situation, missing person or run away, substance abuse while driving, prenatal exposure to controlled substance, etc.
- If the court orders your records or disclosure is required by federal, state or local law (i.e. to comply with a legal, criminal or ethical investigation, a duty to warn or to report).
- If you are a minor, confidentiality is exercised by your parent/legal guardian.
- Although other reasons not foreseen or listed here may be the cause of breaking confidentiality, in most cases, contact will be attempted before case disclosure.
YOUR CLIENTS RIGHTS: (Upon written request)
- You have a right to receive a copy of this notice and ask questions.
- You have the right to request an accounting of our disclosures.
- You have the right to request we communicate privacy information in a certain way or certain location (i.e. only at home or by mail).
- You have the right to revoke an authorized disclosure at any time however any disclosure made before this revoke will not affect a prior disclosure made under this authorization.
- You also have the right (with written request) to limit or restrict our use and disclosure of information. For example you may want us to disclose only certain information to certain people. Please let us what you don’t want disclosed with certain persons or agencies. Information that you do not want to be shared needs to be written and filed in your record.
- You have a right to file any complaints without retaliation
QUESTIONS AND COMPLAINTS
If you have questions about this notice or have other concerns about your privacy rights, you can contact me at 704.756.0339. If you feel your rights are being violated you can write down any complaints and send them to me at 6718 Mounting Rock Road, Charlotte, NC 28217 or to the North Carolina Board of Licensed Professional Counselors (NCBLPC) P.O. Box 77819, Greensboro, NC 27417 or E-mail: firstname.lastname@example.org
*This notice will go into effect on 10/1/2012. If I revise the policies and procedures, I will provide a new notice in my office and on my website at www.wholehealthplus.com. You may also request a personal copy or download one from my website.