Privacy & Client Rights
Notice of Privacy Practices
Your information. Your rights. My responsibilities.
- This notice applies to records created or maintained by this counseling practice.
- You may ask questions or exercise your privacy rights by calling (205) 691-3111
- I will not retaliate against you for asking questions or filing a privacy complaint.
Your Rights
You have the right to:
- Get an electronic or paper copy of your health record.
- Ask me to correct your health record.
- Request confidential communications.
- Ask me to limit what I use or share.
- Get a list of certain disclosures of your information.
- Get a copy of this privacy notice.
- Choose someone with legal authority to act for you.
- File a complaint if you believe your privacy rights have been violated.
Your Choices
In certain situations, you may tell me your preferences about sharing information, including sharing with family, close friends, or others involved in your care or payment for your care. Written permission is generally required for marketing, sale of your information, and most uses or disclosures of psychotherapy notes.
How I May Use and Share Your Information
I may use or share your protected health information (PHI), without your written authorization when permitted by law, to:
- Treat you. I may use your information and share it with other professionals who are treating you, including for care coordination, consultation, or referrals, as permitted by applicable law. Example: I may coordinate with another clinician involved in your care about your treatment needs.
- Run the practice. I may use and share information to manage the practice, improve care, conduct quality activities, and contact you when necessary. Example: I may use information about your services to manage scheduling or evaluate the quality of care.
- Bill for services. I may use and share information with health plans, clearinghouses, billing services, or other entities to obtain payment. Example: I may send information about a counseling session to your health plan so it can process a claim.
- Comply with law and protect health or safety. I may disclose information when state or federal law requires it, for certain public-health activities, to report suspected abuse or neglect, or to prevent or reduce a serious and imminent threat.
- Respond to lawful proceedings and government requests. Subject to applicable privilege and confidentiality law, I may respond to a court or administrative order, subpoena, workers' compensation matter, healthoversight activity, law-enforcement request, coroner or medical examiner, or certain specialized government function.
- Conduct permitted research. Information may be used or shared for health research only when the legal requirements for research are satisfied.
- Respond after death. I may share information with a coroner, medical examiner, funeral director, or organprocurement organization when permitted by law.
Appointment Reminders and Health-Related Communications
I may use or disclose your PHI to contact you about appointments. I may also contact you about treatment alternatives or other health-related services or benefits that may be of interest to you.
Special Protection for Substance Use Disorder Records
To the extent that I receive or maintain substance use disorder patient records protected by 42 CFR part 2 (Part 2), I will not use or share information from those records in a civil, criminal, administrative, or legislative investigation or proceeding against you unless you provide written consent or the use or disclosure is authorized by a Part 2 court order and accompanied by a subpoena or similar legal mandate.
Your Rights in Detail
Get an electronic or paper copy of your health record You may ask to see or receive an electronic or paper copy of the health information I maintain about you. This right generally does not include psychotherapy notes as HIPAA defines that term, although other law may provide additional access rights. I will usually provide a copy or an agreed summary within 30 days. I may charge a reasonable, cost-based fee.
Ask me to correct your health record
You may ask me to amend information you believe is incorrect or incomplete. I may deny the request in some circumstances, but I will explain the denial in writing, generally within 60 days.
Request confidential communications
You may ask me to contact you in a specific way, such as at a particular telephone number, or to send mail to a different address. I will agree to reasonable requests.
Ask me to limit what I use or share
You may ask me not to use or share certain information for treatment, payment, or health care operations. I am not generally required to agree. If I agree, I may still share the information if it is needed for emergency treatment or another law permits or requires disclosure. If you pay in full out of pocket for a service, you may ask me not to share information about that service with your health plan for payment or health care operations. I will agree unless a law requires disclosure.
Get a list of certain disclosures
You may request an accounting of certain disclosures made during the six years before your request. The accounting generally excludes disclosures for treatment, payment, health care operations, disclosures you authorized, and certain other disclosures excluded by law. One accounting in a 12-month period is free; I may charge a reasonable, cost-based fee for an additional accounting during that period.
Get a copy of this notice
You may request a paper copy at any time, even if you agreed to receive the notice electronically. I will provide it promptly.
Choose someone to act for you
A person who has legal authority to act as your personal representative may exercise your rights and make choices about your information. I will verify the person's authority before taking action. Special rules may apply to minors, guardians, and others who lack legal authority to make their own health-care decisions.
File a complaint
If you believe your privacy rights were violated, you may contact the practice at the address or phone number on page 1. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting: hhs.gov/hipaa/filing-a-complaint I will not retaliate against you for filing a complaint.
Your Choices in Detail
If you tell me your preference in the situations below, I will follow your instructions when the law permits:
- Sharing information with family, close friends, or others involved in your care or payment for your care.
- Sharing information in a disaster-relief situation. If you cannot tell me your preference, such as during an emergency, I may share relevant information if I believe doing so is in your best interest or is necessary to lessen a serious and imminent threat to health or safety.
Uses that generally require written permission
- Psychotherapy notes. I maintain psychotherapy notes as HIPAA defines that term. Most uses and disclosures require your written authorization. Exceptions permitted by law include my use in treating you; certain training or supervision; defending myself in a proceeding you bring; HHS compliance activities; uses required
by law; certain oversight of the note's originator; certain coroner duties; and uses needed to avert a serious threat.
- Marketing. I do not use or disclose your PHI for marketing purposes without your written authorization, except for communications the law does not treat as marketing.
- Sale of PHI. I do not sell your PHI in the regular course of business. Any sale of PHI would require written authorization when required by law.
- Other uses. Uses and disclosures not described in this notice will be made only with your written authorization unless another law permits or requires them. You may revoke an authorization in writing, except to the extent I already relied on it.
Fundraising
If I contact you for fundraising, you may tell me not to contact you again. If a fundraising communication would use Part 2 information, I will provide clear and conspicuous advance notice and an opportunity to choose whether to receive it.
Additional Confidentiality for Counseling Records
Counseling records may receive protections under state law and professional ethics rules that are stricter than HIPAA. I will apply the law that provides greater privacy protection when it applies.
- Alabama services. Alabama places licensed counselor-client confidential relations and communications on the same basis as attorney-client confidentiality. Alabama counseling rules require protection of counseling information and written permission to disclose or transfer records to third parties unless an exception applies. When disclosure is required, I disclose only essential information and, when possible, inform you beforehand.
- Georgia services. Georgia counseling rules require me to safeguard information obtained from the first professional contact. Disclosure is limited to circumstances permitted by law, such as client consent, legal requirements, a clear and imminent danger, certain professional-defense matters, or consultation or supervision. When more than one client participates, each person's confidences must be protected. The precise limits of confidentiality depend on the facts and the law where services are provided. Examples of disclosures that may be permitted or required include suspected abuse or neglect, a serious and imminent threat, a valid authorization, treatment or payment activities when authorized or otherwise permitted under applicable state law, a court order or other legal mandate, professional consultation, or defense of the practice. A subpoena alone does not necessarily eliminate an applicable privilege; I will evaluate the legal requirements before disclosing counseling records.
My Responsibilities
- I am required by law to maintain the privacy and security of your PHI.
- I will notify you promptly if a breach occurs that may have compromised the privacy or security of your information, as required by law.
- I must follow the duties and privacy practices described in the notice currently in effect and provide you a copy.
- I will not use or share your information other than as described in this notice unless you authorize it in writing or the law otherwise permits or requires it.
Changes to This Notice
I may change this notice. Changes may apply to all information I maintain, including information created or received before the change. A revised notice will be available upon request, through the practice, and on any practice website that provides information about services.
Questions or Complaints
Contact the practice's Privacy Contact Office: Privacy Contact Office
One Life. Live it. Counseling & Consulting, LLC.
Address
8735 DUNWOODY PLACE #8408; ATLANTA, GA 30350
Phone