NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED BY HEALING WATERS PSYCHOLOGICAL SERVICES, LLC (“THE PRACTICE”) AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. THE PRACTICE’S PLEDGE REGARDING HEALTH INFORMATION:

The Practice understands that health information about you and your health care is personal. The Practice is committed to protecting health information about you. The Practice will create a record of the care and services you receive from it. The Practice needs this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the Practice. This notice will tell you about the ways in which the Practice may use and disclose health information about you. It also describes your rights to the health information kept about you and describes certain obligations the Practice has regarding the use and disclosure of your health information.

It is required by law to:

Make sure that protected health information (“PHI”) that identifies you is kept private.
Give you this notice of its legal duties and privacy practices with respect to health information.
Follow the terms of the notice that is currently in effect.

The Practice can change the terms of this Notice, and such changes will apply to all information the Practice has about you. The new Notice will be available upon request and on the Practice’s website.

II. HOW THE PRACTICE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that the Practice may use and disclose health information. For each category of uses or disclosures, explanations and examples are provided. Not every use or disclosure in a category will be listed. However, all of the ways the Practice is permitted to use and disclose information will fall within one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers, who have direct treatment relationship with the client, to use or disclose the client’s personal health information without the client’s written authorization, to carry out the health care provider’s own treatment, payment, or health care operations. The Practice may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a health care provider were to consult with another licensed health care provider about your condition, they would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the health care provider in diagnosis and treatment of your condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a client for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, the Practice may disclose health information in response to a court or administrative order. The Practice may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

1. Session Notes: The Practice will keep “Session notes” and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:

For use in treating you.
For use in training or supervising associates to help them improve their clinical skills.
For use in defending the Practice in legal proceedings instituted by you.
For use by the Secretary of Health and Human Services to investigate compliance with HIPAA.
Required by law and the use or disclosure is limited to the requirements of such law.
Required by law for certain health oversight activities pertaining to the originator of the session notes.
Required by a coroner who is performing duties authorized by law.
Required to help avert a serious threat to the health and safety of others.

2. Marketing Purposes. As a health care provider, the Practice will not use or disclose your PHI for marketing purposes.

3. Sale of PHI. As a health care provider, the Practice will not sell your PHI in the regular course of its business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION.

Subject to certain limitations in the law, the Practice can use and disclose your PHI without your Authorization for the following reasons:

When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
For health oversight activities, including audits and investigations.
For judicial and administrative proceedings, including responding to a court or administrative order, although the Practice’s preference is to obtain an Authorization from you before doing so.
For law enforcement purposes, including reporting crimes occurring on the Practice’s premises or during a telehealth session.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes, including studying and comparing the clients who received one form of care versus those who received another form of care for the same condition.
Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes. Although the Practice’s preference is to obtain an Authorization from you, the Practice may provide your PHI in order to comply with workers’ compensation laws.
Appointment reminders and health related benefits or services. The Practice may use and disclose your PHI to contact you to remind you of an appointment. It may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that the Practice offers.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

Disclosures to family, friends, or others. The 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. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that the Practice not use or disclose certain PHI for treatment, payment, or health care operations purposes. The Practice is not required to agree to your request, and the Practice may say “no” if it believes it would affect your health care.
The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
The Right to Choose How PHI is Sent to You. You have the right to ask the Practice to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and the Practice will agree to all reasonable requests.
The Right to See and Get Copies of Your PHI. Other than “session notes,” you have the right to get an electronic or paper copy of your medical record and other information maintained. The Practice will provide you with a copy of your record or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and it may charge a reasonable, cost-based fee for doing so.
The Right to Get a List of the Disclosures Made. You have the right to request a list of instances in which the Practice has disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided it with an Authorization. The Practice will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list will include disclosures made in the last six years unless you request a shorter time. The list will be provided to you at no charge, but if you make more than one request in the same year, the Practice will charge you a reasonable cost based fee for each additional request.
The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that the Practice correct the existing information or add the missing information. The Practice may say “no” to your request, but it will tell you why in writing within 60 days of receiving your request.
The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
The Right to File a Complaint. You have the right to file a complaint if you feel your rights are violated. You can complain if you feel that the Practice has violated your rights by contacting the Practice in writing and filing a written complaint with the Civil Rights Division, South Carolina Department of Health and Human Services (SCDHHS), P.O. Box 8206, Columbia, SC 29202-8206 or calling (888) 808-4238. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. The Practice will not retaliate against you for filing a complaint.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html