Notice of Privacy Practices

As required by the privacy regulations established by the Health Insurance Portability and Accountability Act (HIPAA), this notice describes how health information about our clients may be used and disclosed, as well as how clients can access their individually identifiable health information. We encourage you to review this notice carefully.

A. Commitment to your privacy:

At Coeur Health Therapy, we are dedicated to maintaining the privacy of your individually identifiable health information, also known as Protected Health Information (“PHI”). We are legally required to keep records regarding you and the treatment and services we provide. We must maintain the confidentiality of health information that identifies you and provide you with this notice of our legal duties and privacy practices concerning your PHI. By federal and state law, we must follow the terms of the Notice of Privacy Practices that are in effect at the time.

This notice provides important information about:

  • How we may use and disclose your PHI
  • Your privacy rights regarding your PHI
  • Our obligations concerning the use and disclosure of your PHI

The terms of this notice apply to all records containing your PHI that are created or retained by our practice. Please note that we reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment will be effective for all of your records that we have created or maintained in the past and for any of your records that we may create or maintain in the future. If changes are made to our policies, we will notify you immediately, and you may request a copy of this Notice.

B. Questions
If you have questions about this Notice, please contact us at (917) 397-0086.

C. Uses and Disclosures of Your PHI

Your PHI may be used and disclosed in the following ways:

  • For Treatment: We may disclose your PHI to other licensed health care providers involved in your care to coordinate treatment. For example, if you are seeing a psychiatrist, we may share your PHI with them to ensure coordinated care.
  • For Payment: We may use and disclose your PHI to bill and collect payment for the services you receive. This may include contacting your health insurer to verify your eligibility for benefits and providing them with details about your treatment to determine coverage.
  • For Health Care Operations: We may use and disclose your PHI to facilitate the efficient operation of our practice. This includes evaluating the quality of health care services you have received and providing PHI to our attorneys, accountants, and consultants to ensure compliance with applicable laws.
  • For Disclosures Required by Law: We will use and disclose your PHI when required by federal, state, or local law.
  • Other Disclosures: In emergency situations, your consent may not be required, but we will attempt to obtain your consent after treatment is rendered. If you are unable to communicate with us (e.g., if you are unconscious), we may disclose your PHI if we believe you would consent to such treatment.

D. Special Circumstances for Disclosure

We may be compelled to use or disclose your identifiable health information without your consent or authorization in the following unique scenarios:

  • We may provide PHI to law enforcement if it is necessary to prevent or mitigate a serious threat to the safety of a person or the public. This includes situations where we believe you may be a danger to yourself or others.
  • We are mandated by child abuse and neglect reporting laws in New York State to disclose information if we have reasonable suspicion of such abuse or neglect.
  • We must report any suspected elder or dependent adult abuse if we have reasonable suspicion.
  • If you disclose a serious and/or imminent threat of physical violence against identifiable victims, we may disclose your information to prevent harm.
  • Professional misconduct by a health care professional must be reported by other health care professionals.
  • Disclosure may be required by federal, state, or local law, judicial proceedings, or law enforcement.
  • If compelled by a court order or a lawful authority, we may disclose your information.
  • We may disclose PHI for public health activities, such as providing information to a coroner in the event of your death.
  • In the event of a client’s death, spouses or parents of a deceased client have the right to access their records.
  • We may disclose PHI for specific government functions, such as for military personnel and veterans.
  • We may provide information for health oversight activities, such as investigations or inspections of health care organizations.
  • For Worker’s Compensation purposes, we may provide PHI to comply with relevant laws.
  • If disclosure is required or permitted to a health oversight agency for authorized activities, we will comply with such requests.
  • Any other disclosures required by law will be made as necessary.

E. Your Rights Regarding Your PHI

Confidential Communications:
You have the right to request that we communicate with you about your health and related issues in a specific manner or at a certain location. For example, you may ask us to contact you at home instead of at work. To request a type of confidential communication, please let us know, and we will accommodate reasonable requests. You do not need to provide a reason for your request.

Requesting Restrictions:
You have the right to request a restriction on our use or disclosure of your PHI for treatment, payment, or health care operations. Additionally, you can request that we limit our disclosure of your PHI to certain individuals involved in your care or payment for your care, such as family members or friends. If we agree to such a request, we are bound by our agreement, except when otherwise required by law, such as in emergencies or when the information is necessary for your treatment.

Inspection and Copies:
You have the right to inspect and obtain a copy of the PHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. To inspect and/or obtain a copy of your PHI, you must submit your request in writing. We will respond to your request within 30 days of receiving it. Under certain circumstances, we may deny your request, but if we do, we will provide you with written reasons for the denial and explain your right to have our denial reviewed. If you request copies of your PHI, we will not charge you more than $0.25 per page. We may provide you with a summary or explanation of the PHI if you agree to it and its cost in advance.

Amendment:
You may request that we amend your health information if you believe it is incorrect or incomplete. To request an amendment, your request must be made in writing and submitted to us, along with a reason supporting your request. We will deny your request if you fail to submit your request and the supporting reason in writing. We may also deny your request if the information is, in our opinion: (a) accurate and complete, (b) not part of the PHI kept by or for our practice, (c) not part of the PHI that you would be permitted to inspect and copy, or (d) not created by our practice, unless the individual or entity that created the information is unavailable to amend it.

Accounting of Disclosures:
All clients have the right to request an “accounting of disclosures.” This is a list of certain non-routine disclosures we have made of your PHI for purposes not related to treatment, payment, or operations. Routine uses of your PHI as part of patient care do not require documentation. To obtain an accounting of disclosures, you must submit your request in writing, stating a time period that may not exceed six years from the date of disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but we may charge you for additional lists within the same period. We will notify you of any costs involved with additional requests, and you may withdraw your request before incurring any costs.

Minors/Guardianship:
Parents or legal guardians of non-emancipated minor clients have the right to access their records. However, a minor over the age of twelve may request that their PHI be kept from their parents or guardians, and we may honor that request.

Right to a Paper Copy of This Notice:
You are entitled to receive a paper copy of our Notice of Privacy Practices. You may ask us for a copy of this Notice at any time.

Right to File a Complaint:
If you believe we have violated your privacy rights or if you disagree with a decision we made regarding access to your PHI, you have the right to file a complaint with the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W., Washington, D.C., 20201. If you file a complaint about our privacy practices, we will take no retaliatory action against you.

If you have any questions regarding the Notice of Privacy Practices, please contact us at (917) 397-0086.

Your signature below indicates that you have received and understand the Notice of Privacy Practices and agree to the terms.