Columbia Counseling Center | Questions We're Often Asked


	NOTICE OF PRIVACY RIGHTS THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. our privacy commitment Columbia Counseling Center is dedicated to protecting the privacy of your health information. The purpose of this notice is to inform you how we may use and disclose your protected health information (PHI), certain obligations we have regarding the use and disclosure of your PHI, and, most importantly, advise you of your rights. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that we maintain the privacy of your health information, provide you with a Notice of Privacy Practices describing our legal duties, and abide by the terms of the Notice of Privacy Practices. We reserve the right to change our privacy practices and the terms of this notice at any time, as long as the law allows it. We reserve the right to make these changes effective for all medical information that we keep, including medical information we created or received before we made the changes. However, before we make a significant change in our privacy practices, we will change this notice and provide the new notice in the waiting area. You may request a copy of our notice at any time. how we may use and disclose information about you We may use and disclose your health information for purposes of Treatment, Payment and Health Care Operations. For example: Treatment: We are permitted to use and disclose your PHI to provide, coordinate, or manage your health care related services. For example, your protected health information may be provided to a doctor to whom you have been referred to ensure that the doctor has the necessary information to diagnose or treat you. Payment: We are permitted to use and disclose your PHI in activities related to obtaining payment for your health care services. For example, obtaining approval for additional sessions may require that your relevant protected health information be disclosed to your health insurance company. Healthcare Operations: We are permitted to use or disclose PHI about you for our business activities. For example, we may ask that you sign in for your appointments, call your name in the waiting room, and conduct or arrange for medical review and auditing functions. Business Associates: We are permitted to disclose your PHI to our business associates in order to carry out treatment, payment or health care operations. For example, we may disclose your PHI to a transcription service, or a collection service in order to obtain payment for outstanding balances. Whenever an arrangement between a business associate and us involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your PHI. Appointment Reminders: With your permission given on the Patient Agreement, we may call to remind you of an upcoming appointment or to cancel/reschedule an appointment. If desired, a generic message will be left on your answering machine. SPECIAL SITUATIONS Required by Law or Law Enforcement: We may use and disclose information about you as required by law. Your information also may be used and disclosed for law enforcement purposes, as required by law or in response to a valid subpoena. For example, we may disclose information for the following purposes: for judicial and administrative proceedings pursuant to legal authority, to report information related to victims of abuse, neglect and/or domestic violence, to assist law enforcement officials in their law enforcement duties, and for purposes of governmental investigation. Serious Threat to Health or Safety: To avert a serious threat to health or safety, we may use and disclose medical information about you when necessary. Any disclosure, however, would only be to someone able to help prevent such a threat. Workers’ Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to Workers’ Compensation or other similar programs established by law. Military: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. Health Oversight Activities: We may disclose PHI to a health oversight agency for activities authorized by law such as audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. WHEN YOUR AUTHORIZATION IS REQUIRED Uses or disclosures of your PHI for other purposes or activities not listed above will be made only with your written authorization (permission), which may be revoked by you in writing at any time. If you revoke your authorization, we will no longer use or disclose your PHI for the reasons covered by your written permission. However, we are unable to take back any disclosures we have already made with your permission. your rights ► You have the right to request a restriction of your PHI. You may ask us not to use or disclose certain parts of your PHI for treatment, payment or healthcare operations. A form must be completed and is available upon request. We are not required to agree to a restriction that you may request, but if we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment. We will notify you in writing whether we agree or do not agree with your request. ► You have the right to request amendments to your PHI if you believe the information we have is incorrect or incomplete. In order to ensure that we collect the information we need, a form must be completed and is available upon request. If we deny your request for amendment, you have the right to file a statement of disagreement with us. ► You have the right to receive an accounting of all disclosures of protected health information other than for treatment, payment or healthcare operations. Your request must state a time period not longer than six (6) years and may not include dates before April 14, 2003. The first list that you request within a 12-month period will be provided free of charge; however, we may charge you for the cost of providing additional lists within a 12-month period. ► You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternate address or other method of contact. We will accommodate reasonable requests. ► You have the right to receive a copy of this document in its entirety for your personal records. It will be necessary for you to sign an Acknowledgement of Receipt indicating that you have received this document. This signed form will become a part of your file. complaints You have the right to register a complaint with Columbia Counseling Center and/or the U.S. Department of Health and Human Services, if you feel your privacy rights have been violated or if you are in disagreement with the usage and storage of your protected health information. There will be no retaliation to anyone who files a complaint. The person below will handle your complaint for Columbia Counseling Center, or will provide you with the appropriate address should you choose to make your complaint in writing to the U.S. Department of Health and Human Services. Privacy Officer Columbia Counseling Center 900 St. Andrews Road Columbia, SC 29210 Telephone: (803) 731-4708 Fax: (803) 798-7607