Notice of Privacy Policy

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. CROWNTOWN COUNSELING'S PLEDGE REGARDING HEALTH INFORMATION:

CrownTown Counseling (CTC) understands that health information about you and your healthcare is personal. CTC is committed to protecting health information about you. Your therapist at CTC creates a record of the care and services you receive from him/her.This record is needed 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 this mental healthcare practice. This notice will tell you about the ways in which CTC may use and disclose health information about you. This is a description of your rights to the health information CTC keeps about you and a description of the certain obligations CTC has regarding the use and disclosure of your health information. CTC is required by law to:

1. Make sure that protected health information (“PHI”) that identifies you is kept private.

2. Give you this notice of CTC's legal duties and privacy practices with respect to health information.

3. Follow the terms of the notice that is currently in effect.

4. CTC can change the terms of this Notice and such changes will apply to all information CTC has about you. The new notice will be available upon request, within CTC's client portal, and on this website.

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

The following categories describe different ways that CTC uses and disclose health information. For each category of uses or disclosures CTC will explain what each means and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways CTC is permitted to use and disclose information will fall within one of the categories.

FOR TREATMENT, TREATMENT PAYMENT, HEALTH CARE OPERATIONS, INCAPACITATION/EMERGENCIES, or lawsuits and disputes:

Federal privacy rules and 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.

1. For Treatment: CTC may also disclose your protected health information for the treatment activities of any health care provider who is treating you. This too can be done without your written authorization. For example, if a therapist were to consult with another licensed healthcare provider about your condition, CTC would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the therapist in diagnosis and treatment of your mental health condition.

2. To obtain treatment payment: CTC can use your PHI to bill and collect payment for the treatment and services provided by CTC to you. For example, CTC might send your PHI to your insurance company or health plan to get paid for the healthcare services provided to you. CTC may also provide your PHI to business associates, such a CTC's billing companies, claims processing companies, and others that process my health care claims.

3. For Healthcare Operations: CTC can use and disclose your PHI to operate the practice. For example, CTC might use your PHI to evaluate the quality of healthcare services that you received or to evaluate the performance of the health care professionals who have provided such services to you. CTC may also provide your PHI to CTC's accountant, attorney, consultants, or others to further the healthcare operations.

4. For Patient Incapacitation or Emergency: CTC may also disclose yourPHIto others without your consent if you are incapacitated or if an emergency exists. For example, your consent is not required if you need emergency treatment as long as CTC attempts to obtain your consent after treatment is rendered; or if CTC tries to get your consent but you are unable to communicate withCTC (for example, if you are unconscious or in severe pain) and CTC thinks that you would consent to such treatment if you were able to do so.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other healthcare 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 healthcare providers with a third party, consultations between healthcare providers and referrals of a client for healthcare from one healthcare provider to another.

5. Lawsuits and Disputes: If you are involved in a lawsuit, CTC may disclose health information in response to a court or administrative order. CTC 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. Psychotherapy Notes. CTC does keep“psychotherapy notes”as that term is defined in 45CFR§164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:

a. For CTC's use in treating you.

b. For CTC's use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.

c. For CTC's use in defending therapist in legal proceedings instituted by you.

d. For use by the Secretary of Health and HumanServices to investigate CTC's compliance with HIPAA.

e. Required by law and the use or disclosure is limited to the requirements of such law.

f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.

g. Required by a coroner who is performing duties authorized by law.

h. Required to help avert a serious threat to the health and safety of others.

2. Marketing Purposes. As a psychotherapy practice, CTC will not use or disclose your PHI for marketing purposes.

3. Sale of PHI. As a psychotherapy practice, CTC will not sell your PHI in the regular course of business.

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

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

1. 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.

2. 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.

3. For health oversight activities, including audits and investigations.

4. For judicial and administrative proceedings, including responding to a court or administrative order, although CTC's preference is to obtain an Authorization from you before doing so.

5. For law enforcement purposes, including reporting crimes occurring on CTC's premises.

6. To coroners or medical examiners, when. such individuals are performing duties authorized by law.

7. For research purposes, including studying and comparing the mental health of clients who received one form of therapy versus those who received another form of therapy for the same condition.

8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the UnitedStates; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working with in or housed in correctional institutions.

9. For workers' compensation purposes. Although CTC's preference is to obtain an Authorization from you, CTC may provide your PHI in order to comply with workers' compensation laws.

10. Appointment reminders and health related benefits or services. CTC may use and disclose your PHI to contact you to remind you that you have an appointment with a CTC therapist. CTC may also use and disclose your PHI to tell you about treatment alternatives, or other healthcare services or benefits that are offered at CTC.

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

Disclosures to family, friends, or others. CTC 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:

1. The Right to RequestLimits on Uses and Disclosures of Your PHI. You have the right to request CTC not to use or disclose certain PHI for treatment, payment, or healthcare operations purposes. CTC is not required to agree to your request, and CTC may say“no” if your therapist believes it would affect your healthcare.

2. 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 healthcare operations purposes if the PHI pertains solely. to a healthcare item or a healthcare service that you have paid for out-of-pocket in. full.

3. The Right to Choose How CTC Sends PHI to You. You have the right to ask CTC to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and CTC will agree to all reasonable requests.

4. The Right to See and Get Copies of Your PHI. Other than“psychotherapy notes,”you have the right to get an electronic or paper copy of your medical record and other information that CTC has about you. CTC will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30days of receiving your written request, and CTC may charge a reasonable, cost based fee for doing so.

5. The Right to Get a List of the Disclosures CTC Has Made. You have the right to request a list of instances in which CTC has disclosed your PHI for purposes other than treatment, payment, or healthcare operations, or for which you provided CTC with an Authorization. CTC will respond to your request for an accounting of disclosures within 60days of receiving your request. The list CTC will give you will include disclosures made in the last six years unless you request a shorter time. CTC will provide the list to you at no charge, but if you make more than one request in the same year, CTC will charge you a reasonable cost based fee for each additional request.

6. 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 CTC corrects the existing information or add the. missing information. CTC may say“no” to your request, but will tell you why in writing within 60 days of receiving your request.

7. 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.

VII. HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES

If you think that CTC may have violated your privacy rights, or you disagree with a decision CTC has made about access to your PHI, you may file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence AvenueS. W., Washington D. C. 20201. CTC will not take retaliatory action against you if you file a complaint about CTC's privacy practices.

VIII. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT MY PRIVACY PRACTICES:

Cory Stege, LMFT, PO Box 182083 Coronado, CA 92178, 619-432-6892

Last updated April 11, 2021