Notice of Privacy Policy
This notice describes how medical information about you may be used and disclosed. It also describes how you can get access to this information. Please review it carefully.
In order to provide you care, WIDE AWAKE Therapy Christian Counseling (your “Provider”) must collect, create and maintain health information about you, which includes any individually identifiable information that we obtain from you or others that relates to your past, present or future physical or mental health, the health care you have received, or payment for your health care. Your Provider is required by law to maintain the privacy of this information. This Notice of Privacy Practices (this “Notice”) describes how your health information may be used and disclosed and explains certain rights you have regarding this information. Your Provider is required by law to provide you with this Notice and will comply with the terms as stated.
How Provider Uses and Discloses Your Health Information
Your Provider protects your health information from inappropriate use and disclosure, and will use and disclose your health information for only the purposes listed below:
- We may disclose your health information to all professionals who treat you and those that manage our practice in order to improve your care, contact you when necessary, bill, and collect payment from health plans or other entities. We have to meet many conditions in the law before we can share your information for these purposes. More information is available at HHS.gov. We are allowed or required to disclose health information about you for certain situations such as with a coroner, medical examiner, or funeral director when an individual dies, to address workers’ compensation claims, for law enforcement and other special government requests, with health oversight agencies for activities authorized by law, for public health and preventing disease. We are allowed to disclose health information about you when reporting suspected abuse, neglect, or domestic violence, for preventing or reducing a serious threat to anyone’s health or safety, in response to a court or administrative order, subpoena, or if state or federal laws require it, and with the Department of Health and Human Services to show compliance with federal privacy law.
Your Rights Regarding Your Health Information
- Right to Inspect or Get a Copy of Your Medical Record.
- Right to Request Changes to Your Medical Record.
- Right to an Accounting of Disclosures. You have the right to receive a list of all disclosures we have made of your health information.
- Right to Request Restrictions. You have the right to request restrictions on the ways which we use and disclose your health information for treatment, payment and health care operations.
- Right to Request Confidential Communications.
- Right to Receive Notification of Breach.
- Right to Paper Copy of Notice. You have the right to receive a paper copy of this Notice of Privacy Practices at any time. I full version of these rights will be provided to you.
- Right to File Complaints. If you believe your privacy rights have been violated, you may file a complaint with your Provider or with the U.S. Department of Health and Human Services Office for Civil Rights, send a letter to 200 Independence Ave, SW, Washington, D.C. 20201, call 1-877-696-6775, visit HHS.gov. You will not be penalized or retaliated against by your Provider for filing a complaint.
Changes to this Notice
Your Provider may change the terms of this Notice of Privacy Practices at any time. If the terms of the Notice are changed, the new terms will apply to all of your health information, whether created or received by your Provider before or after the date on which the Notice is changed. Any updates to the Notice will be provided to you.