Notice of Privacy Practices

This notice describes how your medical information may be used and disclosed, and how you can get access to this information.

Please review it carefully.

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PURPOSE OF THIS NOTICE

We are required by law to maintain the privacy of your health information. Any information that concerns your treatment is considered confidential and is protected as confidential by Electric City Counseling. This Privacy Notice describes our legal duties and Privacy Practices, specifically the uses and disclosures Electric City Counseling may make of your treatment information and what rights you have with respect to your treatment information.

 

USES AND DISCLOSURES OF PROTECTED INFORMATION

Treatment. Your information may be used and disclosed by those involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members.

Payment. Payment refers to the activities undertaken by a health care provider to obtain or provide reimbursement for the provision of health care. We may use and disclose your health information so that we can receive payment for the treatment services provided to you. This will only be done with your authorization. For example, staff involved with your care may participate in payment-related activities, such as (but not limited to): processing claims with your insurance company, making a determination of eligibility or coverage for insurance benefits, or reviewing services provided to you to determine medical necessity. If it becomes necessary to use a collection process due to lack of payment for services, we will only disclose the minimum amount of information necessary for purposes of collection.

Health Care Operations. Health Care Operations refers to activities undertaken by staff that are regular functions of management and administrative activities. We may use or disclose your health information in order to support our business activities including, but not limited to: monitoring of service quality, legal and financial services, staff training and evaluation, medical reviews, auditing functions, business planning, compliance programs, certification, accreditation, licensing and credentialing activities. We may share your health information with third parties that perform various business activities, provided we have a written contract with the business that requires safeguarding the privacy of your information.

Required by Law. Your health information may be disclosed when required by law or necessary for health care oversight. This includes, but is not limited to: medical emergencies, reporting child abuse or neglect, when court ordered to release information, when required to report certain communicable diseases or injuries, when release of a deceased client’s health information is required by law, or when there is a legal duty to warn or take action regarding imminent danger to others. Treatment information made available shall be limited to that information which is minimum and necessary to the purpose for which the information is sought.

Family Involvement in Care. We may disclose information to caregivers or family members directly involved in your treatment based on your consent or as necessary to prevent serious harm. In situations where the family members are present during a discussion with the client, and it can be reasonably inferred from the circumstances that the client does not object, information may be disclosed in the course of that discussion. However, if the client objects, protected health information will not be disclosed.

Health Oversight. If required, we may disclose health information to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payors based on your prior consent) and peer review organizations performing utilization and quality control.

Client Authorization or Release Information. Electric City Counseling may not use or disclose protected health information in any other way without a signed authorization or release of information. When you sign an authorization, or a release of information, it may later be revoked, provided that the revocation is in writing. The revocation will apply, except to the extent that we have already made a use or disclosure based upon your authorization.

 

YOUR RIGHTS AS A CLIENT

Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your health information for treatment, payment, or health care operations. We are not required to agree to your request unless the request is to restrict disclosure of information to a health plan for purposes of carrying out payment or health care operations, and the information pertains to a health care item or service that you paid for out of pocket. In that case, we are required to honor your request for a restriction.

Right to Request Confidential Communication. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. We will accommodate reasonable requests. We may require information regarding how payment will be handled or specification of an alternative address or other method of contact as a condition for accommodating your request. We will not ask you for an explanation of why you are making the request.

Right of Access to Inspect and Copy. Unless your information was compiled in reasonable anticipation of, or for use in a civil, criminal, or administrative action or proceeding, you have the right, which may be restricted only in exceptional circumstances, to inspect and copy protected health information that is maintained in a “designated record set”. A designated record set contains mental health/medical and billing records and any other records that are used to make decisions about your care. Your right to inspect and copy your health information will be restricted only in those situations where a licensed professional believes it is reasonably likely that access would endanger the life or physical safety of, or cause substantial harm to the individual or another person. We may charge a reasonable cost-based fee for copies. If your records are maintained electronically, you may also request an electronic copy of your information. You may also request that a copy be provided to another person.

Right to Amend. If you feel that the health information we have about you is incorrect or incomplete, you may ask us to amend the information, although we are not required to agree to the amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and will provide you with a copy. Please contact the Privacy Officer if you have any questions.

Right to an Accounting of Disclosures. You have the right to request an accounting of certain of the disclosures that we make of your health information. We may charge you a reasonable fee if you request more than one accounting in any 12-month period.

Breach Notification. If there is a breach of unsecured protected health information concerning you, we may be required to notify you of this breach, including what happened and what you can do to protect yourself.

Right to a Copy of this Notice. You have the right to a paper copy of this notice

 

COMPLAINTS

If you believe we have violated your privacy rights, you have the right to file a complaint in writing with our Privacy Officer at 127 S Main Ave, #53, Scranton, PA 18504 or with the Secretary of the Federal Department of Health and Human Services. Under no circumstances shall Electric City Counseling retaliate against you for filing a complaint.

 

TERMS OF THIS NOTICE

Electric City Counseling has duty to maintain the privacy of your documented treatment information and to provide you with notice of its legal obligations and Privacy Practices with respect to your treatment information.

Electric City Counseling must date and comply with the Privacy Notice currently in effect. Electric City Counseling reserves the right to amend and/or update its Privacy Notice from time to time upon change of practices or revision of laws. If its Privacy Notice is revised, copies of the revised and dated Privacy Notice shall be posted in Electric City Counseling service areas. Electric City Counseling hereby reserves the right to implement the changes prior to issuing the revised Privacy Notice.

 

 

The effective date of this notice is July 7, 2019.