Notice of Privacy Practices/HIPAA

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.

Vista North Counseling is committed to protecting your privacy and ensuring the confidentiality of your health information. This Notice of Privacy Practices (NPP) outlines how we may use or disclose your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA), applicable federal regulations, and Minnesota state laws. It also describes your rights regarding your PHI and how you can exercise those rights.

I. YOUR PROTECTED HEALTH INFORMATION (PHI):

PHI refers to information about your physical or mental health, healthcare services provided to you, and payment for such services that can be used to identify you. PHI may include your name, address, birth date, diagnosis, treatment records, and other relevant information.

USES AND DISCLOSURES OF PHI:

A. Permitted Uses and Disclosures Without Your Written Authorization Under HIPAA, we may use or disclose your PHI without your written consent or authorization for the following purposes:

1. Treatment: We may use and disclose your PHI to provide, coordinate, or manage your healthcare. This includes sharing information with other healthcare providers involved in your treatment.

2. Payment: We may use and disclose your PHI to obtain payment for services we provide, including billing and collection activities. This may involve sharing your PHI with your insurance company or other third-party payers.

3. Healthcare Operations: We may use or disclose your PHI for administrative purposes, such as quality assessment, licensing, staff training, and internal audits. These activities are necessary to ensure the proper functioning of our practice and to maintain high-quality care.

4. Appointment Reminders and Health-Related Communications: We may contact you to remind you of appointments or to provide information about treatment alternatives or other health-related services that may be of interest to you.

5. Public Health and Safety: We may disclose your PHI when required by law to report to public health authorities for purposes of preventing or controlling disease, injury, or disability. This includes disclosures related to child abuse or neglect, domestic violence, and other public health issues.

6. Legal Obligations: We may disclose your PHI to comply with federal, state, or local laws, including reporting suspected abuse or responding to legal requests such as court orders, subpoenas, or other legal proceedings.

7. Health Oversight Activities: We may disclose your PHI to government agencies responsible for overseeing healthcare systems or ensuring compliance with healthcare laws, including Minnesota state health oversight agencies.

8. Research: Under certain circumstances, we may use or disclose your PHI for research purposes, but only after strict ethical and legal reviews are conducted.

9. Workers’ Compensation: We may disclose your PHI as authorized to comply with workers' compensation laws and similar programs that provide benefits for work-related injuries or illnesses.

10. Law Enforcement: We may disclose your PHI in response to a law enforcement request, such as providing information about a victim of a crime or reporting a death that may have resulted from criminal conduct.

11. To Avert a Serious Threat to Health or Safety: We may disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of others, in accordance with Minnesota statutes and ethical guidelines.

12. Military, National Security, or Incarceration: If you are involved with the military or national security, or you are incarcerated, we may be required to disclose your PHI as authorized by law.

B. Uses and Disclosures Requiring Your Written Authorization In all other cases, we will not use or disclose your PHI without your written authorization. This includes:

1. Psychotherapy Notes: Use or disclosure of psychotherapy notes requires your specific written authorization, except as required by law.

2. Marketing: We will not use your PHI for marketing purposes without your written authorization.

3. Sale of PHI: We will not sell your PHI without your written consent. You have the right to revoke your authorization at any time, except to the extent that we have already acted on the authorization.

YOUR RIGHTS REGARDING YOUR PHI:

A. Right to Access:

You have the right to access and receive a copy of your PHI contained in your records, including medical and billing records. This includes electronic copies if your records are stored electronically. You must submit a written request to obtain access, and we may charge a reasonable fee for the cost of copying, mailing, or preparing the records.

B. Right to Amend:

If you believe that the information in your records is incorrect or incomplete, you have the right to request an amendment. We may deny your request if we determine that the PHI is accurate and complete, or if the information was not created by us. If we deny your request, you have the right to submit a statement of disagreement.

C. Right to an Accounting of Disclosures:

You have the right to request a list of certain disclosures we have made of your PHI for purposes other than treatment, payment, or healthcare operations. The list will not include disclosures made before April 14, 2003, or disclosures you authorized. Your request must be in writing and may cover up to six years of disclosure history. The first request in a 12-month period is free; subsequent requests may incur a fee.

D. Right to Request Restrictions:

You have the right to request restrictions on the use or disclosure of your PHI. While we are not required to agree to all requests, we will comply with any agreed-upon restrictions unless the information is needed for emergency treatment. You may also request that we not disclose information to your health plan if the services are paid for in full by you out-of-pocket.

E. Right to Request Confidential Communications:

You have the right to request that we communicate with you in a specific way (e.g., using a specific phone number or email address) or send communications to a different address. We will accommodate reasonable requests, provided they are practical.

F. Right to a Paper Copy of This Notice:

You have the right to request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Our Responsibilities:

We are required by law to maintain the privacy of your PHI, provide you with this Notice of our legal duties and privacy practices, and follow the terms of this Notice. If we revise our privacy practices, we will notify you and provide an updated Notice. In the event of a breach of your unsecured PHI, we will notify you as required by law.

Complaints:

If you believe your privacy rights have been violated, you have the right to file a complaint with Vista North Counseling or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

To file a complaint with us, please contact:

Vista North Counseling

PO Box 1173

Lakeville, MN 55044

612-208-3807

To file a complaint with the U.S. Department of Health and Human Services, you can contact:

Office for Civil Rights

U.S. Department of Health and Human Services

200 Independence Avenue SW

Washington, D.C. 20201

Phone: 1-877-696-6775

Website: www.hhs.gov/ocr/privacy