Notice of Privacy Practices

Our commitment to your privacy

Holistic Care Mental Health Association will maintain the privacy of your protected health information (PHI). In this Notice, PHI means health information which may identify you and which relates to past, present, or future physical and/or mental health.

We may use your PHI in the following ways

Treatment: We create records regarding your treatment and may disclose your PHI to a physician or other healthcare provider with whom you receive services.

Payment

We may use your PHI in order to bill and collect payment for the services and items you may receive from us.

Health care operations

We may use your PHI to operate our business and to assess the quality of care and outcomes of your case.

Written authorizations

We will obtain your written authorization before disclosing your PHI. You may withdraw or revoke this authorization in writing at any time. We will then stop using or disclosing your PHI, except to the extent that we have already acted upon that authorization.

Your Rights 

You have the right to inspect and a copy your protected health information.  This usually includes medical and/or billing records.  You must ask us in writing and agree to be responsible for a reasonable fee before we provide you with your copy. You may ask us to provide your electronic record in electronic format. If we are unable to provide you with the record in the format you request, we will provide it in a form that works for you and our office.  You may also ask us to transmit your record to a specific person or entity via email if a) you provide the email address in writing and b) sign a statement that you fully understand that email comes with inherent risks that we cannot prevent and for which our offices are not responsible. Under certain circumstances, your provider may not allow you to see certain parts of your record.  You may ask that this decision be reviewed by another licensed professional.

You have the right to request a restriction on your protected health information.  This means you may ask us not to use or disclose all or part of your protected health information for the purpose of treatment, payment or healthcare operations. We will consider your request carefully and may honor reasonable requests where possible. We are not required to honor all requests.

If you have received services from our healthcare providers or hospitals and do not wish to share your health information with your insurer, we must honor your request if you have paid out of pocket in full for your services and as long as sharing your claim is not required by law. Please discuss this request with us.

You may also ask if any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices.  Your request must tell us the specific restriction requested and to whom you want the restriction to apply.

You have the right to receive an account of disclosures we have made of your protected health information. This essentially means you may receive a listing of certain uses or disclosures made for other than treatment, payment or business operations, and which you have not received or authorized, such as where we have shared information for public health purposes.

You may ask us to amend your record.  While we cannot erase your record, we will add your written statement to your protected health information to correct or clarify the record.  Your provider may submit a response to the new correction, which will be provided to you.

Breach Notification. We are required to have safeguards in place that protect your health information. In the event there is a breach of those protections, we will notify you, government officials, and others, as the law requires.

Complaints. You may make a complaint to the Administrator or Clinical Director at the HCMHA office where you receive services or to the Office of Civil Rights at the Department of Health and Human Services if you believe your privacy rights have been violated by us.