Privacy Practices
The privacy policy below describes how we collect, use, and protect your personal health information in compliance with HIPAA regulations. We are committed to safeguarding your privacy and ensuring the security of your information. For any questions or concerns, please contact us at (208) 446-5940 .
Unbreakable YOU Counseling and Wellness, Inc.
2600 E Seltice Way, Ste. A, Box 425
Post Falls, ID 83854
(208) 446-5940
samantha@unbreakableyoucounseling.com
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. YOU MAY HAVE ADDITIONAL RIGHTS UNDER STATE AND LOCAL LAW. PLEASE SEEK LEGAL COUNSEL FROM AN ATTORNEY LICENSED IN YOUR STATE IF YOU HAVE QUESTIONS REGARDING YOUR RIGHTS TO HEALTH CARE INFORMATION.
EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on June 28, 2023.
ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE
Under the Health Insurance Portability and Accountability Act of 1996 (hereafter, “HIPAA”), you have certain rights regarding the use and disclosure of your protected health information (hereafter, “PHI”).
I. OUR PLEDGE REGARDING HEALTH INFORMATION:
The clinicians, therapists, and staff at Unbreakable YOU Counseling and Wellness INC (hereafter, “We”, Unbreakable YOU”, and “mental health practice”) understand that health information about you and your health care, including information related to mental health services, is personal. We are committed to protecting health information about you. Your therapist will create a record of the care and services you receive from Unbreakable YOU. They need this record 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 health care practice. This notice will tell you about the ways in which we may use and disclose health information about you. It also describes your rights to the health information kept about you and describes certain obligations we have regarding the use and disclosure of your health information.
We are required by law to:
Make sure that PHI that identifies you is kept private.
Give you this notice of this mental health practice’s legal duties and privacy practices with respect to health information.
Follow the terms of the notice that is currently in effect.
We can change the terms of this Notice, and such changes will apply to all the information we have about you. The new Notice will be available upon request, via email transmission, via the client portal, and on my website.
II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
In general, Unbreakable YOU and it’s representatives may not disclose your private health information and must keep your information private unless it’s under certain circumstances or the therapist believes you or someone else may be in danger. The following categories describe different ways that Unbreakable YOU therapists and staff use and disclose health information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
For Treatment, Payment, or Health Care Operations: Federal privacy rules (regulations) allow healthcare providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the patient/client’s own treatment, payment or health care operations. Unbreakable YOU may also disclose your PHI for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider within your treatment team about your condition, we would be permitted to use and disclose your PHI, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your health condition. Unbreakable YOU may also use your PHI for business operations purposes, including sending you appointment reminders, billing invoices and other documentation. While Unbreakable YOU is considered out-of-network for all insurance plans, if you would like to utilize your insurance benefits we will provide you with a statement of completed sessions and amounts paid (called a superbill) for you to submit to your insurance company for reimbursement. Please note that any statements or billing documentation that you request will include personal health information such as a diagnosis code, your name and other identifying information, and session dates/times.
Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care 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 health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.
Abuse, Neglect, Public Safety (Duty to Warn): There are some circumstances in which Unbreakable YOU is required by law to disclose your personal health information.
Abuse or Neglect: All staff and providers at Unbreakable YOU are mandated reporters meaning they are ethically and legally required to report any suspected abuse or neglect of a child (under 18), disabled person, or elder (65 or older). The provider will use their discretion to disclose the minimum information necessary to make the report to the proper authorities to ensure safety. The providers will not need to report situations in which there is clear documentation or information showing that a report has already been made and the situation has already been addressed. Due to the diversity of the history, experiences, and challenges our clients may face, we want to recognize that clients and/or their families may experience anxiety or other reactions to a provider making a report. Please know that in situations in which it is possible and clinically appropriate, providers will make their best effort to discuss the need to make a report with the client and/or family (if not involved in the reportable situation) prior to or directly after making such a report to support the client and/or family through the process. This does not imply the provider will avoid making a report in a timely manner or that a family is able to in any way influence the decision to make the report. The choice to discuss making a report with the client and/or family is solely up to the provider’s clinical discretion noting that ensuring the safety of the child, elder, or disabled person is paramount.
National Security: Disclosure as necessary in cases of national security or terrorism in which a provider has relevant and pertinent information pertaining to a threat.
Public Safety (Duty to Warn); Disclosure of personal information regarding a serious threat of bodily harm or death to an identifiable person(s), as required by law. (Often referred to as TARASOFF)
Lawsuits and Disputes: If you are involved in a lawsuit, it is the approach of Unbreakable YOU that your PHI remains private however, we may disclose health information in response to a court or administrative order. We may also disclose health information about you or your minor child(ren) 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. Unbreakable YOU does not provide documentation to lawyers in custody proceedings. We will not provide records for custody hearings unless we are legally ordered to by the court. If this is the case, the client or responsible party will be billed for documentation/report creation time and any time required of providers to be in court. These rates can be found in the good faith estimates and in the consent for treatment documentation.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
Psychotherapy Notes. Therapists do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:
For the therapist’s use in treating you.
For the therapist’s use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy. Any mental health practitioners receiving supervision from a therapist at Unbreakable YOU are required to uphold the privacy practices with the same commitment as the treating therapist.
For our use in defending ourselves or the company in legal proceedings instituted by you.
For use by the Secretary of the Department of Health and Human Services (HHS) to investigate our compliance with HIPAA.
Required by law and the use or disclosure is limited to the requirements of such law.
Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
Required by a coroner who is performing duties authorized by law.
Required to help avert a serious threat to the health and safety of others.
Marketing Purposes. Unbreakable YOU will not use or disclose your PHI for marketing purposes without your prior written consent. For example, if we request a review from you and plan to share the review publicly online or elsewhere to advertise our services or practice, we will provide you with a release form and HIPAA authorization. The HIPAA authorization is required in the instance that your review contains PHI (i.e., your name, the date of the service you received, the kind of treatment you are seeking or other personal health details). Because you may not realize which information you provide is considered “PHI,” we will send you a HIPAA authorization and request your signature regardless of the content of your review. Once you complete the HIPAA authorization, we will have the legal right to use your review for advertising and marketing purposes, even if it contains PHI. You may withdraw this consent at any time by submitting a written request to Unbreakable YOU via the email address listed on our website or via certified mail to our address. Once we have received your written withdrawal of consent, we will remove your review from our website and from any other places where we may have posted it. Unbreakable YOU cannot guarantee that others who may have copied your review from our website or from other locations will also remove the review. Please consider that once information is posted on the internet Unbreakable YOU cannot guarantee how that information will be used or who will access it. It is possible for information to still be available on some parts of the internet even though Unbreakable YOU will make every effort to remove the information from the websites in which we posted it. This is a risk that we want you to be aware of, should you give us permission to post your review. Also note that access to services, the quality or frequency of services, and if you continue as a client of Unbreakable YOU is not dependent in any way on allowing us to use your review or information for marketing purposes.
Sale of PHI. Unbreakable YOU will never sell your PHI.
IV. USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION.
Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons. I have to meet certain legal conditions before I can share your information for these purposes:
Appointment reminders and health-related benefits or services. We may use and disclose your PHI to contact you to remind you that you have an appointment with your therapist. We may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that we offer.
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.
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.
For health oversight activities, including audits and investigations.
For judicial and administrative proceedings, including responding to a court or administrative order or subpoena, although our preference is to obtain an Authorization from you before doing so if we are so allowed by the court or administrative officials.
For law enforcement purposes, including reporting crimes occurring on our premises. If you utilize our virtual meeting space for sessions, the therapist may disclose your personal information to your local law enforcement agencies to report suspected abuse, in the case of a threat of real and imminent harm to self or others, or to report major crimes that are directly observed by the therapist during a live session.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, we may provide your PHI in order to comply with workers’ compensation laws.
For organ and tissue donation requests.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.
Disclosures to family, friends, or others: You have the right and choice to tell us that we may provide your PHI to a family member, friend, or other person whom you indicate is involved in your care or the payment for your health care, or to share your information in a disaster relief situation. The opportunity to consent may be obtained retroactively in emergency situations to mitigate a serious and immediate threat to health or safety or if you are unconscious.
VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask us not to use or disclose certain PHI for treatment, payment, or health care operations purposes. We are not required to agree to your request, and we may say “no” if we believe it would affect your health care.
The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on the disclosure of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
The Right to Choose How We Send PHI to You. You have the right to ask Unbreakable YOU to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and we will agree to all reasonable requests.
The Right to See and Get Copies of Your PHI. Other than in limited circumstances, you have the right to get an electronic or paper copy of your medical record and other information that we have about you. Ask us how to do this. We will provide you with a copy of your record, or if you agree, a summary of it, within 30 days of receiving your written request. Unbreakable YOU may charge a reasonable cost-based fee for doing so.
The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which Unbreakable YOU has disclosed your PHI for purposes other than treatment, payment, or health care operations, and other disclosures (such as any you ask us to make). Ask us how to do this. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge you a reasonable cost-based fee for each additional request.
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 we correct the existing information or add the missing information. We may say “no” to your request, but we will tell you why in writing within 60 days of receiving your request.
The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by email. And, even if you have agreed to receive this Notice via email, you also have the right to request a paper copy of it.
The Right to Choose Someone to Act For You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can make choices about your health information.
The Right to Revoke an Authorization.
The Right to Opt out of Communications and Fundraising from our Organization.
The Right to File a Complaint. You can file a complaint if you feel we have violated your rights by contacting us using the information on page one or by filing a complaint with the HHS Office for Civil Rights located at 200 Independence Avenue, S.W., Washington D.C. 20201, calling HHS at (877) 696-6775, or by visiting www.hhs.gov/ocr/privacy/hipaa/complaints. Unbreakable YOU and it’s employees will not retaliate against you for filing a complaint.
VII. CHANGES TO THIS NOTICE
Unbreakable YOU can change the terms of this Notice, and such changes will apply to all the information we have about you. The new Notice will be available upon request and on our website.