Notice of Privacy Practices

Federal and state laws allow health care providers to use and disclose protected health information (PHI) for certain purposes related to treatment, payment, and health care operations. The following are the most common ways your information may be used.

Treatment

We may use and disclose your health information to provide, coordinate, and manage your mental health care. This may include consulting with other healthcare professionals involved in your care, coordinating referrals, or discussing your treatment with members of your treatment team when clinically appropriate and permitted by law.

For example, if your therapist consults with another licensed mental health professional regarding your treatment, relevant health information may be shared to support accurate diagnosis, effective treatment planning, and continuity of care.

Payment

We may use your protected health information to bill and collect payment for services provided. If you choose to submit claims for out-of-network reimbursement, information necessary for payment may be included on documentation such as superbills.

Legal Proceedings and Protection of Legal Rights

If legal proceedings involve your care or our professional relationship, we may disclose protected health information as required or permitted by law, including in response to a valid court order, subpoena, or other lawful legal process.

We may also use or disclose protected health information, to the extent permitted by law, when necessary to establish, exercise, or defend the legal rights of Upstate Integrative Mind Counseling or its clinicians. This may include consultation with legal counsel, professional liability insurers, licensing boards, or other appropriate entities when responding to legal claims, complaints, investigations, or other actions involving the practice or its providers.

Whenever possible, we will disclose only the information reasonably necessary for the purpose and will take appropriate steps to protect your privacy.

Health Care Operations

We may use your information to support the day-to-day operations of our practice. This includes activities such as quality improvement, supervision, consultation, staff training, accreditation, licensing, business management, and other administrative functions necessary to provide high-quality care.

Whenever possible, only the minimum necessary information will be used or disclosed to accomplish these purposes.

In most situations beyond treatment, payment, health care operations, or those otherwise permitted or required by law, we will obtain your written authorization before using or disclosing your protected health information (PHI).

You may revoke your authorization at any time by providing written notice, except to the extent that we have already relied upon your authorization.

Psychotherapy Notes

Psychotherapy notes receive special protection under HIPAA. These notes are separate from your clinical record and document a therapist's personal observations, impressions, or reflections that assist in providing treatment.

We will not use or disclose psychotherapy notes without your written authorization except when permitted or required by law, including:

• For your therapist's use in providing treatment.

• For supervision, consultation, or training of mental health professionals.

• To defend against legal actions or complaints brought by you.

• As required by the U.S. Department of Health and Human Services for HIPAA compliance investigations.

• As otherwise required or permitted by federal or state law, including mandatory reporting obligations or to prevent a serious and imminent threat to the health or safety of you or another person.

Marketing

Upstate Integrative Mind Counseling will not use or disclose your protected health information for marketing purposes without your written authorization.

Sale of Protected Health Information

We will never sell your protected health information.

Federal and state law permit or require us to use or disclose your protected health information (PHI) in certain circumstances without your written authorization. These situations include, but are not limited to, the following:

As Required by Law

We may disclose your protected health information when required to do so by federal, state, or local law.

Public Health and Safety

We may disclose information when necessary to prevent or lessen a serious and imminent threat to the health or safety of you or another person, or when required to report suspected abuse, neglect, exploitation, or domestic violence in accordance with applicable law.

Health Oversight Activities

We may disclose information to government agencies responsible for oversight of the healthcare system, licensing boards, audits, investigations, inspections, accreditation, and other activities authorized by law.

Judicial and Administrative Proceedings

We may disclose protected health information in response to a court order or other lawful legal process, or as otherwise permitted by law.

Law Enforcement

We may disclose information to law enforcement officials when required or permitted by law, including reporting crimes occurring on practice property or cooperating with lawful investigations.

Coroners, Medical Examiners, and Funeral Directors

We may disclose protected health information to coroners, medical examiners, or funeral directors as authorized by law.

Research

In limited circumstances, protected health information may be used or disclosed for research purposes when approved and conducted in accordance with applicable federal and state privacy laws.

Workers' Compensation

We may disclose information as necessary to comply with workers' compensation or similar programs established by law.

Appointment Reminders and Practice Communications

We may use your contact information to communicate with you regarding appointments, scheduling, billing, administrative matters, or information about services offered by Upstate Integrative Mind Counseling that may benefit your treatment.

In certain circumstances, we may share limited protected health information with individuals who are involved in your care or payment for your care, such as a family member, spouse, close friend, or another person you identify.

Whenever possible, we will ask for your permission before sharing this information. If you object, we will not disclose your information unless otherwise permitted or required by law.

If you are unable to communicate your wishes due to an emergency or incapacity, we may use our professional judgment to determine whether sharing limited information is in your best interest. Any disclosure will be limited to information that is directly relevant to that person's involvement in your care or payment for your care.

You have important rights regarding your protected health information. If you wish to exercise any of these rights, please submit your request to our office in writing.

Right to Request Restrictions

You have the right to request restrictions on how we use or disclose your protected health information for treatment, payment, or healthcare operations. While we will carefully consider your request, we are not required to agree to every restriction if doing so would interfere with your care or our legal obligations.

Right to Restrict Disclosure to Your Health Plan

If you pay for a service out of pocket in full, you have the right to request that we not disclose information about that service to your health insurance plan for payment or healthcare operations, unless disclosure is otherwise required by law.

Right to Request Confidential Communications

You may request that we contact you in a specific way or at a specific location, such as by using a different phone number, email address, or mailing address. We will accommodate all reasonable requests whenever possible.

Right to Access Your Records

You have the right to inspect or obtain a paper or electronic copy of your designated record set, subject to applicable federal and state laws. Requests must be submitted in writing. We will respond within the timeframes required by law and may charge a reasonable, cost-based fee for copies when permitted.

Right to Request an Amendment

If you believe information in your record is inaccurate or incomplete, you have the right to request that we amend your record. While we may deny certain requests as permitted by law, we will provide a written explanation if we are unable to make the requested amendment.

Right to Receive an Accounting of Disclosures

You have the right to request a list of certain disclosures of your protected health information that we have made outside of treatment, payment, healthcare operations, and other exceptions permitted by law. We will provide this accounting in accordance with HIPAA requirements.

Right to Receive a Copy of This Notice

You have the right to receive a paper or electronic copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, please contact Upstate Integrative Mind Counseling so we can address your concerns. You also have the right to file a complaint with the U.S. Department of Health and Human Services without fear of retaliation. We will never retaliate against you for exercising your privacy rights or filing a complaint.

Questions or Complaints
If you have questions about this Notice or believe your privacy rights have been violated, please contact Upstate Integrative Mind Counseling. We welcome the opportunity to address your concerns.

You also have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR). Filing a complaint will not affect your care, and we will never retaliate against you for exercising your rights.

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201
Toll-Free: 1-800-368-1019
TDD: 1-800-537-7697
Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

All clinicians at Upstate Integrative Mind Counseling are licensed by the appropriate state licensing boards. Information regarding a clinician's license status or the process for filing a professional complaint is available upon request or through the applicable state licensing board.