This notice describes how medical information about you may be used and disclosed by Sage Holistic Counseling and how you can access this information.
If you make a written request for your medical records and other health information. We will provide a copy or summary within 15 days of the request and may charge a reasonable fee. You can ask us to correct inaccurate health information. We will accommodate all reasonable requests. If we deny the request, we’ll explain in writing within 60 days. You can ask us not to use or share certain health information for treatment, payment, or operations. We may deny the request if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for payment or our operations with your health insurer. We’ll accommodate the request unless the law requires us to share that information. You can ask for a list (accounting) of the times we have shared your health information for six years before the date you ask, including who we shared it with and why. We include all disclosures except for those about treatment, payment, health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but charge a reasonable, cost-based fee if you request another one within 12 months. You can request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.
If someone is your legal guardian or has medical power of attorney, they can exercise your rights and make choices about your health information. We’ll make sure the person has this authority and can act on your behalf before taking action.
You may file a complaint if you feel we have violated your rights by contacting us directly. To file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, send a letter to 200 Independence Ave, SW, Washington, D.C. 20201, call 1-877-696-6775, visit HHS.gov. We will not retaliate against you for filing a complaint.
You can tell us your choices about what we share and how we share your information in the situations described here by contacting our office. You have both the right and choice to tell us to share information with your family, close friends, or others involved in your care. We never share or sell your information for marketing purposes.
Our Uses and Disclosures
Within our practice, we may disclose your health information to all professionals who treat you and those that manage our practice in order to improve your care, contact you when necessary, bill, and collect payment from health plans or other entities. We have to meet many conditions in the law before we can share your information for these purposes. More information is available at HHS.gov. We are allowed or required to disclose health information about you for certain situations such as with a coroner, medical examiner, or funeral director when an individual dies, to address workers’ compensation claims, for law enforcement and other special government requests, with health oversight agencies for activities authorized by law, for public health and preventing disease. We are allowed to disclose health information about you when reporting suspected abuse, neglect, or domestic violence, for preventing or reducing a serious threat to anyone’s health or safety, in response to a court or administrative order, subpoena, or if state or federal laws require it, and with the Department of Health and Human Services to show compliance with federal privacy law.
Federal law requires us to maintain the privacy and security of your protected health information. If a breach occurs that may have compromised your information, we will let you know promptly. We must follow the duties and privacy practices described in this notice and give you a copy. We will not use or share your information other than as described here unless you provide written authorization. You may change your mind at any time by letting us know in writing. For more information, visit HHS.gov.
Changes to the Terms of this Notice
We can change the terms of this notice, applicable to all the information we have about you. The new notice will be available on our website and in our office upon request.