THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION (PHI) MAY BE USED AND DISCLOSED AS WELL AS HOW YOU CAN GET ACCESS TO THIS INFORMATION.

Information in this document was updated in July 2023.

Your protected health information (PHI) is confidential. We are committed to protecting health information about you. Our general policy is that before disclosing mental health information about you to others, we will request your consent, and have you sign a document granting permission. There are a few exceptions. We describe the very few exceptions to this below.

RECORDS

Your therapist will create a record of the care and services you receive at Carolinas Counseling Group (CCG) in order to provide you with quality care and comply with certain legal and ethical requirements.

The kind and amount of information will vary with different therapists. If you have questions about this, you can ask your therapist.

We are required to keep a copy of your records for 7 years for adults and 7 years after the 18th birthday of a minor. After that, the documents may be destroyed. This notice applies to all of the records of your care generated by CCG.

The following will tell you how your therapist may use and disclose information about you. All therapists have certain legal and ethical obligations that may impact the use and disclosure of your PHI. We also explain your rights regarding your PHI.

We are required to:

• Make sure that the PHI which identifies you is kept private.

• Give you this notice of our legal duties and privacy practices with respect to protected health information.

• Follow the terms of the notice that is currently in effect.

• We can change the terms of this document, and such changes will apply to all information we have about you.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that we use and disclose health information. Not every use or disclosure in a category may be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories below. In general, we will attempt to discuss and obtain your consent prior to any disclosure. However, there are exceptions as described below.

1.For Treatment, Payment, or Health Care Operations:

•  Federal and State privacy rules and regulations allow health care providers who have direct treatment relationship with the client to use or disclose the client’s personal health information without the client’s written authorization to carry out the health care provider’s own treatment, payment, or health care operations.

• We may also disclose your protected health information for the treatment activities of any health care provider with whom you are currently receiving treatment. If we are referring you for treatment we may disclose some of your PHI as well. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your PHI, which is otherwise confidential, in order to assist your clinician in the diagnosis and treatment of your mental health condition.

• Your PHI may be included during training or supervising your counselor to help improve their skills or provide input regarding your treatment. If the supervisor is not part of CCG, that person will be identified in your specific therapist's professional disclosure statement. When possible identifying information will not be disclosed.

• Your PHI may be included during our staff peer supervision. It is the practice at CCG to present cases and get feedback to improve both your treatment and our own skill level. This practice is part of providing the most effective treatment and encouraging the development of our clinicians. Identifying information is not disclosed unless necessary for treatment purposes.

• We may use and give your health information to others to bill and collect payment for the treatment and services provided to you. Before you receive scheduled services, we may share information about these services with your insurance provider. Sharing information allows us to ask for coverage under your plan or policy and for approval of payment before we provide the services. If you use insurance for your treatment, the insurance company will have access to some of your PHI and it may be accessible by other providers, employees of the insurance company, and other entities. We have no control over further disclosure once your PHI is provided to the insurance carrier.

• For scheduling, use of the portal, and other administrative activities we use a service provided by TheraNest. It meets the standards of privacy required by law but they may have access to some of your PHI in order to provide the service. As with any service or vendor, including TheraNest, who might have access to PHI, we have a signed Business Associate Agreement that ensures your information remains strictly confidential.

• If you leave a message or we call, email, or text to schedule or remind you of an appointment, some of your information will be accessible to our administrative staff.

• If an account is unpaid after attempts to collect any outstanding fees, we have the right to turn the account over to a collection agency.

2. Disclosures for treatment purposes are not limited to the minimum necessary standard because therapists and other health care providers may need access to the full record and/or full and complete information in order to provide quality care or other services. 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 from one health care provider to another.

3.  Disclosure may be necessary when the use and/or disclosure of your PHI is to avert, prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

• If you threaten to harm either yourself or someone else, we are obligated to take whatever actions deemed necessary to protect any involved people from physical harm. This disclosure includes the obligation to warn any person who may be harmed by your behavior. This responsibility is not one we take lightly and would happen only if it was determined that danger was imminent and unavoidable.

• We may be obligated by law to disclose PHI as it relates to minors or the elderly who are or may be victims of abuse, neglect, or violence. For example, if we are informed or reasonably suspect that a child is or has been abused or neglected by you or a family member, we are mandated by law to report that to the Department of Social Services (DSS). Child abuse includes, but may not be limited to severe physical punishment, sexual molestation, neglect and abandonment.

4.  If you are involved in a lawsuit, we may disclose protected health information in response to a court or administrative order. We may also use PHI in defense in legal proceedings that you initiate. We may also disclose health information about your child in response to a subpoena, discovery request, or other lawful processes by someone else involved in the dispute. However, we will make a reasonable effort to tell you about the request or to obtain an order protecting the information requested. Additional fees will apply.

If there are law enforcement situations or your treatment is under the oversight of the court or a correctional institution, we may be required to disclose PHI in part or in full.

If there are other Federal or State legal requirements that compel us to disclose your PHI we may be required to do so.

PHI may be disclosed for workers' compensation claims or disability application purposes. We will attempt to obtain authorization from you unless otherwise required by law.

5.  Marketing: We will not use or disclose your PHI for marketing purposes. If you leave comments, feedback, or post on any social media platform, you assume full responsibility for that disclosure.

6.  Sale of PHI: We will never sell your PHI.

CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

Disclosures to Family, Friends, or Others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. Consent may be obtained retroactively in emergency situations.

YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. 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 not be able to continue treatment depending on your request.

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid In Full. You have the right to request restrictions on PHI disclosures to health plans for payment or healthcare operation purposes if the PHI pertains solely to a healthcare item or a healthcare service you have paid for out-of-pocket in full.

3. The Right to Choose How We Send PHI to You. You have the right to ask us 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.

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a summary of it, and we may charge a reasonable, cost-based fee for doing so. A consent to disclose will be required from anyone who participated in your therapy (e.g., marriage therapy).

5. The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided a written and/or signed authorization.

6. 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 decline your request but, if we do, we will provide our reasoning in writing within 60 days of receiving your request.