HIPAA Notice of Privacy Practices

I.               THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

 

II.            IT IS MY LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).

I, Eden Stone, LPC (Founder of Eden Stone Therapy, PLLC) am committed to protecting your privacy. I am required by federal law to maintain the privacy and security of Protected Health Information (“PHI”), which is information created or noted by me that identifies or could be used to identify you. It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. I am required to provide you with this Notice of Privacy Practices (this “Notice”), which explains my legal duties and privacy practices and your rights regarding PHI that I collect and maintain.

III.         YOUR RIGHTS

Your rights regarding your PHI are explained below. To exercise these rights, you must submit a written request to me at the address noted below.

  1. To Inspect and Copy Your PHI.

    • You can ask for an electronic or paper copy of PHI. I may charge you a reasonable fee. If I do not have your PHI, but I know who does, I will advise you how you can get it.

    • I may deny your request if I believe the disclosure will endanger your life or another person's life. You may have a right to have this decision reviewed.

  2. To Amend Your PHI.

    • You can ask to correct PHI you believe is incorrect or incomplete. I may require you to make your request in writing and provide a reason for the request.

    • I may deny your request. I will send a written explanation for the denial and allow you to submit a written statement of disagreement.

  3. To Request Confidential Communications.

    • You can ask me to contact you in a specific way. I will say “yes” to all reasonable requests.

  4. To Limit What is Used or Shared.

    • You can ask me not to use or share PHI for treatment, payment, or business operations. I am not required to agree if it would affect your care.

    • If you pay for a service or health care item out-of-pocket in full, you can ask me not to share PHI with your health insurer.

    • You can ask for me not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.

    • You do not have the right to limit the uses and disclosures that I am legally required or permitted to make.

  5. To Obtain a List of Those with Whom Your PHI has Been Shared.

    • You can ask for a list, called an accounting, of the times your health information has been shared. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.

    • The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, or to corrections or law enforcement personnel. Disclosure records will be held for six years.

  6. To Receive a Copy of this Notice.

    • You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.

  7. 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 exercise your rights.

IV.         MY USES AND DISCLOSURES

  1.  Routine Uses and Disclosures of PHI

    I am permitted under federal law to use and disclose PHI, without your written authorization, for specific routine uses and disclosures, such as those made for treatment, payment, and the operation of my business. I typically use or share your health information in the following ways:

    • To treat you.

      I can use and share PHI with other professionals treating you, to coordinate your care. Example: Your primary care doctor, psychiatrist, dietitian, or other licensed healthcare provider involved in your care asks about your mental health treatment.

    • To run the health care operations.

      I can use and share PHI to run my business, improve your care, and contact you. Example: I use PHI to send you appointment reminders if you choose.

    • To bill for your services.

      I can use and share PHI to bill and get payment from health plans or other entities. Examples: I give your PHI to your health insurance plan so it will pay for your services. I could also provide your PHI to business associates, such as billing companies, claims processing companies, and others that process health care claims for my office.

    • Other disclosures.

      Examples: Your consent isn't required if you need emergency treatment provided that I attempt to get your consent after treatment is rendered. In the event that I try to get your consent but you are unable to communicate with me (for example, if you are unconscious or in severe pain) but I think that you would consent to such treatment if you could, I may disclose your PHI.

  2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object

    I may use or disclose PHI without your authorization or an opportunity for you to object, including:

    • To help with public and health safety issues

      • Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.

      • Required by the Secretary of Health and Human Services: I may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.

      • Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.

      • Serious threat to health or safety: To prevent a serious and imminent danger.

      • Abuse or Neglect: To report abuse, neglect, or domestic violence.

    • To comply with law, law enforcement, or other government requests

      • Required by law: If required by federal, state or local law.

      • Judicial and administrative proceedings: Respond to a court order, subpoena, or discovery request.

      • Law enforcement: For law, locate and identify you or disclose information about a victim of a crime. Example: If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.

      • Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.

      • National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons, or foreign heads of state, for the purpose of determining your own security clearance and other national security activities authorized by law.

      • Workers' Compensation: To comply with workers' compensation laws or support claims.

    • To comply with other requests

      • Coroners and Funeral Directors: To perform their legally authorized duties.

      • Organ Donation: For organ donation or transplantation.

      • Research: For research approved by an institutional review board.

      • Inmates: I created or received your PHI while providing care.

      • Business Associates: To organizations that perform functions, activities or services on our behalf.

  3. Uses and Disclosures of PHI That May Be Made with Your Authorization or Opportunity to Object

    Unless you object, I may disclose PHI:

    • To your family, friends, or others if PHI directly relates to that person's involvement in your care or responsibility for the payment for your health care, unless you object in whole or in part.

    • If it is in your best interest if you are unable to state your preference (e.g., retroactive consent may be obtained in emergency situations).

  4. Uses and Disclosures of PHI Based Upon Your Written Authorization

    I must obtain your written authorization to use and/or disclose PHI for the following purposes: Marketing, sale of PHI, and psychotherapy notes.
    You may revoke your authorization at any time by contacting me in writing, using the contact information in section VI below. I will not use or share PHI other than as described in the Notice unless you give your written permission.

 

V.            MY RESPONSIBILITIES

  • I am required by law to maintain the privacy and security of PHI.

  • I am required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, I will abide by the more stringent law.

  • I reserve the right to amend this Notice. All changes apply to PHI collected and maintained by me. Should I make changes, you may obtain a revised Notice by requesting a copy from me, using the information above, or by viewing a copy on my website: https://edenstonetherapy.com/hipaa

  • I will inform you if PHI is compromise in a breach.

 

VI.         HOW TO COMPLAIN ABOUT THE PRIVACY PRACTICES

If, in your opinion, I may have violated your privacy rights, or if you object to a decision I made about access to your PHI, you are entitled to file a complaint with the person listed in Section VII below.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

I will not retaliate against you for filing a complaint about the privacy practices.  

VII.     PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT THE PRIVACY PRACTICES

If you have any questions about this notice or any complaints about the privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact me at: Eden Stone, 5840 Balcones Dr, Ste 200, Austin, TX 78731, eden@edenstonetherapy.com, (512) 399-8396

VIII.  EFFECTIVE DATE OF THIS NOTICE

This notice is effective on December 1st, 2024, and the last update occurred on December 14th, 2024.