Notice of HIPAA Privacy Practices

This Notice applies to Global Therapy, Inc., Donna M. Hunter, LCSW, and the clinicians and workforce members associated with Global Therapy who are permitted to use or disclose protected health information through the practice. In this Notice, “we,” “our,” and “Global Therapy” refer to Global Therapy, Inc.

Our responsibilities

We are required by law to maintain the privacy and security of protected health information (PHI), provide you with this Notice of our legal duties and privacy practices, and follow the Notice currently in effect. PHI is information about your health, care, or payment for care that identifies you or could reasonably be used to identify you.

We will notify affected individuals as required if a breach may have compromised the privacy or security of their information. We will not use or disclose PHI except as described in this Notice or otherwise permitted or required by law.

How we may use and disclose your information

Treatment, payment, and health-care operations

We may use and disclose PHI for treatment, payment, and health-care operations without a separate written authorization when permitted by law.

Treatment. We may use your information and share it with physicians, psychiatrists, psychologists, therapists, supervisors, or other health professionals involved in your treatment or care coordination. For example, your therapist may consult with another treating provider regarding diagnosis, medication, safety, or continuity of care.

Payment. We may use and disclose information to verify benefits, obtain authorization, submit and correct claims, bill a health plan or responsible party, receive payment, and collect a valid unpaid balance. For example, a claim may include your diagnosis, dates of service, service code, and provider information.

Health-care operations. We may use and disclose information to operate the practice, supervise and train workforce members, review quality and clinician performance, conduct compliance activities, credential clinicians, perform audits, manage business and legal matters, and work with business associates that support the practice. Business associates must appropriately safeguard PHI.

Other uses and disclosures permitted or required by law

We may use or disclose PHI in the following circumstances when the applicable legal conditions are satisfied:

• When disclosure is required by federal, state, or local law.
• For public-health activities, including legally required disease or adverse-event reporting and other activities authorized by law.
• To report suspected abuse, neglect, or exploitation of a child or an adult protected by reporting law.
• To reduce or prevent a serious and imminent threat to the health or safety of a person or the public, including disclosure to someone reasonably able to reduce the threat.
• For health-oversight activities, including lawful audits, inspections, investigations, credentialing, and licensing-board activities.
• For workers' compensation or similar programs as authorized by law.
• For certain lawful law-enforcement purposes and in response to a warrant, court order, administrative demand, or other legal process meeting applicable requirements.
• In response to judicial or administrative proceedings, subject to applicable privilege, authorization, notice, court-order, protective-order, and other legal requirements. A subpoena does not automatically permit immediate disclosure of psychotherapy records.
• To a coroner, medical examiner, or funeral director as authorized by law, and for organ or tissue donation purposes when applicable.
• For approved research when the authorization requirement has been satisfied or waived under applicable law.
• For specialized government functions permitted by law, including certain military, veterans, national-security, intelligence, protective-service, and correctional-institution functions.

Contacting you

We may contact you regarding appointments, scheduling, billing, treatment follow-up, care alternatives, or health-related services that may be relevant to your care. We will honor reasonable requests for confidential communications and will use the communication preferences available to us.

People involved in your care or payment

Unless you object, we may share information directly relevant to a family member, close friend, caregiver, or other person involved in your care or payment for care. When you are not present or cannot state a preference, we may share limited information when permitted by law and when, in our professional judgment, disclosure is in your best interest. We may also disclose limited information for disaster-relief purposes as permitted by law.

Uses and disclosures requiring written authorization

Uses and disclosures not otherwise permitted or required by law generally require your written authorization. We will obtain authorization for most uses or disclosures of psychotherapy notes, uses or disclosures for marketing that require authorization, and the sale of PHI. Global Therapy does not sell client information.

You may revoke an authorization in writing at any time. Revocation applies prospectively and does not affect actions already taken in reliance on the authorization. A legally valid authorization may also expire according to its stated expiration date or event.

Mental-health and substance-use-disorder information

Federal and state laws may provide additional protection for mental-health information, psychotherapy notes, substance-use-disorder records, HIV-related information, and other specially protected records. We will apply the protections required in the circumstances.

To the extent Global Therapy maintains or receives substance-use-disorder patient records protected by 42 C.F.R. Part 2, those records will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against the patient without the patient's specific written consent or a qualifying court order accompanied by a subpoena, as required by law. Part 2 records received under a valid consent for treatment, payment, or health-care operations may be redisclosed as permitted by HIPAA, except that they may not be used or disclosed in proceedings against the patient except as permitted by Part 2.

If Global Therapy ever uses Part 2 records to send fundraising communications as permitted by law, the communication will provide a clear and conspicuous opportunity to opt out. Global Therapy does not currently use client records for fundraising.

Your rights

You may exercise the following rights by contacting Global Therapy's Privacy Officer. Some rights are subject to legal limitations, verification of identity, and documentation requirements.

Inspect or obtain a copy of your record. You may ask to inspect or receive an electronic or paper copy of the medical record and other PHI we maintain about you. We will ordinarily act within 30 days. Psychotherapy notes, as narrowly defined by HIPAA and maintained separately from the medical record, are generally excluded from the HIPAA right of access. Other limited grounds for denial may apply, and some denials may be reviewed by another qualified professional.

Fees for copies. We may charge only a reasonable, cost-based fee permitted by HIPAA and applicable state law for allowable copying labor, supplies, and postage. Per-page fees are not charged for PHI maintained electronically unless permitted by applicable law and consistent with HIPAA. We will provide an advance estimate when required.

Request an amendment. You may ask us in writing to correct or add to information you believe is inaccurate or incomplete. We may deny the request in circumstances permitted by law, but we will explain a denial in writing, generally within 60 days.

Request confidential communications. You may ask us to contact you in a particular way or at a different address. We will agree to reasonable requests. You do not have to explain the reason for the request.

Request restrictions. You may ask us not to use or disclose certain information for treatment, payment, or health-care operations. We are generally not required to agree. If you pay in full out of pocket for a service and ask us not to disclose information about that service to your health plan for payment or health-care operations, we will agree unless disclosure is required by law.

Receive an accounting of disclosures. You may ask for a list of certain disclosures made during the six years before your request. The list will not include every disclosure, including most disclosures for treatment, payment, health-care operations, or disclosures you authorized. One accounting in a 12-month period is free; a reasonable cost-based fee may apply to additional requests after advance notice.

Receive a copy of this Notice. You may request a paper copy at any time, even if you agreed to receive it electronically. The current Notice is also available in our office and on our website.

Choose a personal representative. A person with lawful authority, such as a legal guardian, health-care agent, or other authorized representative, may exercise rights on your behalf. We will verify the person's authority before acting. Special rules may apply to minors and services a minor may lawfully consent to independently.

Questions and complaints

You may ask questions or complain to Global Therapy's Privacy Officer if you believe your privacy rights were violated. We will not retaliate against you for making a complaint or exercising a privacy right.

Privacy Officer, Global Therapy, Inc.
1002 McClain Road, Suite 108
Bentonville, AR 72712
Telephone: 479-268-4598
Email: admin@global-therapy.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Complaints may be submitted online at www.hhs.gov/hipaa/filing-a-complaint, by mail to 200 Independence Avenue, S.W., Washington, D.C. 20201, or by calling 1-877-696-6775.

Changes to this Notice

We may change this Notice and our privacy practices. A revised Notice may apply to PHI we already maintain as well as information received after the change. The current Notice will be available upon request, posted prominently in our office, and posted on our website. Material changes will be communicated as required by law.

Global Therapy, Inc. | 1002 McClain Road, Suite 108, Bentonville, AR 72712 | 479-268-4598

Original document

Download the original HIPAA privacy notice

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