FAQS

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.

 

Strength, Love, and Motivation, LLC (the “Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.

 

YOUR INFORMATION. 

YOUR RIGHTS. 

OUR RESPONSIBILITIES.

 

This notice is required by law and describes how your health information may be used and disclosed, and how you can obtain access to this information. Please review it carefully.

 

YOUR INFORMATION

Your information may be shared without your permission when:    

•    Strength, Love, and Motivation, LLC employees and/or staff communicate internally for consultative and supervisory purposes to ensure the highest levels of care for you.

•    You disclose information that as mandated reporters our clinicians are required by law to report to the proper authorities. 

•    We are required to do so by federal, state, or local law. 

•    Your health information is ordered to be disclosed by court order, subpoena, warrant, summons or similar process. 

•    Your information is disclosed in a way that does not reveal your identity.

 

Your information may be shared without your permission when:    

•    A third party is billed for your treatment. 

•    You request specific information be shared with a third party.

 

YOUR RIGHTS

Get an electronic or paper copy of your health record:    

•    You may request to see a copy of your health record and other health information we may have about you. Ask us how to do this. 

•    We will provide a copy or a summary of your health record within 30 days of your written request.

•    We may charge a reasonable, cost-based fee.

 

Ask us to correct your health record:    

•    You may ask us to correct health information about you that you believe is incorrect or incomplete. Ask us how to do this.

•    We may deny your request, but we will explain our denial in writing within 60 days.

 

Request confidential communications:    

•    You may ask us to contact you using a specific phone number or email.

•    We will accommodate all reasonable requests.

 

File a complaint if you feel your rights are violated:    

•    You may file a complaint in writing to the President of Strength, Love, and Motivation, LLC if you feel we have violated your rights: PO Box 764, Jonestown, PA 17038

•    You will not be penalized for filing a complaint.

 

OUR RESPONSIBILITIES

•    We are required by law to maintain the privacy and security of your protected health information.

•    We will let you know promptly if the privacy and security of your information may have been compromised. 

•    We will never sell your health information. 

•    We will never use your health information for marketing or promotional purposes without your express written consent.

•    We will give you a copy of this document upon your request.

 

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to it. Please review carefully.

 

1.    Your medical records are used to provide treatment, bill and receive payments, and conduct healthcare operations. Examples of these activities include but not limited to review of treatment records to ensure appropriate care, electronic or mail delivery of billing for treatment to you or other authorized payers, appointment reminder telephone calls, and records review to ensure completeness and quality of care. Use and disclosure of medical records is limited to the internal use outlined above except required by law or authorized by the patient or legal guardian.

 

2.    Federal and State laws require abuse, neglect, domestic violence, threats, disclosure of self-harm or harm to others and to be reported to social services or other protective agencies. If such reports are made they will be disclosed to you or your legal representative unless disclosure increases risk of further harm.

 

3.    Disclosed information will be limited to the minimum necessary. You may request an account for any uses or disclosures other than those described in Sections 1 and Sections 2.

 

4.    You, or your legal representative, may request your records to be disclosed to yourself or any other entity. Your request must be made in writing, clearly identify the person authorized to request the release, specify the information you want disclosed, the name and address of the entity you want the information released to, purpose and the expiration date of the authorization. Any authorization provided may be revoked in writing at anytime. Psychotherapy notes are part of your medical records. We have 30 days to respond to a disclosure request and 60 days if the records is stored off site.

 

5.    You may request corrections to your records.

 

6.    A request for disclosure may be denied under the following circumstances: disclosure would likely endanger the life or physical safety of you or another person, requested information references other persons, except another healthcare provider, or if released to a legal representative would likely result in harm.

 

7.    If a request for disclosure is denied for reasons outlined in Section 6, you or your legal representative may request review of the denial. A review will be conducted by another licensed healthcare provider appointed by the original reviewer, who was not involved in the original decision to deny access. A review will be concluded within 30 days.

 

8.    You may request that we restrict uses and disclosures outlined in Section 1. However, we are not required to agree to the restrictions. If an agreement is made to restrict use or disclosure, we will be bound by such restriction until revoked by you or your legal representative orally or in writing, except when disclosure is required by law or in an emergency. We may also revoke such restrictions for information gathered when required by law or in an emergency. 

 

9.    This agreement may be modified or amended as required by law or in the course of health care operations.

 

 

REITERATION:

 

YOUR RIGHTS

Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice at the address noted below.

 

To inspect and copy PHI.

  • You can ask for an electronic or paper copy of PHI. The Practice may charge you a reasonable fee.

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

 

To amend PHI.

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

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

 

To request confidential communications.

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

 

To limit what is used or shared.

  • You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice is 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 the Practice not to share PHI with your health insurer.

  • You can ask for the Practice 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.

 

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.

 

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.

 

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.

 

To file a complaint if you feel your rights are violated.

  • You can file a complaint by contacting the Practice using the following information:

   Strength, Love, and Motivation, LLC

    PO Box 764, Jonestown, PA 17038

    Phone: (717) 673-8277

 

  • You can 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/.

  • The Practice will not retaliate against you for filing a complaint.

 

To opt out of receiving fundraising communications.

  • The Practice may contact you for fundraising efforts, but you can ask not to be contacted again.

 

OUR USES AND DISCLOSURES

1. Routine Uses and Disclosures of PHI

The Practice is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. The Practice typically uses or shares your health information in the following ways:

 

To treat you.

  • The Practice can use and share PHI with other professionals who are treating you.

  • Example: Your primary care doctor asks about your mental health treatment.

 

To run the health care operations.

  • The Practice can use and share PHI to run the business, improve your care, and contact you.

  • Example: The Practice uses PHI to send you appointment reminders if you choose.

 

To bill for your services.

  • The Practice can use and share PHI to bill and get payment from health plans or other entities.

  • Example: The Practice gives PHI to your health insurance plan so it will pay for your services.

 

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

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

 

To help with public health and 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: We 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 threat.

  • 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:  To 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.

  • 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 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 that has been approved by an institutional review board.

  • Inmates:  The Practice created or received your PHI in the course of 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, the Practice may disclose PHI:

 

To your family, friends, or others if PHI directly relates to that person's involvement in your care.

 

If it is in your best interest because you are unable to state your preference.

 

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

The Practice 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 the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.

 

OUR RESPONSIBILITIES

• The Practice is required by law to maintain the privacy and security of PHI.

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

• The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website www.strengthloveandmotivation.com.

• The Practice will inform you if PHI is compromised in a breach.