Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Your health record contains personal information about you and your health. It can include identifying information about you that relates to your past, present, or future medical conditions and or past, present, or future mental health conditions. Such personal and identifiable medical or mental health information is referred to as Protected Health Information or (“PHI”). This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable laws and the AAMFT code of ethics. It also describes your rights regarding how you gain access to and control your PHI.

New Leaf Counseling Services LLC is required by law to maintain the privacy of PHI and to disclose what my legal duties and privacy practices are with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. New Leaf Counseling Services LLC reserves the right to change the terms of Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices by sending a copy to you in the mail or email upon request or by providing one to you at your next appointment.

Your PHI may be used and disclosed by those who are involved in your immediate care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or members of the treatment plan. We may disclose PHI to additional consultants, but only with your authorization or informed consent.

New Leaf Counseling Services LLC may use and disclose PHI so that I can provide the necessary information for your insurance carrier, explaining the treatment services you received. This will only be done with your informed consent. Examples of payment related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities.

Under the law, New Leaf Counseling Services LLC is required to disclose your PHI upon your request. In addition, I am required to make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating and determining my compliance with the requirements of the Privacy Rule.

Applicable law and ethical standards permit me to disclose information about you without your consent only in a limited number of situations. Instances where disclosures may be made without your informed consent are:

Required by law: the mandatory reporting of child abuse or neglect and mandatory government agency audits or investigations (such as the Board of Professional Counselors and Therapists or the Department of Health and Mental Hygiene).
Required by Court Order: If subpoenaed by a court of law, we may be required to disclose your PHI.
Imminent threat or danger to self or others: We are required by law to disclose information if we feel you may be a threat to yourself or others. For example, disclosure may be necessary to prevent or lessen a serious or imminent threat to the health and safety of yourself, a specific individual, or the public. If information is disclosed to prevent or lessen a serious threat, it will be disclosed to a person or persons reasonably able to prevent or lessen the threat including the target of the threat.