Notice of Privacy Practices
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Notice of Privacy Practices *
Notice of Privacy Practices
This Notice of Privacy Practices describes how medical information about you may be used and disclosed, and how you can access this information. Please review it carefully.
Our Commitment to Your Privacy
In order to provide you with care, Jeannuel Williams, LCSW (“Provider”) must collect, create, and maintain health information about you. This includes any individually identifiable information related to your past, present, or future physical or mental health condition, the health care you receive, or payment for that care.
The Provider is required by law to maintain the privacy of your protected health information (PHI) and to provide you with this Notice explaining the Provider’s legal duties and privacy practices. The Provider will comply with the terms of this Notice.
This practice provides psychotherapy services through secure telehealth platforms, and reasonable administrative, technical, and physical safeguards are used to protect your information.
Services are provided only to clients who are physically located in Texas or Illinois at the time of service, in accordance with state licensing laws.
How the Provider Uses and Discloses Your Health Information
The Provider protects your health information from inappropriate use and disclosure and may use or disclose your health information only for the purposes described below.
Uses and Disclosures for Treatment, Payment, and Health Care Operations
Treatment and Care Management
Health information may be used or disclosed to provide, coordinate, or manage your treatment with other health care providers.
Payment
Health information may be used or disclosed to obtain payment for services provided to you, including determining eligibility for benefits and obtaining payment from insurers or other entities responsible for payment.
Health Care Operations
Health information may be used or disclosed to support health care operations such as quality improvement, performance evaluation, care coordination, and resolving complaints or grievances.
Uses and Disclosures Without Your Authorization
The Provider may use or disclose your health information without your written authorization in the following circumstances, as permitted or required by law:
As Required by Law
Public Health Activities
Victims of Abuse, Neglect, or Domestic Violence
Health Oversight Activities
Judicial and Administrative Proceedings
Law Enforcement Purposes
Deceased Individuals
Organ or Tissue Donation
Research (with required approvals)
Health or Safety Concerns
Specialized Government Functions
Workers’ Compensation
Individuals Involved in Your Care
Appointment Reminders and Health-Related Communications
Incidental Uses and Disclosures
Certain incidental uses and disclosures may occur as a by-product of otherwise permitted uses and are not considered violations of your rights.
Special Protections
Some health information, including HIV-related information, genetic information, alcohol and substance use treatment records, and certain mental health records, may be subject to additional confidentiality protections under applicable state and federal laws.
Uses and Disclosures Requiring Authorization
The Provider will obtain your written authorization before using or disclosing your health information for purposes not described in this Notice, including:
Psychotherapy notes (when applicable)
Marketing purposes
Sale of health information
You may revoke your authorization at any time in writing, except where the Provider has already relied on it.
Your Rights Regarding Your Health Information
You have the right to:
Inspect or obtain a copy of your medical records
Request amendments to your records
Receive an accounting of disclosures
Request restrictions on certain uses or disclosures
Request confidential communications
Receive notification of a breach of unsecured health information
Receive a paper copy of this Notice at any time
Requests must be submitted to the Provider and may be subject to limitations permitted by law.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with the Provider or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Changes to This Notice
The Provider reserves the right to change the terms of this Notice at any time. Any changes will apply to all health information maintained and will be made available upon request.
Contact Information
If you have questions about this Notice or wish to exercise your rights, please contact:
Jeannuel Williams, LCSW
Licensed Clinical Social Worker
Licensed in Texas and Illinois
Email: Jeannuel.lcsw@gmail.com
Phone: 832-862-5796
Location: United States