Gathering Precious Stones, LLC
Counseling and Assessment Services
Notice of Privacy Policy
THIS NOTICE DESCRIBES HOW MENTAL HEALTHAND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
TO THIS INFORMATIONPLEASE REVIEW IT CAREFULLY
Our Commitment to Protect Your MentalHealthandMedicalInformation
Youhavearighttoprivacywithrespecttoyourpast,present,andfuturementalhealthandmedicalinformation. Gathering Precious Stones, LLC.isrequiredbylawtoprotectyourinformationandtoprovideyouwiththisNoticeofourlegaldutiesand privacypracticeswithrespecttoyourprotectedhealthinformation. Youhavetherighttoreceiveapapercopyofthis Notice.Anelectroniccopyofthis
WearerequiredtofollowtheprivacypracticesdescribedinthisNotice,thoughwereservetherighttochangeourprivacy practicesandthetermsofthisNoticeatanytime. IntheeventthisNoticeisrevised,youmayrequestapapercopyofthe revised notice or view the revised notice at the aboveweb address.
How We May Use and Disclose Your Protected Health Information
Weuseanddiscloseprotectedhealthinformationforavarietyofreasons. Ingeneral,ouruseanddisclosuresfallwithin the following three categories: treatment, payment, and health care operations.
Treatment–Wewilluseyourprotectedhealthinformationanddiscloseittoothersasnecessarytoprovidetreatmentto you. Forexample,membersofourclinicalstaffmayaccessyourrecordinthecourseofyourcare,orshareinformation intheprocessofcoordinatingyourcare. Suchstaffmembersincludephysicians,psychologists,nurses,andothermental healthprofessionals. Additionally,disclosuretoanotherfacility,communityhealthcenter,orprivatepractitionermay become necessary foryourcontinued treatment.
Payment–Wewilluseordiscloseyourprotectedhealthinformationasnecessarytoarrangeforpaymentofservices providedtoyou. Forexample,informationaboutyourdiagnosisandtheservicesweprovidetoyoumaybeincludedina bill that we send to a third-partypayer.
HealthCareOperations–WewilluseordiscloseyourprotectedhealthinformationinthecourseofoperatingGathering Precious Stones, LLC.Centersorforthehealthcareoperationsofanotherorganizationthathasarelationshipwithyou. Forexample,our qualityassurancestaffreviewsrecordstoensurethatourhighstandardsoftreatmentdeliveryarereachedconsistently. In addition,Gathering Precious Stones, LLC. maycontractwithoutsidecompanies,or “businessassociates”, suchas consultants, accountants,lawyers,andmedicaltranscriptions,toprovideservicesthatmayinvolvetheuseofyourprotectedhealth information.
Unlessyouinstructusotherwise,wemayalsosendappointmentreminders,informationabouttreatmentoptionsandother health-related benefits that may be of interest, and other similarmaterials to you.
Uses and Disclosures Requiring Your Authorization
Wearegenerallyprohibitedfromusingordisclosingyourprotectedhealthinformationforpurposesotherthantreatment, payment,andhealthcareoperationswithoutyourwrittenauthorization,unlesstheuseordisclosureiswithinoneofthe categories described below. In addition, we generally may not use or disclosepsychotherapy notes written byyour mental healthproviderwithoutyourwrittenauthorization,evenfortreatment,paymentandhealthcareoperations. Youhavethe righttorevokeyourauthorizationinwritingatanytime,excepttotheextentthatwehavealreadyundertakenanactionin reliance uponyour authorization
Uses and Disclosures Not Requiring an Authorization
Bylaw,wemayuseordisclosecertainofyourprotectedhealthinformationwithoutanauthorizationinthefollowing circumstances:
Whenrequiredbylaw–Wemaydiscloseprotectedhealthinformationwhenalawrequiresthatwereportinformation aboutsuspectedabuse,neglect,ordomesticviolence,orrelatingtocertaincriminalactivity,orinresponsetoacourt order. Wemustalsodiscloseprotectedhealthinformationtoauthoritiesthatmonitorourcompliancewiththeseprivacy requirements.
Forpublichealthactivities–Wemaydisclosecertainprotectedhealthinformationtopublichealthagenciesas permitted or required by law.
Forhealthoversightactivities–Wemaydisclosecertainprotectedhealthinformationtocertaingovernmentagencies for oversightactivities authorized by law.
JudicialandAdministrativeProceedings–Wemaydiscloseprotectedhealthinformationinresponsetoacourtor administrativeorder. Wemayalsodiscloseprotectedhealthinformationincertaincasesinresponsetoasubpoena, discovery request, or otherlawful process, subject toyour notice and opportunity to object.
Relatingtodeceasedindividuals–Wemaydisclosecertainprotectedhealthinformationrelatedtodeathtopursuanttoa valid subpoena of a coroner or medical examiner.
Toavertaseriousthreattohealthorsafety–Wemaydiscloseprotectedhealthinformation,inordertoavoidaserious threat toyour health or safety and the health and safety of thepublic or another person.
Forspecificgovernmentfunctions – Wemay disclose protectedhealth information as required by military authorities,to correctionalfacilitiesincertainsituations,togovernmentbenefitprogramsrelatingtoeligibilityandenrollment,andfor national security and intelligence reasons,such as protection of thePresident.
Uses and Disclosures of Alcohol/Drug Treatment Records
AtGathering Precious Stones, LLC.,personallyidentifyinginformationrelatedtothetreatmentofsubstanceabusehasspecial legalprivacyprotections. WewillnotdiscloseanyinformationidentifyingyouasaClientofourservicesorprovide anymentalhealthormedicalinformationrelatingtosubstanceabusetreatmentexceptincertaincircumstances, including butnotlimitedto: (1)youconsentinwriting;(2)acourtordersdisclosureoftheinformationafterashowcausehearing asrequiredunderGeorgiaLaw;(3)medicalpersonnelneedtheinformationtomeetamedicalemergency;(4)qualifying personnelusetheinformationforthepurposeofconductingresearch,managementaudits,orprogramevaluation;or(5)it isnecessarytoreportacrimeorthreattocommitacrimeortoreportchildabuseorneglectasrequiredbylaw. As applicable, you will be provided an additional notice regarding theconfidentiality of substance abuse information.
Uses and Disclosures toWhich You May Object
Inthefollowingsituations,wemaydisclosealimitedamountofyourprotectedhealthinformationifweinformyouin advance and youdo not object, as long as law does not otherwise prohibit the disclosure:
Tofamilies,friends,orothersinvolvedinyourcare–Wemaysharewiththesepeoplecertaininformationdirectly relatedtotheirinvolvementinyourcare,orpaymentforyourcare. Wemaysharecertainprotectedhealthinformation with these people to notify themaboutyourlocation,general condition, or death.
Patient directories – Your name, location, and general condition may beput into a facility patient directory for disclosure to callers or visitors who ask foryou byname. Additionally,your religious affiliation may be shared with clergy.