Snyder Counseling, LLC                                              20 Erford Road, Suite 8, Lemoyne, PA 17043

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DECRIBES HOW MEDICAL/MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective date: 08/01/2024

1.      My Duties

The privacy and confidently of your health information is especially important and Snyder Counseling, LLC is committed to protecting it to the extent possible, consistent with law and ethical standards.  Your health information includes records Snyder Counseling, LLC creates and obtains to provide care for you.  For example, it includes a record of your symptoms, examination and test results if applicable, diagnoses, summary of your treatment and referrals.  Bills, insurance claims and other payment information are also included in the record of your health information.

This notice tells you about the different ways Snyder Counseling, LLC may use and disclose your healthy information.  It also describes your rights and my obligations. Snyder Counseling, LLC is required to:

·        Maintain the privacy of your protected health insurance (PHI) by law.

·        Provide you with the Notice of my legal duties and privacy practices with respect to your health information that is collected and maintained.

·        Follow the terms of my Notice that is currently in effect.

2.      Uses and Disclosures of PHI – Payment, Treatment, and Health Care Operations

Under federal law, Snyder Counseling, LLC is permitted to use and disclose PHI without authorization of treatment, payment, and health care operations.  However, state law or the ACA’s code of ethics may require Snyder Counseling, LLC to obtain your express authorization before disclosing certain portions of your record and PHI.  Snyder Counseling, LLC may also choose to require your release of information in circumstances.  Treatment: For example, your therapist may discuss certain aspects of your counseling with your psychiatrist in order to provide the best treatment and medication for you. Likewise, your psychiatrist may discuss certain medication management issues with our therapist so your therapist can collaborate in treatment.  Payment: If your health insurance company, for payment, needs more information than what is printed on your receipt, Snyder Counseling, LLC will only provide the minimum amount of information necessary for the insurance company to process the claim.  This may include the diagnosis and explanation of care.

3.      Other Uses and Disclosure of PHI – Besides use and disclosure of treatment, payment and health care operations, Snyder Counseling, LLC may use and disclose your PHI without authorization for the following purposes:

·        Abuse, Neglect or Domestic Violence: Your therapist may disclose PHI about you to a state or federal agency if he/she is required or permitted by law to report child or vulnerable adult abuse or neglect or domestic violence.  When possible, and as consistent with my professional judgement in order to avoid harm to you or others, your therapist will inform you of the need to make such a disclosure.

·        Judicial and Administration Proceedings: Your therapist may disclose PHI about you during a judicial or administrative proceeding as required by law. For example, if a court orders your therapist to release information, your therapist must generally comply with the order.  In some circumstances, your therapist may be required to turn over information in response to a subpoena.  If Snyder Counseling, LLC receives a subpoena for your records, your therapist will attempt to contact you and/or your attorney if that is feasible.  Your attorney may be able to file a motion which will lead to a court order.

·        Law Enforcement: If authorized or required by law, Snyder Counseling, LLC may release health information to law enforcement officials.  For example, your therapist may release information to help identify a suspect or fugitive or report a crime related to a medical emergency.

·        Health Oversight Activities: Snyder Counseling, LLC may disclose health information about you to governmental, licensing, auditing, or health care accrediting agencies where authorized or required by law.  For example, information may be released to the state counselor licensure board if a complaint is filed against your counselor.

·        Appointment Reminders and Other Health Services: Your therapist may contact you to remind you of appointments or to inform you of treatment alternatives or other options and services that may be of interest to you.

·        Prevention of Serious Threat to Public Health or Safety: In accordance with the law the ethics, your therapist may use and disclose health information about you to present or minimize the risk of a serious and imminent threat to your health and safety or to the health and safety of another person or the public.

·        Minors: If you are an unemancipated minor under the law of the state of Pennsylvania, your therapist may, in certain circumstances, disclose health information about you to a parent, guardian or other authorized person, in accordance with law and ethics.

·        Parents: If you are the parent of an unemancipated minor, your therapist may disclose health information about your children to you in certain circumstances. For example, your therapist must legally obtain your consent in order to treat your child, when you are acting as the child’s “personal representative” under law, your therapist may disclose health information about your children to you.  In other circumstances, such as when your child is legally authorized to consent to treatment without a separate consent from you, where the child does not request that you act as his/her “personal representative”, your therapist may not disclose health/mental health information about your child to you without your child’s authorization.

·        Personal Representative: If you are an adult or emancipated minor, your therapist may disclose health information about you to a “personal representative” authorized to act on your behalf in making health care decisions.

·        Research and Related Activities: Snyder Counseling, LLC may disclose health information about you for research purposes in accordance with my legal and ethical obligations. Additionally, federal law allows us to create a “limited data set”, which does not include information such as your name, address, or social security number.  This limited data set may be shared with those who have signed a contract promising to protect the privacy of the information and to use it only for research, health oversight, and health care operations.

·        Worker’s Compensation/Employee Assistant Program (EAP): Your therapist may disclose health information about you for worker’s compensation or EAP as authorized or required by law.  These programs provide benefits for certain work-related illnesses and injuries, or employee related mental health issues.

·        Required by Law: Your therapist may disclose information about you when required to do so by federal, state, or other applicable law.

Authorization Required for Other Uses or Disclosures: Your therapist may obtain your written authorization for any other use or disclosure of your PHI.  You have the right to revoke any authorization, in writing and in accordance with this Notice, to the extent that action has not been taken in reliance on the authorization.  Psychotherapy notes are not among the records that you may, by law, review or copy, unless your therapist believes it is in your best interest to access them.  Your therapist will be happy to discuss the issue of psychotherapy notes with you if you have any questions.

4.      Your Rights Regarding Health Information

You have certain rights regarding health information that is created and maintained by you. These rights include:

·        Right to request restrictions: You have the right to request restrictions on certain uses and disclosures of PHI about you.  You also have the right to request a limit on the medical information disclosed about you to someone who is involved in your care or for the payment of your care.  If you ask to disclose information to another party, you may request that limited information is disclosed.  However, Snyder Counseling, LLC is not required to agree to a restriction you request.  To request restrictions, you must make your request in writing, and tell me: 1) what information you want to limit, 2) whether you want to limit by use, disclosure, or both, and 3) to whom you want the limits to apply.

·        Right to receive confidential communications by alternative means and at alternative locations: You have the right to request and receive confidential communication of PHI by alternative means and to alternative locations.  For example, you may not want a family member to know that you are seeing a therapist.  Upon your request, your therapist will send your bills to another address.  You may also request that your therapist contact you only at work, or that your therapist does not leave voicemail messages. To request alternative communications, you must make your request in writing, specifying how or where you wish to be contacted.

·        Right to an accounting disclosure: You generally have the right to receive an accounting of disclosure of your PHI for which you have neither provided consent nor authorization. Upon your written request, your therapist will discuss with you the details of this accounting process.

·        Right to inspect and copy: In most cases, you have the right to inspect and copy your medical and billing records.  To do this, you must submit your request in writing.  If you request a copy of the information, Snyder Counseling, LLC may charge a fee for the costs of copying and mailing.  An initial review of your records will be conducted with your therapist in order to explain any portion of information contained in your notes.

·        Right to amend: If you feel that PHI is incorrect or incomplete, you may ask me to amend the information.  To request an amendment, your request must be made in writing, and submitted to your therapist.  In addition, you must provide a reason that supports your request.  Snyder Counseling, LLC may deny your request if you ask to amend information that: 1) was not created by Snyder Counseling, LLC, 2) is not part of the medical information kept by Snyder Counseling, LLC, 3) is not part of the information which you would be permitted to inspect and copy, 4) is accurate and complete.

·        Right to receive a paper copy of this Notice: You have the right to request a paper copy of this Notice at any time, even if you agreed to receive it electronically.  In order to make a request or exercise any rights set forth above, you must submit your request in writing to Snyder Counseling, LLC, 20 Erford Road, Suite 8, Lemoyne, PA 17043.

You may also contact Snyder Counseling, LLC by phone (717) 876-6325 or email amandasnyderlpc@yahoo.com during normal business hours.

5.      Questions or Complaints

If you believe that your privacy rights have been violated, you may file a written complaint and address it to Snyder Counseling, LLC as listed in Section 4 above.  If that does not satisfy your concerns, you may complain to the Secretary of Health and Human Services (HHS).  Instructions for filing a complaint with the appropriate office for your region can be found at https://www.hhs.gov/civil-rights/filing-a-complaint/complaint-process/index.html. Alternatively, you may call 1-800-368-1019 and request instructions for filing a complaint. There will not be relation for filing a complaint.

6.      Future Changes to this Notice and My Privacy Practices

Snyder Counselor, LLC reserves the right to amend the terms of my privacy practices and policies and this Notice.  If this Notice is revised, the changed terms will apply to all health information about you, including information obtained before the effective date of the revised Notice.  Any materially revised Notice will be distributed to all clients and available upon request.