NOTICE OF PRIVACY PRACTICES (HIPAA)
Services are provided by WholeHeart Counseling & Play Therapy PLLC, a registered DBA of WholeHeart Counseling Services PLLC, a Texas professional limited liability company authorized to do business in Oklahoma.
This Notice describes how medical and mental health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
OUR LEGAL DUTY
We are required by law to:
· Maintain the privacy and security of your protected health information (PHI)
· Provide you with this Notice of our legal duties and privacy practices
· Follow the terms of the Notice currently in effect
· Notify you following a breach of unsecured PHI
Protected Health Information includes information that identifies you and relates to your physical or mental health, health care services, or payment for services.
HOW WE MAY USE AND DISCLOSE YOUR INFORMATION
1. Treatment
We may use and share your PHI to provide, coordinate, or manage your mental health care. This may include consultation with other licensed providers, treatment team members, referral sources, and care coordinators involved in your treatment.
2. Payment (Insurance-Based Practice)
We may use and disclose your PHI to obtain payment for services provided. This includes disclosures to health insurance plans, managed care organizations, employee assistance programs (EAPs), Medicare or Medicaid (if applicable), billing services, and clearinghouses. Information shared may include diagnoses, service dates, treatment codes, clinical information required for authorization, and other information required to determine benefits or coverage.
If you choose to use insurance, please be aware that your insurance company may request and retain information about your diagnosis, treatment plan, progress, and medical necessity. This information is governed by your insurer’s privacy practices.
3. Health Care Operations
We may use and disclose your PHI for health care operations, which include practice management, quality assessment, licensing, credentialing, audits, compliance reviews, supervision, training, and business administration.
4. Care Coordination and Utilization Review
We may disclose PHI to insurance companies or utilization review entities to obtain prior authorization, continued stay approvals, or medical necessity determinations, as required by your health plan.
5. Telehealth and Electronic Communications
We may provide services via HIPAA-compliant telehealth platforms. Communications with insurance companies and electronic transmissions of PHI (such as claims submissions and authorizations) are conducted through secure systems; however, electronic communication may involve some privacy risk.
6. Health Information Exchanges (HIEs)
We may participate in Health Information Exchanges to securely share and access PHI for treatment, payment, and health care operations, unless you request otherwise where permitted by law.
7. Appointment Reminders and Practice Communications
We may contact you to remind you of appointments, discuss insurance or billing matters, provide information about benefits, or communicate practice-related information.
USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION
We will obtain your written authorization before using or disclosing your PHI for:
· Psychotherapy notes (with limited legal exceptions)
· Marketing purposes
· Sale of PHI
· Any other use not described in this Notice
You may revoke your authorization in writing at any time, except where we have already relied on it.
USES AND DISCLOSURES WITHOUT AUTHORIZATION (AS REQUIRED OR PERMITTED BY OKLAHOMA AND FEDERAL LAW)
We may disclose PHI without your authorization when required or permitted by Oklahoma or federal law, including but not limited to:
· Suspected abuse or neglect of a child, elder, or vulnerable adult (Oklahoma mandatory reporting laws)
· Serious and foreseeable threat to your safety or the safety of others
· Court orders, subpoenas, or lawful legal processes under Oklahoma law
· Public health reporting as required by the Oklahoma State Department of Health
· Law enforcement purposes as permitted by law
· Workers’ compensation or other legally authorized claims
YOUR RIGHTS REGARDING YOUR PHI
Right to Access
Under Oklahoma and federal law, you have the right to inspect or obtain a copy of your PHI, including electronic copies, typically within 30 days of your request.
Right to Request Amendments
You may request corrections to your PHI if you believe it is inaccurate or incomplete. We may deny the request if the record is accurate and complete or created by another provider.
Right to an Accounting of Disclosures
You may request a list of certain disclosures of your PHI made in the past six years, as permitted by law.
Right to Request Restrictions
You may request limits on how your PHI is used or disclosed. We are not required to agree to all requests. Oklahoma law allows disclosures necessary for treatment, payment, health care operations, and safety-related reporting.
If you use insurance, disclosures required by your health plan cannot be restricted. If you pay out-of-pocket in full, you may request that information about that service not be shared with your health plan, and we will honor that request as required by law.
Right to Confidential Communications
You may request that we contact you in a specific way or at a specific location (for example, only at work or by mail).
Right to a Paper Copy
You may request a paper copy of this Notice at any time.
Right to Choose Someone to Act for You
If you have a legal guardian, personal representative, or valid power of attorney under Oklahoma law, that person may exercise your rights.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice to comply with changes in Oklahoma or federal law. Any revised Notice will apply to all PHI we maintain and will be made available upon request and on our website.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
Privacy Officer: Charlena Priddy, LPC, RPT
Practice Name: WholeHeart Counseling & Play Therapy, PLLC
Address: 324 S. Husband St., Ste 101, Stillwater, OK 74074
Phone: 405-927-4728
You may also file a complaint with the U.S. Department of Health and Human Services:
Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 1-877-696-6775 www.hhs.gov/ocr
You will not be penalized or retaliated against for filing a complaint.