Notice Of Privacy Policies & Practices
This notice describes how your counseling information may be used and disclosed, and how you can get access to this information. PLEASE READ IT CAREFULLY!
Uses and disclosures of your counseling record, payment, and Counseling Services Operations
Your written counseling information is very personal and we are committed to protecting information about your services at Community Christian Counseling (herein after “CCC”) We will create a written record of your services, and for your protection will comply with certain legal requirements. This notice applies to all the records CCC generates for your services we provide.
With your written consent, our record of your Counseling Services may be disclosed to others which are also providing health care services for you.
Payment: While CCC does not bill insurance companies for our services, it may be necessary for us to disclose your counseling information to insurance companies or third party-payers for the purposes of billing, payment or reimbursement.
Counseling Services Operations: Your case information (without you personally being identified of mentioned) may be discussed by the CCC staff for quality assessment and/or counselor training.
Other uses and disclosures with neither consent or authorization
Required by Law: We will discuss or release your counseling information when required to do so by local, state or federal law enforcement.
Abuse or Neglect: We may discuss or release your counseling information to appropriate authorities if we reasonably believe that you are a victim of abuse, neglect, domestic violence, or the possible victim of other crimes. We may discuss your counseling information to the extent necessary to avert a serious threat to your health or safety, or that of others.
Military and Veterans: If you are a member of the United States Armed Forces, we may release your counseling information as required by military command authorities. If you are a veteran, we may be required to release your information to the Department of Veterans Affairs. We may also release you counseling information about foreign military personnel to the appropriate foreign military authorities.
Worker’s Compensation: We may release your counseling information for worker’s compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Health Oversite Activities: We may disclose your counseling information to a health oversite agency for activities authorized by law. For example, these oversite activities may include audits, investigations, inspections, and licensure.
Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may disclose your counseling information to response to a court administered order. That may include information about you in response to a subpoena, discovery request, or other lawful process.
National Security or Intelligence Activities: We may discuss or release your counseling information to authorized Federal officials regarding these types of activities or investigations as authorized by law.
Client’s Rights and Counselor Duties
Right to Inspect or Obtain a Copy: You have the right to inspect or obtain a copy of your records or billing information at CCC, but this does not include the Counseling Notes. We will, of course discuss with you the details of your request and denial process. To inspect or obtain a copy of your records at CCC (other than Counseling Notes) will require a written request from you, and there may be a fee for the process.
Right to Amend: If you feel your information at CCC is incorrect or incomplete, you may ask us to amend your records. The request will need to be in writing and clearly state your reason for the request to amend your records. Our willingness or ability to amend your information at CCC includes only the information that was generated by a representative of CCC.
Right to an Accounting of Disclosures: You may have the right to request an “accounting of disclosures” of your information at CCC. Such a request must be submitted in writing, must state the reason for the accounting, must state the time period for record disclosure(s), must not extend beyond six years after you last visit to CCC, and cannot include dates earlier than November 3, 2003.
Right to Request Restrictions: You have the right to request restriction on certain uses and disclosures of your information at CCC, but we are not required to agree to restriction you request.
Right to Request Confidential Communications: You have the right to request that we communicate with you about your counseling matters in a certain way or at a certain location; through the mail or at your place of work, for instance. Such a request must be made in writing. We will accommodate all such reasonable requests.
Right to a Paper copy of this Notice: You have a right to a paper copy of this Notice, and you may ask us to provide the copy at any time during normal business hours.
We are required by law to maintain your privacy and to provide you with a notice of our legal duties and privacy policies. We reserve the right to change our privacy policies and practices as described in the Notice. This Notice is valid and in effect, thus accomplishes that requirement.
If you are concerned that CCC has violated your privacy rights, or you disagree with a decision we have made about access to your records, you are encouraged to contact and file your complaint with the Executive Director of CCC ce. Your complaint must be in writing, specifically describe the nature and date of the infraction, and be delivered by Registered Mail to the center’s Executive Director or delivered in person.
This Notice was originally established November 3, 2003
Rev. September 5, 2020