HIPAA Notice of Privacy Practices

Updated: February 10, 2025

 

Introduction

This Notice explains how ELEANOR BROWN COUNSELING, PLLC may use and share your protected health information (PHI) and outlines your rights regarding your health information. Please review it carefully and keep a copy for your records.

ELEANOR BROWN COUNSELING, PLLC and its covered entities, employees, and business associates are committed to maintaining and protecting the confidentiality of your PHI. PHI includes individually identifiable health information, including demographic information, related to your past, present, or future mental health condition and related health care services.

OUR OBLIGATIONS TO YOU

As required by law, ELEANOR BROWN COUNSELING, PLLC must:

Protect the privacy of your Protected Health Information (PHI).
Provide this Notice of Privacy Practices, explaining our safeguards and policies.
Follow the terms of this notice until a new one is issued.

USE AND DISCLOSURE OF YOUR PROTECTED INFORMATION

The following describes the ways ELEANOR BROWN COUNSELING, PLLC may use and disclose PHI. Except for the purposes described below, ELEANOR BROWN COUNSELING, PLLC will use and disclose PHI only with your written permission. You may revoke such permission at any time by writing to ELEANOR BROWN COUNSELING, PLLC’s Compliance Officer.

For Treatment: Federal law provides that we may use your PHI for your treatment, without further specific notice to you, or written authorization by you. For example, your health care provider may share information about your condition with staff members or other consultants to make a diagnosis.

For Payment: Federal law provides that we may use your medical information to obtain payment for our services without further specific notice to you, or written authorization by you. For example, under a health plan, we are required to provide the health insurance company with a diagnosis code for your visit and a description of the services rendered.

For Health Care Operations: Federal law provides that we may use your medical information for health care operations without further specific notice to you, or written authorization by you. For example, we may use the information to evaluate the quality of care you received from us or to conduct cost-management and business planning activities for our practice.

Appointment reminders: We may contact you via phone, email, or text to remind you of upcoming appointments. If you have preferences regarding how we contact you, please let us know.

As Required by Law: We may disclose PHI without your authorization when required by law, including but not limited to:

  • Public health reporting (e.g., disease control).

  • Mandated reporting of abuse or neglect (child, elder, or dependent adult abuse).

  • Health oversight activities (e.g., audits, investigations).

  • Legal proceedings (court orders, subpoenas).

  • Law enforcement requests (e.g., locating a missing person).

  • Serious threats to health or safety.

Other Uses and Disclosures of Health Information: Other situations in which ELEANOR BROWN COUNSELING, PLLC may use very limited disclosure of your private health information is if ELEANOR BROWN COUNSELING, PLLC needs to claim a delinquent account via a collection agency or in the event of a medical emergency to ensure that emergency medical care is rendered.

Certain types of uses and disclosures of protected health information require authorization, these include:

  • uses and disclosures of psychotherapy notes;

  • uses and disclosures of PHI for marketing purposes; and

  • disclosures that constitute the sale of PHI.

Other uses and disclosures not described in this Notice of Privacy Practices will be made only with an individual’s authorization.

Your Privacy Rights Include:

Right to Inspect and Copy: You have the right to inspect and copy your protected health information (PHI), such as progress notes (other than psychotherapy notes) and billing records with a written request. To inspect and copy your PHI, you must make your request, in writing. ELEANOR BROWN COUNSELING, PLLC has up to 30 days to make your PHI available to you, and ELEANOR BROWN COUNSELING, PLLC may charge you a reasonable fee for the costs of copying, mailing, or other supplies associated with your request. ELEANOR BROWN COUNSELING, PLLC may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state or federal needs-based benefit program. ELEANOR BROWN COUNSELING, PLLC may deny your request in certain limited circumstances. If ELEANOR BROWN COUNSELING, PLLC does deny your request, you have the right to have the denial reviewed by a licensed healthcare professional that was not directly involved in the denial of your request, and ELEANOR BROWN COUNSELING, PLLC will comply with the outcome of the review.

Right to Get Notice of a Breach: ELEANOR BROWN COUNSELING, PLLC is committed to safeguarding your PHI. If a breach of your PHI occurs ELEANOR BROWN COUNSELING, PLLC will notify you in accordance with state and federal law.

Right to Amend, Correct, or Add an Addendum: If you feel that the PHI ELEANOR BROWN COUNSELING, PLLC has is incorrect, incomplete, or you wish to add an addendum to your records, you have the right to make such request as long as the information is kept by or for ELEANOR BROWN COUNSELING, PLLC office. You must make your request in writing to the Department in which your care was provided. In the case of claims that the information is incorrect or incomplete, or if the record was not created by Eleanor Brown Counseling, PLLC, Eleanor Brown Counseling, PLLC may deny your request. However, if Eleanor Brown Counseling, PLLC denies any part of your request, Eleanor Brown Counseling, PLLC will provide you with a written explanation of the reasons for doing so within 60 days of your request.

Requests to amend PHI may be denied if:

  • The record was not created by us (e.g., previous provider records).

  • The information is accurate and complete as is.

  • The amendment would alter the original documentation inappropriately (e.g., changing a diagnosis after the fact).

Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures ELEANOR BROWN COUNSELING, PLLC made of PHI for purposes other than treatment, payment, health care operations, and certain other purposes consistent with law, or for which you provided written authorization. To request an accounting of disclosure, you must make your request, in writing. You may request an accounting of disclosures for up to the previous six years of services provided before the date of your request. If more than one request is made during a 12-month period, ELEANOR BROWN COUNSELING, PLLC may charge a cost-based fee.

Right to Request Restrictions: You have the right to request that ELEANOR BROWN COUNSELING, PLLC restrict or limit the use or disclosure of your Protected Health Information (PHI) for treatment, payment, or health care operations. You may also request restrictions on disclosures to individuals involved in your care or payment, such as a family member or friend.

To request a restriction, you must submit a written request specifying the limitation you are seeking. While we are not required to agree to most restriction requests, we must honor a request to restrict disclosure of PHI to a health plan if:

  • The disclosure is only for payment or health care operations, and

  • The PHI pertains exclusively to a service that you have paid for in full, out-of-pocket.

If you use insurance to pay for services, we are legally required to provide the necessary information to your insurance company for billing and claims processing. You cannot restrict these disclosures if your insurance is covering the service.

If we accept your restriction request, we will comply unless the information is needed for emergency treatment or is required by law. If we are unable to grant your request, we will provide a written explanation.

Out-of-Pocket Payments: If you pay out-of-pocket in full for a specific item or service, you have the right to ask that your PHI with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and ELEANOR BROWN COUNSELING, PLLC will honor that request.

Right to Request Confidential Communications: You have the right to request that we communicate with you in a specific way (e.g., only by email or phone) or at a specific location (e.g., your work address). We will honor reasonable requests; however, please note that some communication methods (e.g., unencrypted email, text messaging) may not be fully secure. If you prefer a specific method of communication, let us know so we can accommodate your request as best as possible.

To request confidential communications, you must make your request, in writing. Your request must specify how or where you wish to be contacted. ELEANOR BROWN COUNSELING, PLLC will accommodate reasonable requests.

Right to Choose Someone to Act for You: If you give someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI. Eleanor Brown Counseling, PLLC will use our best efforts to verify that person has authority to act for you before ELEANOR BROWN COUNSELING, PLLC takes any action.

Right to a Paper Copy of This Notice of Privacy Practices: You may request a paper copy of this Notice at any time, even if you have been provided with an electronic copy. You may obtain an electronic copy of this Notice at our website, WWW.ELEANORBROWNCOUNSELING.COM.

Requirements Regarding This Notice:

CHANGES TO THIS NOTICE OF PRIVACY PRACTICES:

ELEANOR BROWN COUNSELING, PLLC reserves the right to change this Notice of Privacy Practices and make the new Notice of Privacy Practices apply to PHI ELEANOR BROWN COUNSELING, PLLC already has as well as any information ELEANOR BROWN COUNSELING, PLLC receives in the future. ELEANOR BROWN COUNSELING, PLLC will post a copy of Eleanor Brown Counseling, PLLC current Notice of Privacy Practice at our office and/or on our website, and copies will be available there. The Notice of Privacy Practices will contain the effective date on the first page. You will be asked to sign off on the new Notice of Privacy Practices at your next scheduled appointment. Each time you register at ELEANOR BROWN COUNSELING, PLLC for health services, you may receive a copy of the Notice in effect at the time.

Complaints and Communications to the Federal Government

If you believe that your privacy rights have been violated, you have the right to file a complaint with ELEANOR BROWN COUNSELING, PLLC and/or the federal government. You will not be penalized or retaliated against for filing a complaint to ELEANOR BROWN COUNSELING, PLLC or to the Department of Health and Human Services. You may write to:

COMPLAINTS & CONTACT INFORMATION

If you believe your privacy rights have been violated, you may file a complaint with:

ELEANOR BROWN COUNSELING, PLLC

ATTN: HIPAA COMPLIANCE OFFICER

2809 W STAN SCHLUETER LOOP SUITE 101406

KILLEEN, TEXAS 76549-7026

(254) 300-7837 | ELLY@ELEANORBROWCOUNSELING.COM

OR

SECRETARY, OFFICE OF CIVIL RIGHTS REGION VI

U.S. DEPT. OF HEALTH AND HUMAN SERVICES

1301 YOUNG ST., SUITE 1169, DALLAS, TEXAS, 75202

(800) 368-1019 | FAX: (214) 767-0432 | TDD: (800) 537-7697

YOU WILL NOT BE PENALIZED FOR FILING A COMPLAINT.

Contact ELEANOR BROWN COUNSELING, PLLC’s HIPAA Compliance Officer, if:

You have any questions about this Notice;

You wish to request restrictions on uses and disclosures for health care treatment, payment, or operations; or

You wish to obtain a form to exercise your individual rights.

Any reproduction of this form in any form or by any means without the prior written permission of ELEANOR BROWN COUNSELING, PLLC is prohibited. Rev_04 – 02/10/2025.

ACKNOWLEDGMENT OF RECEIPT

By reviewing this Notice of Privacy Practices, you acknowledge that you have received, read, and understand how ELEANOR BROWN COUNSELING, PLLC may use and protect your health information.

REV_04 – EFFECTIVE FEBRUARY 10, 2025.

How to Contact Us

If you have any questions about this Privacy Policy, please contact us at ELLY@ELEANORBROWNCOUNSELING.COM.