MBSS Counseling Group ("MBSS," "we," "our," or "us") is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) and your rights regarding that information, in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations.
1. Our Legal Duty
We are required by law to maintain the privacy of your PHI, to provide you with notice of our legal duties and privacy practices, and to notify you following a breach of your unsecured PHI. We are required to abide by the terms of this Notice currently in effect. We reserve the right to change the terms of this Notice and to make new provisions effective for all PHI we maintain. If we revise this Notice, we will make the revised version available upon request.
2. What Is Protected Health Information (PHI)?
PHI is information that identifies you and relates to your past, present, or future physical or mental health condition; the provision of health care to you; or the past, present, or future payment for the provision of health care to you. This includes information in your medical record, conversations between your counselor and other healthcare providers about your treatment, billing information, and any other health information that identifies you.
3. How We May Use and Disclose Your PHI
We use and disclose health information about you for the following primary purposes:
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your mental health and substance abuse treatment and any related services. For example, we may share information with other healthcare providers who are involved in your care.
Payment. We may use and disclose your PHI to obtain payment for services we provide to you. For example, we may contact your health insurer to confirm your coverage or to submit a bill for services rendered.
Health Care Operations. We may use and disclose your PHI in connection with our healthcare operations, including quality assessment, staff training, licensing, and business management activities necessary to run our practice.
We may also use or disclose your PHI in the following circumstances without your written authorization:
- · As required by law, court order, or government authority
- · To avert a serious threat to health or safety
- · For public health activities and reporting
- · For health oversight activities by government agencies
- · To coroners, medical examiners, and funeral directors
- · For workers' compensation purposes
- · For research purposes under specific HIPAA-compliant conditions
Substance Use Disorder Records — Additional Protections. Records related to substance use disorder treatment are afforded extra protection under 42 CFR Part 2. We will not disclose these records without your written consent except in cases of medical emergency, to qualified personnel for research or audit purposes (who cannot identify patients), or as required by law.
4. Uses and Disclosures Requiring Your Authorization
Other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. This includes most uses of psychotherapy notes, uses of PHI for marketing purposes, and the sale of PHI. You may revoke any written authorization at any time by notifying us in writing, except to the extent we have already acted in reliance on it.
5. Your Rights Regarding Your PHI
You have the following rights with respect to your PHI. To exercise any of these rights, please submit a written request to our Privacy Officer.
Right to Access
You have the right to inspect and obtain a copy of your PHI used to make decisions about your care, including medical and billing records.
Right to Amend
You have the right to request an amendment to your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures of your PHI we have made in the six years prior to your request.
Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to all requests, but we will consider each request carefully.
Right to Confidential Communications
You have the right to request that we communicate with you about your health information in a specific way or at a specific location (e.g., only at home, only by mail).
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically.
Right to Be Notified of a Breach
You have the right to be notified in the event of a breach of your unsecured PHI, in accordance with applicable law.
6. Safeguarding Your Information
MBSS Counseling Group implements appropriate administrative, physical, and technical safeguards to protect the privacy and security of your PHI, whether stored in paper or electronic format. Our staff are trained on HIPAA requirements and are required to maintain confidentiality as a condition of employment.
7. How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with MBSS Counseling Group or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.
To file a complaint with us, please contact our Privacy Officer in writing at info@mbsscounsult.com or call (214) 810-4921.
8. Contact Our Privacy Officer
MBSS Counseling Group — Privacy Officer
Email: info@mbsscounsult.com
Phone: (214) 810-4921
Website: mbsscounsult.com
This Notice is effective as of January 1, 2025. MBSS Counseling Group reserves the right to change the terms of this Notice and to make the new Notice provisions effective for all PHI maintained by us. We will provide a revised Notice upon request.
