HIPAA Notice of Privacy Practices
Effective Date: January 2025
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.
Wisdom Within Counseling PLLC (“we,” “us,” or “our”) is required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice, and follow the terms of this Notice.
1. Your Rights
You have the right to:
1.1 Get an electronic or paper copy of your medical record
You may request to see or get a copy of your PHI.
We will provide a copy or a summary, usually within 30 days of your request.
A reasonable fee may apply.
1.2 Ask us to correct your record
If you believe your PHI is incorrect or incomplete, you may request a correction.
We may deny your request, but we will give you a written explanation.
1.3 Request confidential communications
You may ask us to contact you in a specific way (e.g., through a specific phone number or email).
We will accommodate reasonable requests.
1.4 Ask us to limit what we use or share
You may request that we not use or share certain information.
We are not required to agree, but we will consider your request.
1.5 Ask for a list of disclosures
You may request a list of times we shared your PHI in the past six years, excluding disclosures for treatment, payment, and health care operations.
1.6 Get a copy of this Notice
You may request a paper or electronic copy at any time.
1.7 Choose someone to act for you
If you have a legal guardian or medical power of attorney, they may exercise your rights on your behalf.
1.8 File a complaint
If you believe your privacy rights have been violated, you may file a complaint with:
U.S. Department of Health & Human Services (HHS)
Office for Civil Rights
Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints
You may also contact us directly (see Contact Information below).
You will not be penalized for filing a complaint.
2. How We Use and Share Your Information
We typically use or share your PHI in the following ways:
2.1 Treatment
We may use your PHI to provide and coordinate care.
Example: sharing information with another treating provider with your consent.
2.2 Payment
We may use and share your PHI to bill and get payment from health plans or other entities.
2.3 Health care operations
We may use your PHI to manage our practice and improve services.
3. Other Uses and Disclosures
We may also share your information in other ways permitted by law:
3.1 When required by law
We will share PHI if required by federal, state, or local law.
3.2 To address serious threats to health or safety
We may share information when necessary to prevent a serious threat to your safety or the safety of others.
3.3 Public health and safety
For example:
Preventing disease
Reporting abuse or neglect
Reporting adverse reactions to medications
3.4 Research
We may share PHI for approved research when privacy protections are in place.
3.5 Legal purposes
We may share PHI in response to:
A court order
A subpoena
Other lawful processes
3.6 Workers’ compensation, law enforcement, and other government requests
Only as allowed or required by law.
3.7 Appointment reminders and administrative messages
We may contact you about scheduling, billing, or practice updates.
4. Our Responsibilities
We are required to:
Maintain the privacy and security of your PHI
Notify you promptly if a breach occurs that may have compromised your information
Follow the duties and privacy practices described in this Notice
Provide you with a copy of this Notice upon request
We will not use or share your information for marketing or sell your PHI without your written authorization.
If we change our privacy practices, we will update this Notice.
The new terms will apply to all PHI we maintain.
5. Contact Information
For questions, requests, or concerns related to this Notice, contact:
Wisdom Within Counseling PLLC
6172 Airways Blvd, Suite 115
Chattanooga, TN 37421
Email: info@wisdom-within-lpc.com
Phone: 423-218-3152