Privacy Policy
Open Door Counseling
Melanie Harrison, LICSW
5220 Willson Rd Suite 150-5028
Edina, MN 55424
- Notice of Privacy Practices -
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Purpose of this Notice
This Notice describes Open Door Counseling (ODC)/Melanie Harrison, LICSW (referred to henceforth as‘ provider’) and its privacy practices and how they protect the confidentiality of your health information. Federal law, the Health Insurance Portability and Accountability Act (HIPPA), requires that the provider keep your Protected Healthcare Information (PHI) private and to give you this notice of my legal duties and privacy practices (Notice of Privacy Practices). Provider must follow the Notice that is currently in effect and may change the terms of this Notice in accordance with changes in the laws. Any such changed Notice will be effective for health information they already have about you, as well as for new information. Provider will make a paper copy of any such new Notice available to you.
Uses and Disclosures of Your Health Information
Typically, the Provider cannot and will not disclose any health information to any party without your
consent. According to HIPAA, Provider may use and disclose your health information for the following purposes:
Treatment: The Provider will use and disclose your health information to provide, coordinate, or manage your health care and any related services or products. For example, this Provider may disclose information about you to doctors, nurses, social workers, and other clinicians to coordinate and provide you with necessary services in emergency situations. Outside of emergency situations this Provider will request your written permission first.
Payment: Provider may use and disclose your health information to obtain payment for your health care services. For example, the Provider may tell your health plan or medical insurer about treatment you have received or are going to receive to obtain payment or determine whether your insurance plan will cover it.
Research: Provider will not use or disclose any health information that identifies you or can be used to identify you for any research purposes without obtaining your prior written authorization or following state law procedures for attempting to notify you of his research request. You will be asked to sign additional authorizations if you wish to participate in clinical research.
Individuals Involved in Your Care: If you agree, Provider may release certain health information about you to a friend or family member involved in your care or payment related to your care. If you are unable to agree due to your incapacity or emergency circumstances, Provider may disclose your health information if they determine it is in your best interest, based on Provider’s professional judgment.
Provider may disclose information about you to an organization assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Workers’ Compensation: Provider may disclose your health information as authorized to comply with workers’ compensation laws and other similar legally established programs.
Other uses and disclosures Without Your Authorization
In addition to the above-listed purposes, the Provider may need to use or disclose your health information without your authorization for the following purposes:
-to a law enforcement official, responding to a court order to identify or to locate a suspect, witness, or missing person, or to a court or party in litigation in response to a valid court or administrative order
- to a coroner or funeral director as permitted or required by law to identify a deceased person, determine the cause of death, or otherwise as necessary to carry out their duties
- if you are an inmate of a correctional institution, to the institution as necessary for your health and the safety of other individuals
- for military, national security or lawful intelligence activities; or
- otherwise as permitted or required by law.
Other uses and disclosures of your health information will be made only with your written authorization (Release of Information). You may revoke that authorization in writing at any time, but the Provider cannot take back any disclosures already made in reliance on your previous authorization.
Your Rights Regarding Your Health Information
Access to Your Health Information: With some exceptions, you have the right to inspect and request a copy of your medical al, billing records and records used to make decisions about your care or services if those records include health information about you and are maintained or used by us. If you wish to access to your health information, please write to the Provider and they will respond to your request and tell you when and where you can review your health information in Provider’s possession. If you would like a copy of your health information, Provider may charge a reasonable administrative fee for copying your health information to the extent permitted by applicable law. If Provider denies your request for review or copy of your health information, a written explanation will be provided. If your request to review or copy your medical information is denied, you can request in writing that this Provider ask another qualified health care professional to review your request and the denial.Right to Amend Your Health Information: You have the right to request amendments to your health information if you feel that records are incorrect or incomplete. If you wish to have your health information corrected or updated, please write to us and tell us what you want changed and why. The Writer will respond to you in writing, either accepting or denying your request. If denied, Provider will explain why.
Right to Receive an Accounting of Disclosures of Your Health Information: You have the right to request an accounting of certain disclosures that he makes of your health information. You can request an accounting by writing to the Provider. Certain disclosures, such as those made with your consent and/or for treatment, payment, or health care operations, will not be included in the accounting provided to you.
Your request must fall within a time period, which may not be longer than seven years and may not
include dates before April 14, 2003 (the date these laws take effect). The first accounting you request within a 12-month period will be free. For additional accountings, Provider may charge you for the costs of providing the accounting. Provider will notify you in advance of the cost involved. After you complete services, your records will be retained for 7 years. At the end of 7 years, the record will be entirely destroyed, leaving only the name of the client and date of record destruction. The time period begins from the date of the last visit. Right to Request Restrictions: You have the right to request restrictions on how I use and disclose your health information for treatment, payment, and health care operations. The Provider is not required to agree to your request. If accepted, Provider will comply with your request (unless the information is required to provide emergency treatment). To request a restriction, you must make your request in writing
to:
Open Door Counseling
in c/o Melanie Elizabeth Harrison
5200 Willson Rd Suite 150-5028
Edina, MN 55424
In your request, you must tell us (1) what information you want to limit; (2) whether and how you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply.
Right to Confidential Communications: You have the right to request that Provider send your health information to you in a confidential manner. For example, you may request that Provider send your health information by an alternate means (e.g., sending by registered mail) or to an alternate address, or sending a letter to you at your office address (rather than your home address). Provider will attempt to accommodate any reasonable requests, unless they are administratively too burdensome, or prohibited by law. Your request for an alternate form of communication should specify where and/or how you prefer to be contacted.
Right to Receive Notification of Breach. You have the right to receive a notification, in the event that there is a breach of your unsecured health information, which requires notification under the Privacy Rule.
Right to Paper Copy of Notice.
You have the right to receive a paper copy of this Notice of Privacy Practices at any time.
Right to File Complaints
If you believe your privacy rights have been violated, you have the right to contact the Secretary of the Federal Department of Health and Human Services. This Provider will not retaliate in any way in response to such action.
Changes to this Notice
Your Provider may change the terms of this Notice of Privacy Practices at any time. If the terms of the Notice are changed, the new terms will apply to all of your health information, whether created orreceived by your Provider before or after the date on which the Notice is changed. Any updates to the Notice will be provided to you.