Our Legal Duty to Protect Your Health Information
NewVision Counseling and Consulting Services, PLLC is required by law to maintain the privacy of your protected health information (PHI) and to provide you with this Notice of Privacy Practices describing our legal duties and privacy practices.
We are required to:
Protect personal health information that we create or receive about your past, present, or future mental health care
Provide notice of how your protected health information may be used and disclosed
Follow the terms of this Notice currently in effect
We reserve the right to change the terms of this Notice and to make revised provisions effective for all protected health information we maintain. Updated notices will be posted on our website and made available upon request.
How We May Use and Disclose Your Health Information
For Treatment
Your protected health information may be used and disclosed for purposes of providing, coordinating, or managing your mental health treatment and related services. This may include consultation with clinical supervisors or other treatment professionals. Disclosure to outside consultants will occur only with your authorization unless otherwise permitted by law.
For Payment
With your authorization, we may use and disclose your protected health information to obtain payment for services provided. This may include:
Determining insurance eligibility or coverage
Submitting claims to insurance companies
Reviewing services for medical necessity
Conducting utilization review activities
If collection activity becomes necessary due to nonpayment, only the minimum necessary information will be disclosed.
For Health Care Operations
We may use or disclose protected health information as needed to support business operations, including:
Quality assessment and improvement activities
Licensing and credentialing
Administrative and billing services (with contracted business associates who are required to protect your information)
Appointment reminders and treatment-related communications
Information will be used for training or teaching purposes only with your authorization.
Disclosures Required or Permitted Without Authorization
Applicable law and ethical standards permit disclosure of protected health information without authorization in limited circumstances, including:
Required by law, such as mandatory reporting of abuse or neglect or government audits and investigations (including the NC Board of Licensed Clinical Mental Health Counselors)
Court orders or legal proceedings
To prevent or lessen a serious and imminent threat to the health or safety of a person or the public
With verbal permission, information may be shared with family members directly involved in your care
Only the minimum necessary information will be disclosed in these situations.
Uses and Disclosures With Authorization
Any uses or disclosures of protected health information not described in this Notice will be made only with your written authorization. You may revoke such authorization in writing at any time.
Your Rights Regarding Your Health Information
You have the following rights regarding the protected health information we maintain about you:
Right to Inspect and Copy
You have the right to inspect and copy your health record, except in limited circumstances where access may be restricted to prevent serious harm. Reasonable fees may apply.
Right to Amend
You may request an amendment if you believe your health information is incorrect or incomplete. We are not required to agree to all amendment requests.
Right to an Accounting of Disclosures
You may request a list of certain disclosures of your health information. A reasonable fee may apply for multiple requests within a 12-month period.
Right to Request Restrictions
You may request restrictions on how your health information is used or disclosed. We are not required to agree to requested restrictions.
Right to Request Confidential Communications
You may request that we communicate with you in a specific way or at a specific location.
Right to a Copy of This Notice
You have the right to receive a copy of this Notice at any time.
To exercise any of these rights, submit a written request to:
NewVision Counseling and Consulting Services, PLLC
1101 Sunset Road, Suite 680313
Charlotte, NC 28216
Complaints
If you believe your privacy rights have been violated, you may file a written complaint with:
Privacy Officer
Rita L. Berry
NewVision Counseling and Consulting Services, PLLC
1101 Sunset Road, Suite 680313
Charlotte, NC 28216
You may also file a complaint with the U.S. Department of Health and Human Services:
200 Independence Avenue, S.W.
Washington, DC 20201
Phone: (202) 619-0257
You will not be retaliated against for filing a complaint.
Acknowledgment of Review
Clients are asked to acknowledge review of this Notice of Privacy Practices as part of the NewVision Intake Packet prior to beginning services.