Privacy Practices
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. Please review it carefully.Luxterra Counseling, PLLC ("Luxterra Counseling" or "Luxterra") is committed to protecting your privacy. Luxterra is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. Luxterra is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains Luxterra's legal duties and privacy practices and your rights regarding PHI that is collected and maintained.
Your Rights
Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to Luxterra at the email address noted below, including a specific request of your PHI:
lauren@luxterracounseling.com
To inspect and copy PHI.
• You can ask for an electronic or paper copy of PHI. Luxterra may charge you a reasonable fee for a paper copy; an electronic copy may be provided at no cost.
• Luxterra may deny your request if it believes the disclosure will endanger your life or another person's life. You may have a right to have this decision reviewed.
To amend PHI.
• You can ask to correct PHI you believe is incorrect or incomplete. Luxterra requires you to make your request in writing via email (email address listed above) and you must provide a reason for the request.
• Luxterra may deny your request. Luxterra will send a written explanation via email for the denial and allow you to submit a written statement of disagreement.
To request confidential communications.
• You can ask Luxterra to contact you in a specific way, as well as to not contact you through specific channels; via email, via phone call, or via text message. You acknowledge that any communication outside of your session cannot guarantee confidentiality.
To limit what is used or shared.
• You can ask Luxterra not to use or share PHI for treatment, payment, or business operations. Luxterra is not required to agree if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask Luxterra not to share PHI with your health insurer.
To obtain a list of those with whom your PHI has been shared.
• You can ask for a list, called an accounting, of the times your health information has been shared. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.
To receive a copy of this Notice.
• You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.
To choose someone to act for you.
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights.
To file a complaint if you feel your rights are violated.
• You can file a complaint by contacting Luxterra using the following information:
Luxterra Counseling
Attn: Lauren DeVore
935 White Plains Road, suite 203
Trumbull, CT 06611
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• Luxterra will not retaliate against you for filing a complaint.
Uses and Disclosures
1. Routine Uses and Disclosures of PHI
Luxterra is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. Luxterra typically uses or shares your health information in the following ways:
To treat you.
• Luxterra can use and share PHI with other professionals who are treating you with your consent.
• Example: Your primary care doctor asks about your mental health treatment and a Release of Information (ROI) has been signed.
To run the health care operations.
• Luxterra can use and share PHI to run the business, improve your care, and contact you.
• Example: Luxterra uses PHI to send you appointment reminders if you choose.
To bill for your services.
• Luxterra can use and share PHI to bill and get payment from health plans or other entities.
• Example: Luxterra gives PHI to your health insurance plan so it will pay for your services.
2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object
Luxterra may use or disclose PHI without your authorization or an opportunity for you to object, including:
To help with public health and safety issues
• Public health: To prevent the spread of disease and report adverse reactions to medication.
• Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
• Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
• Serious threat to health or safety: To prevent a serious and imminent threat.
• Abuse or Neglect: To report abuse, neglect, or domestic violence.
To comply with law, law enforcement, or other government requests
• Required by law: If required by federal, state or local law.
• Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.
• Law enforcement: For law to locate and identify you or disclose information about a victim of a crime.
• Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.
• National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons or foreign heads of state, for purpose of determining your own security clearance and other national security activities authorized by law.
• Workers' Compensation: To comply with workers' compensation laws or support claims.
To comply with other requests
• Business Associates: To organizations that perform functions, activities or services on our behalf.
3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object
Luxterra may disclose PHI with a Release of Information on file and signed by you (client/parent/guardian) to a person or institution involved in your care; you can choose to designate limitations of disclosure, opt for full disclosure, or opt for full non-disclosure. You will also be notified of any information that is shared with your knowledge.
You may revoke your authorization, at any time, by contacting Luxterra in writing via email, using the information above. Luxterra will not use or share PHI other than as described in Notice unless you give your permission in writing.
Our Responsibilities
• Luxterra is required by law to maintain the privacy and security of PHI.
• Luxterra is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, Luxterra will abide by the more stringent law.
• Luxterra reserves the right to amend this Notice. All changes are applicable to PHI collected and maintained by Luxterra. Should Luxterra make changes, you may obtain a revised Notice by requesting a copy from the Practice using the information above.
• Luxterra will inform you if PHI is compromised in a breach.