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Notice of Privacy Policies

At Emerald Path Therapy (“EPT”, “we”, or “us”) we are committed to treating and using protected health information responsibly. This Notice describes the procedures we use to protect your information, the circumstances under which your personal health information may be disclosed, and your rights as it relates to this information. It also describes how you can get access to this information. The rules for confidentiality of mental health records are recorded in the Illinois Mental Health and Developmental Disabilities Confidentiality Act and in the privacy rules of the Health Insurance Portability and Accountability Act (HIPPA). Please review these provisions carefully and in its entirety in order to fully understand our procedures and your rights.

 

OUR RESPONSIBILITIES

At EPT, every effort is made to protect and keep your personal health information private. Some of our procedures will be evident to you. For example, when you call to discuss an issue with office staff, we may ask you for some piece of identifying information to confirm your identity. Others happen behind the scenes. If you have any concerns about your privacy, please bring them to our attention.

 

YOUR RIGHTS

You are entitled to copy or review your mental health records. You have the right to inspect and/or copy your health record. Emails that include clinical information may be included as part of the record. If, after reviewing your record, you believe that any statement is in error, you have a right to request that the person who made the entry make a correction. Anytime you request a revision, your request and the action taken must be noted in the record. If a professional chooses to stand by a statement with which you disagree, you have the right to add a written amendment stating why you believe the entry is in error. Any time that section of the record is released, your amendment must be included.

 

You have the right to request restrictions on certain uses and disclosure of personal health information. However, EPT is not required to agree to a requested restriction, and in some situations, is prohibited by law from agreeing to a requested restriction. You have the right to request and receive an accounting of disclosures that we make to other individuals.

 

HOW EPT MAY USE AND SHARE YOUR HEALTH INFORMATION

EPT may, without your written permission, use your health information within EPT and share or disclose your health information to others outside EPT in the following ways:

 

Treatment

EPT may use your health information and share it with other professionals who are treating you. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another. For example, if you were receiving both couples and individual counseling within EPT, your couples’ counselor may ask your individual counselor about your overall mental health condition. Note, however, that we may ask for your written permission if certain kinds of information are being disclosed.

 

Payment

EPT may use and share your health information to bill and get payment from health plans or other entities. For example, we may send health information about you to your health insurance plan so it will pay for your services. We may also disclose your information to other providers for their payment activities.

 

Healthcare operations

EPT may use and disclose your health information to run our organization, improve your care, and contact you when necessary. For example, we use health information to manage your treatment and services, including to contact you to remind you that you have an upcoming psychotherapy appointment. We may also disclose information to clinicians, interns, and other authorized personnel for educational and learning purposes.

 

To parents and legal guardians

EPT may share a minor’s health information, unless such disclosure is otherwise prohibited by law, to:

  • parents and legal guardians of minors under the age of 12

  • parents and legal guardians of minors who are at least 12 years of age but under 18 years of age, so long as the minor does not object or the clinician does not find compelling reason to deny access

  • legal guardians of clients who are 18 years or older.

 

For example, a minor’s parents may discuss mental health treatment with the clinician. Note, however, that if a minor is emancipated, married, pregnant or a parent, we will not share information with the minor’s parents or guardians. We will not disclose information to the minor’s parents or guardians except in certain situations as required or allowed by law (including,

but not limited to, if doing so is necessary to protect the minor’s safety or that of a family member or other individual or if, in the professional judgment of the clinician, notification would be in the minor’s best interest and we have first sought unsuccessfully to persuade the minor to notify his or her parents).

 

To respond to lawsuits and legal actions

EPT may disclose health information about you in response to a court or administrative order, or non-sensitive information in response to a subpoena if there is a qualified protective order or satisfactory assurances.

 

LIMITATIONS OF CONFIDENTIALITY

There are circumstances that impose limitations on a client’s right or ability to maintain privileged communication. EPT may release your records without your permission under the following circumstances:

  • For consultation and/or treatment purposes with a clinical supervisor, a clinical colleague, a staff member participating in the provision of services, a record custodian, or a person acting under the clinical supervision of the clinician.

  • When a clinician believes a clear and immediate danger exists to one or more persons.

  • When disclosure is necessary to provide a recipient with emergency medical care or access to needed benefits when the recipient is not in a condition to waive or assert his or her rights

  • When abuse or neglect of a child is suspected.

  • For consultation and/or treatment purposes with an employer, attorney, professional liability company, or other relevant business associate concerning the care or treatment he or she has provided, including disclosure to business associates who may help us pursue payment (but each of these recipients shall be held to HIPAA privacy standards and may not redisclose the information).

  • When a recipient introduces his or her mental condition or any aspect of services received for such condition as an element of a claim or defense.

  • To notify the Illinois Department of Human Services of anyone who is determined to be a “clear and present danger” to themselves or others or determined to be developmentally or intellectually disabled as part of the Illinois Firearm Concealed and Carry Act (PA98-063).

  • When required by law.

 

CHANGES TO THIS NOTICE

We can change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request from your therapist or on our website at http://www.EmeraldPathTherapy.com. However, any changes to the terms will not change EPT’s commitment to complying with applicable laws and ensuring the privacy of patient information.

 

WHO TO CONTACT FOR INFORMATION OR WITH A COMPLAINT

If you believe your privacy has been violated, first bring the matter to the Office Manager of the office where you are receiving services. If you have a dispute that cannot be resolved, please contact our office at (331) 272-0272. You may also file a complaint with the Office for Civil Rights, U.S. Dept of Health & Human Services, 200 Independence Ave: S.W., Room 509F, HHH Building, Washington, DC 20201. There can be no retaliation for filing a complaint

 

NOTICE OF DISCLOSURE AND EFFECTIVE DATE

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. This Notice of Privacy Practices serves as a disclosure of Emerald Path Therapy LLC’s HIPPA Notice of Privacy Practices. This notice went into effect on 07/01/2024.

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