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Information contained on this website is educational/informational in nature, and does not take the place of a professional medical
assessment. Consult with medical professionals for diagnosis and treatment. No patient/professional relationship is established
by viewing the website. Copyright 2005-2012 Coastal Counseling Associates, LLC
assessment. Consult with medical professionals for diagnosis and treatment. No patient/professional relationship is established
by viewing the website. Copyright 2005-2012 Coastal Counseling Associates, LLC
Coastal Counseling Associates LLC, accepts major insurance plans offered in the shoreline communities
of Madison, Clinton, Old Saybrook, Essex, Guilford, Branford, Killingworth and throughout Connecticut
of Madison, Clinton, Old Saybrook, Essex, Guilford, Branford, Killingworth and throughout Connecticut
We have federal laws, state laws, and our own privacy policies and procedures
in place to protect your Private Health Information(PHI).
Who is a covered entity by The HIPPA Privacy Rule? Health plans Health care
providers Health care clearing houses- transmits health information in electronic
form What is the HIPPA Privacy Rule? The rule ensures that medical information
that is private (such as the medical information you share with your doctors or
other providers such as hospitals) is protected and confidential:
1. Gives patients greater access to their medical records
2. Gives patients greater protection of their medical records
3. HIPPA places restrictions on both use and disclosure of personal health
information.
What is Protected Health Information (PHI)? HIPPA is personal health information
given to a covered entity; it includes; information about a person's
physical/mental, services or payment for services rendered. Examples of (PHI)
could be billing information, Social Security number, or demographic information
for an individual. This includes information sent in written, electronic, or oral
forms.
When is Coastal Counseling LLC permitted to disclose/use Protected Health
Information (PHI)? Health care oversight and operations; we, at Coastal
Counseling Associates, LLC are permitted to disclose/use (PHI) for treatment,
health care operations billing. Written authorization; Providers of health care can
disclose (PHI) from the individual patient with agreement/authorization. Coastal
Counseling Associates, LLC will obtain a written authorization prior to making
any disclosure or use other than for the above reasons. A written authorization
will inform you of the person to whom we are disclosing or using the (PHI), what
information is being disclosed or used, and it will contain an expiration date. You
may revoke a written authorization at any time. This must be done in writing, and
Coastal Counseling Associates, LLC will no longer disclose or use this
information after written authorization is withdrawn. We, at Coastal Counseling
Associates LLC, may be required to disclose or use (PHI) to family health care
representatives such as parents of minor children, or to other individuals that
are legally authorized to handle your health care issues. In an emergency
situation, Coastal Counseling Associates, LLC may disclose or use (PHI)
relevant to the emergency circumstances based upon professional judgments
and assessment. Are there special circumstances when disclosures/uses (PHI)
can be released without permission?
1.Workers Compensation Laws and Claims-under limited circumstances relating
to workplace injury or illness or medical surveillance
2.Report victim abuse, domestic violence; or to report neglect as authorized by
law
3.Required by law
4.Required by law enforcement- in response to a subpoena, request from law
enforcement in specific circumstances, court or other legal process, criminal
conduct
5.Business associates such as billing services, legal, or accounting consultants,
health oversight audits or inspections
6. National security, or other specialized government functions as required by
law 7.Preventing personal injury, disability, and/or damage to you or another
individual or property
8.Department of Public Health and Safety as authorized by law
9.The Dept of Veteran's Affairs- for those in the military services by appropriate
authorities, as authorized by law.
10.Health oversight activities; This may include investigations, inspections,
audits, surveys, licenser, civil, administrative, and criminal actions as authorized
by law Your Rights Counseling Associates LLC may deny access to your health
information. In the case that Coastal Counseling Associates LLC denies your
access to health care information Access records-You have the right to request
to view/copy; your health care information. This request must be made in writing,
include specific dates and nature of request. An administrative charge will be
incurred to cover postage and copying expenses. There are certain
circumstances that Coastal, we will discuss with you the reasons and tell you
how you can appeal the denial. You must request an Amendment to your
records-You have the right to request in writing, an amendment to your records
at Coastal Counseling Associates, LLC if you believe that the record is
incomplete or incorrect. This request should include reasoning behind the
changes, and counselors will discuss matters with you. Only documents created
by Coastal Counseling Associates LLC can be amended, and this request may
be denied under certain circumstances. Right to a paper copy of this notice-
You may receive a paper copy of this notice at any time, contact; Privacy Officer
Coastal Counseling Associates LLC at 203-245-1956.
in place to protect your Private Health Information(PHI).
Who is a covered entity by The HIPPA Privacy Rule? Health plans Health care
providers Health care clearing houses- transmits health information in electronic
form What is the HIPPA Privacy Rule? The rule ensures that medical information
that is private (such as the medical information you share with your doctors or
other providers such as hospitals) is protected and confidential:
1. Gives patients greater access to their medical records
2. Gives patients greater protection of their medical records
3. HIPPA places restrictions on both use and disclosure of personal health
information.
What is Protected Health Information (PHI)? HIPPA is personal health information
given to a covered entity; it includes; information about a person's
physical/mental, services or payment for services rendered. Examples of (PHI)
could be billing information, Social Security number, or demographic information
for an individual. This includes information sent in written, electronic, or oral
forms.
When is Coastal Counseling LLC permitted to disclose/use Protected Health
Information (PHI)? Health care oversight and operations; we, at Coastal
Counseling Associates, LLC are permitted to disclose/use (PHI) for treatment,
health care operations billing. Written authorization; Providers of health care can
disclose (PHI) from the individual patient with agreement/authorization. Coastal
Counseling Associates, LLC will obtain a written authorization prior to making
any disclosure or use other than for the above reasons. A written authorization
will inform you of the person to whom we are disclosing or using the (PHI), what
information is being disclosed or used, and it will contain an expiration date. You
may revoke a written authorization at any time. This must be done in writing, and
Coastal Counseling Associates, LLC will no longer disclose or use this
information after written authorization is withdrawn. We, at Coastal Counseling
Associates LLC, may be required to disclose or use (PHI) to family health care
representatives such as parents of minor children, or to other individuals that
are legally authorized to handle your health care issues. In an emergency
situation, Coastal Counseling Associates, LLC may disclose or use (PHI)
relevant to the emergency circumstances based upon professional judgments
and assessment. Are there special circumstances when disclosures/uses (PHI)
can be released without permission?
1.Workers Compensation Laws and Claims-under limited circumstances relating
to workplace injury or illness or medical surveillance
2.Report victim abuse, domestic violence; or to report neglect as authorized by
law
3.Required by law
4.Required by law enforcement- in response to a subpoena, request from law
enforcement in specific circumstances, court or other legal process, criminal
conduct
5.Business associates such as billing services, legal, or accounting consultants,
health oversight audits or inspections
6. National security, or other specialized government functions as required by
law 7.Preventing personal injury, disability, and/or damage to you or another
individual or property
8.Department of Public Health and Safety as authorized by law
9.The Dept of Veteran's Affairs- for those in the military services by appropriate
authorities, as authorized by law.
10.Health oversight activities; This may include investigations, inspections,
audits, surveys, licenser, civil, administrative, and criminal actions as authorized
by law Your Rights Counseling Associates LLC may deny access to your health
information. In the case that Coastal Counseling Associates LLC denies your
access to health care information Access records-You have the right to request
to view/copy; your health care information. This request must be made in writing,
include specific dates and nature of request. An administrative charge will be
incurred to cover postage and copying expenses. There are certain
circumstances that Coastal, we will discuss with you the reasons and tell you
how you can appeal the denial. You must request an Amendment to your
records-You have the right to request in writing, an amendment to your records
at Coastal Counseling Associates, LLC if you believe that the record is
incomplete or incorrect. This request should include reasoning behind the
changes, and counselors will discuss matters with you. Only documents created
by Coastal Counseling Associates LLC can be amended, and this request may
be denied under certain circumstances. Right to a paper copy of this notice-
You may receive a paper copy of this notice at any time, contact; Privacy Officer
Coastal Counseling Associates LLC at 203-245-1956.
Right for you. Right for now.
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| Coastal Counseling Associates, LLC 149 Durham Road Suite 31 Madison, CT 06443 203-245-1956 phone 203-245-6710 fax |
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