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.
Our Duty to Protect Your Information
Rego Park Counseling is required by law to keep your health information private, give you this notice of our legal duties and privacy practices, follow the notice currently in effect, and tell you if a breach affects your unsecured information.
Extra Protection for Substance Use Treatment Records
Records of substance use disorder treatment are also protected by federal law (42 CFR Part 2) and New York State law. In general, we cannot share information that identifies you as receiving substance use treatment without your written consent, except as these laws allow. Part 2 records cannot be used or disclosed in civil, criminal, administrative or legislative proceedings against you without your written consent or a court order that meets Part 2 requirements.
How We May Use and Share Your Information
- Treatment: to provide and coordinate your care, including with other providers you are working with.
- Payment: to bill and get paid by Medicaid or your health plan.
- Health care operations: to run our clinic, train staff and improve quality.
- Appointment reminders: by phone, mail or text, as you choose.
Other Uses and Disclosures Allowed or Required by Law
When required by law; to prevent a serious threat to health or safety; to report suspected child abuse or neglect; for public health activities; for health oversight audits; in response to a court order; to law enforcement in limited cases; to coroners and medical examiners; and for workers’ compensation — each only as the law permits, and with the stricter limits that apply to substance use records and New York mental health records.
Uses That Need Your Written Permission
Most uses of psychotherapy notes, marketing, and sale of your information require your written authorization. You may cancel an authorization in writing at any time, except for actions already taken.
Your Rights
- Get a copy of your records (paper or electronic), usually within 30 days. A reasonable, cost-based fee may apply.
- Ask us to correct your records if you believe they are wrong or incomplete.
- Ask for confidential communications, for example a different phone number or mailing address.
- Ask us to limit what we use or share. We are not required to agree in all cases, but must agree not to share with your health plan for a service you paid for in full yourself, if you ask.
- Get a list of disclosures we made in the past six years, with some exceptions.
- Get a paper copy of this notice at any time.
- Choose someone to act for you, such as a health care proxy or legal guardian.
- File a complaint if you believe your rights were violated (below). We will not retaliate against you.
Complaints
Contact our Privacy Officer: (718) 459-2558, management@regoparkcounseling.com, 63-36 99th Street, Rego Park, NY 11374. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at hhs.gov/ocr/complaints or 1-877-696-6775.
Changes to This Notice
We may change this notice. The new notice will apply to all information we have, and will be posted at our clinics and on this website.
