Fresh Start Counseling

Privacy Policy

 

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.

 

Fresh Start Counseling is required by law to maintain the privacy of your health care information, to provide you with a notice of Fresh Start Counseling’s legal duties and privacy practices with respect to your health care information and to notify affected individuals if there should be a breach of unsecured health information held by Fresh Start Counseling. Fresh Start Counseling is required to follow the terms of the privacy notice in effect at any particular time, but Fresh Start Counseling reserves the right to change its privacy practices at any time. Any change will apply to all health care information maintained by Fresh Start Counseling and will be set forth in a new notice of privacy practices which will be available at your next visit following the change. At any time, you may obtain a copy of the notice of privacy practices currently in effect by requesting a copy in writing from Fresh Start Counseling’s Proprietor at the address specified below.

 

Use and disclosure of your health care information

 

Fresh Start Counseling may use your health care information for purposes of treatment, payment and health care operations. For example:

 

• Your information may be used to assess your needs and develop an individualized service plan or to coordinate a referral to another health care provider.

• Portions of your information may be submitted to a state agency, insurance carrier or other third-party payer to secure payment for services provided to you, unless you have arranged personally to pay in full all charges for services provided to you.

• Your information may be used for operations of Fresh Start Counseling related to health care activities, such as quality assurance, evaluation, training, audits and administration.

 

Fresh Start Counseling may use your health care information to contact you to remind you of an appointment or to provide information about treatment alternatives or other health services or about Fresh Start Counseling and our programs. We may also use it to contact you for fundraising purposes, but if we do so, you have the right to choose not to receive subsequent fundraising communications and we will offer you the option to do so.

 

Fresh Start Counseling may disclose your health care information to another person or entity performing services on Fresh Start Counseling’s behalf which relate to treatment, payment or health care operations and which require access to your information. That person or entity will have access to your information only to perform those services and must agree in writing to maintain the confidentiality of your information.

 

Fresh Start Counseling may disclose your health care information without your authorization as permitted or required by applicable law, including any of the following: to comply with public health statutes and rules; to make any required reports of abuse or neglect; to comply with health care oversight activities of a government agency (such as licensing); to comply with a court order, search warrant or other lawful process; to allow approved research projects to be conducted; to provide information to a medical examiner in the event of your death; to avert a serious threat to your or anyone else’s health or safety; or to provide information for workers’ compensation purposes.

 

Except as described above, Fresh Start Counseling will not use or disclose your health care information without your written authorization. Your written authorization will in any event be required for any use or disclosure of psychotherapy notes and for any use or disclosure of health care information which is for marketing purposes or which involves sale of your health care information. You may revoke any authorization at any time, in writing or verbally, by communicating the revocation to the clinician principally responsible for your care. Revocation will not, however, be effective with regard to actions already taken in reliance on your authorization.

 

Your privacy rights

 

You may request restrictions on the use or disclosure of your health care information, but Fresh Start Counseling is not required to agree to any requested restriction. It is Fresh Start Counseling’s policy not to agree to such a restriction unless Fresh Start Counseling determines, in its sole discretion, that there is a compelling need for the restriction and the restriction can feasibly be implemented. Fresh Start Counseling will, however, agree not to disclose your health care information to a health plan in order to obtain payment for services provided to you if Fresh Start Counseling has received payment in full for the services from you or someone acting on your behalf.

 

You may request that communications to you be given in a way which will help keep them confidential, for example, by using a particular address or telephone number to contact you. Fresh Start Counseling will comply with such a request if it is reasonable and feasible.

 

To request restrictions or a confidential manner of communicating, you should submit a written request to the clinician principally responsible for your care.

 

You have the right:

 

• to receive an accounting of any disclosures of your health care information apart from ones which you authorized or which were made for treatment, payment or health care operations;

• to inspect and copy your health care information;

• to amend your health care information; and

• to receive a paper copy of this Notice of Privacy Practices.

 

To exercise any of the above rights, please submit your request in writing to Fresh Start Counseling’s Proprietor at the address below. You may also contact the Proprietor to obtain further information about Fresh Start Counseling’s privacy policies and practices.

 

If you believe your privacy rights have been violated, you may complain to Fresh Start Counseling or to the Secretary of the U.S. Department of Health and Human Services. To file a complaint with Fresh Start Counseling, please submit your complaint in writing to Fresh Start Counseling’s Proprietor at the address below. A complaint form will be supplied upon request but is not required. Nobody is permitted to retaliate against you for filing a complaint.

 

To exercise rights, obtain information, or to file a complaint with Fresh Start Counseling:

 

Proprietor

Fresh Start Counseling

333 Lincoln St., Ste. 216

Saco, ME 04072

1-888-342-8764