MENTAL HEALTH CLIENT PRIVACY NOTICE
NOTICE OF PRIVACY PRACTICES
Effective Date: February 26, 2025
THIS NOTICE DESCRIBES HOW YOUR MENTAL HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to Your Privacy
We are dedicated to maintaining the privacy of protected health information (PHI). This notice details our privacy practices, legal responsibilities, and your rights concerning your personal health information. We are required by law to maintain the confidentiality of health information that identifies you, to provide you with this notice of our legal duties and privacy practices, and to follow the terms of this notice currently in effect.
How We May Use and Disclose Your Health Information
Treatment: We may use and disclose your health information to coordinate and manage your mental health care and related services. For example, we may consult with other healthcare providers involved in your care.
Payment: We may use and disclose your health information to obtain payment for services provided. This may include contacting your health insurer to verify coverage, obtain authorization, or for billing purposes.
Healthcare Operations: We may use and disclose your health information for operational purposes. This includes quality assessment, employee review, training, licensing, and business planning.
Appointments and Services: We may contact you to provide appointment reminders or information about treatment alternatives.
As Required by Law: We will disclose your health information when required by federal, state, or local law.
Special Situations
Public Health Risks: We may disclose your health information to prevent or control disease, injury, or disability; to report births and deaths; to report abuse or neglect; to report adverse reactions to medications; to notify people of product recalls; or to notify a person who may have been exposed to a disease or at risk for contracting or spreading a disease.
Health Oversight Activities: We may disclose health information to agencies for activities authorized by law such as audits, investigations, inspections, and licensure.
Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court or administrative order, subpoena, discovery request, or other lawful process.
Law Enforcement: We may release health information if asked to do so by law enforcement officials in limited circumstances.
Serious Threats to Health or Safety: We may use and disclose health information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public.
Your Rights Regarding Your Health Information
Right to Inspect and Copy: You have the right to inspect and obtain a copy of your health information that may be used to make decisions about your care.
Right to Amend: You have the right to request an amendment if you believe your health information is incorrect or incomplete.
Right to an Accounting of Disclosures: You have the right to request a list of disclosures we have made of your health information.
Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you.
Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice.
SMS Text Messaging Opt-In/Opt-Out Process
Opt-In Process
1. You will be asked during your initial intake if you wish to receive text message communications.
2. If you choose to opt-in, you will need to complete and sign our Text Message Authorization Form.
3. The form will specify what types of communications you may receive (appointment reminders, scheduling changes, general office announcements).
4. You will receive a confirmation text message that requires your response to complete the opt-in process.
Opt-Out Process
1. You may opt-out of text communications at any time by:
- Replying "STOP" to any text message you receive from us
- Contacting our office directly by phone at 215-341-7003
- Submitting a written request to our office
- Updating your communication preferences through our patient portal
2. Upon receipt of your opt-out request, we will send a confirmation message and remove you from our text messaging system within 3 business days.
3. Please note that any information exchanged via text message prior to opting out will remain part of your medical record.
Standard Message and Data Rates
Standard message and data rates may apply based on your mobile carrier's text messaging plan. We are not responsible for any fees charged by your mobile carrier.
Security Considerations
Text messages are not encrypted and may be intercepted by unauthorized third parties. We will limit the information contained in text messages to minimize security risks, but you should be aware that SMS is not a fully secure communication method.
Changes to This Notice
We reserve the right to change this notice. We will post a copy of the current notice in our facility and on our website.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Contact Information
For questions about this notice, please contact:
FAMILY MATTERS COUNSELING SERVICES, LLC
350 South York Rd. Hatboro, PA 19040
215-341-7003
Admin@fammatters.net