HIPAA Notice Of Privacy Practices

Understanding This Notice

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Who Must Follow This Notice

This notice explains the privacy practices of Unwilted Counseling, LLC and applies to all Protected Health Information (PHI) handled by:

• Destina, LMHC

• All staff and employees of the practice

• Business associates supporting practice operations

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What Is PHI?

PHI includes any information that can identify you, such as:

• Mental health conditions and services received

• Payment information

• Demographics (name, address, email, DOB)

• Social Security number

• Any other identifying information

 

Our Legal Duty

Federal law requires us to:

• Protect your PHI

• Provide this Notice of privacy practices

• Follow the current Notice terms

• Notify you if requested restrictions cannot be honored

• Accommodate reasonable requests for confidential communications

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Your Rights

You have rights regarding your PHI, detailed in Section 4 of this Notice.

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Permitted Uses and Disclosures 

We may use or share your health information (PHI) for:

• Treatment: Coordinating care, developing plans, consulting with providers (with authorization), or referrals.

• Payment: Insurance claims, verifying coverage, collecting payment limited to necessary info (dates, codes, provider, costs).

• Healthcare Operations: Quality reviews, staff training, administrative and compliance tasks.

• Treatment Options & Services: Sharing relevant health services or appointment reminders (with consent).

• As Required by Law: Court orders, legal reporting, or workers’ compensation.

These uses ensure care, payment, and legal compliance while protecting your privacy

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When We May Disclose Your Information

Your PHI may be shared in special situations, including:

• Serious Threats: To protect your safety or others’ safety.

• Abuse or Neglect: Reporting required by law for children or vulnerable adults.

• Public Health: Disease control, medication safety, or recalls.

• Health Oversight: Audits, investigations, and licensure monitoring.

• Legal Proceedings: Court orders, subpoenas, or lawful requests.

• Law Enforcement: Identifying suspects, reporting injuries, or deaths.

• Coroners/Funeral Directors: Identifying deceased or determining cause of death.

• Workers’ Compensation: Related to work-related injuries or claims.

• Military & National Security: Required disclosures for armed forces or VA benefits.

• Inmates/Custody: Ensuring safety, security, and health in facilities.

All disclosures are limited to what’s necessary and follow legal guidelines. 

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Your HIPAA Privacy Rights

1. Request Restrictions: Limit how your PHI is used or shared (e.g., family, insurance). Must be in writing; emergencies override restrictions.

2. Confidential Communications: Choose how and where we contact you. Submit requests in writing.

3. Inspect & Copy Records: View or get copies of your health and billing records. Some records (psychotherapy notes, legal info) may be restricted.

4. Amend Records: Request corrections to inaccurate or incomplete PHI. Submit in writing; denials may include a statement of disagreement.

5. Accounting of Disclosures: Get a list of certain disclosures from the past 6 years. First request per year is free.

6. Paper Copy of Notice: Request anytime in-office, by phone, email, or website.

7. Breach Notification: You’ll be notified within 60 days of any PHI breach.

These rights let you control and protect your health information.

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When We Need Your Written Permission 

Certain uses of your health information (PHI) require your written authorization:

1. Psychotherapy Notes: Notes from your counseling sessions are separate from medical records and won’t be shared without your permission, except for training, legal defense, required by law, safety threats, or health oversight.

2. Marketing: PHI will not be used for marketing without authorization. Routine treatment or care coordination communications are not considered marketing.

3. Sale of PHI: Your PHI will not be sold without your written consent.

4. Other Uses: Disclosures not covered by this Notice like sharing with family, friends, employers, schools, attorneys, or other therapists require your permission.

5. Revoking Authorization: You can revoke consent anytime in writing. Revocation does not affect actions taken before it or collection of unpaid fees.

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Privacy Rights for Adolescent Clients

• Parental Access: Indiana law allows parents/guardians to access minors’ records, but adolescent privacy is protected in therapy.

• Balanced Approach (Ages 13-17): We balance parental rights, the teen’s need for confidential space, and professional judgment about what’s in the minor’s best interest.

• Typical Practice: Parents receive general updates, treatment goals, home support tips, and safety-related information. Private session content and personal disclosures remain confidential.

• Safety Overrides Privacy: Parents are notified if the teen is at risk of harm, abuse is suspected, or legal/clinical requirements demand disclosure.

• Collaborative Boundaries: Confidentiality rules are discussed with both teen and parents, documented, and may be adjusted as needed.

 

Notice Revisions

Right to Revise: We may update this Notice at any time due to changes in law, privacy practices, healthcare standards, or our organization.

Effective Date: The "Effective Date" at the top shows when the current version applies, both to existing and future PHI.

Notification of Changes: Revised Notices will be:

• Posted in our office and on our website

• Provided at your next session or upon request

• For major changes, mailed, emailed, or directly notified during appointments

Access Current Notice: Request a copy anytime in-office, by phone, email, or download from www.unwiltedcounseling.com.

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Questions about Privacy Practices 

Destina, LMHC
Unwilted Counseling, LLC, Fort Wayne, IN
Phone: 260-255-6432 | Email: destina@unwiltedcounseling.com
Website: www.unwiltedcounseling.com
Office: Scheduling: Mon-Thu 9:00 AM – 6:00 PM | Fri 3:00 PM – 6:00 PM | Sat 9:00 AM – 3:00 PM | Sun: Closed