Understanding this Notice

This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. 

The following information is disclosed only with your written permission and you can limit the information available to others, except as noted below:

Treatment: We may use or disclose your protected health information to a physician or other healthcare provider providing treatment to you.

Payment: We may use or disclose your protected health information to obtain payment for the services we provide to you.

Health care operations: We may use or disclose your protected health information in connection with our health care operations. Healthcare operations include activities such as quality assurance and improvement, evaluating practitioner and provider performance, and conducting training programs.

Health oversight activities: We may use and disclose your protected health information for health oversight activities: For example, your health information may be disclosed to agencies that conduct audits or inspections to assure that appropriate care is received.

To you: We will disclose your health information to you, as described below in the Patient Rights section.

Your authorization: If you give us written authorization to do so, we may disclose your health information to anyone for any purpose. Authorization may be revoked in writing at any time.

Persons involved in care: We may use or disclose health information to notify a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present, we will provide you with an opportunity to reject such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose only health information that is directly relevant to the person’s involvement in your care.

Business associates: We may provide certain services through business associates. An example of a service we might provide through a business associate might be billing services. We may disclose your protected health information to our business associates, but to protect your information, we require our business associates to take appropriate steps to safeguard that information.

Required by law: We may use or disclose our health information when we are required to do so by law.

Abuse or neglect: We may use or disclose your protected health information in cases of abuse, neglect, domestic violence or other violent crime.

Harm to self or others: We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

Court or Hearing proceedings: We may use or disclose your protected health information if we receive an order for your records from a court of competent jurisdiction. We may use or disclose your protected health information for our defense if you prosecute a complaint or a lawsuit against Insight Associates, LLC or its agents or providers.

Worker’s compensation: We may use or disclose your protected health information to comply with worker’s compensation laws. We may disclose your protected health information only to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Appointment reminders: We may use your protected health information to call to remind you of appointments.

Other uses and disclosures require your authorization: We will not use or disclose your protected health information for any purpose, other than those summarized above, without your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a letter in writing stating that you want to revoke the authorization.

Individual Rights

You have certain rights under federal privacy regulations. These include:

The right to inspect and copy your protected health information. As permitted by federal regulations, we require that requests to inspect or copy protected health information be submitted in writing. Send your request to C. Richard Panther, Insight Associates, LLC, PO Box 893, Clyde, NC 28721.

The right to receive an accounting of how and to whom your protected health information has been disclosed in certain circumstances.

The right to request additional restrictions on the use and disclosure of your protected health information. However, we are not required to agree to these requests. We will attempt to notify you if we are unable to agree to your request.

The right to receive communications concerning your medical/mental health condition and treatment by alternative means or at alternative locations. We will attempt to accommodate reasonable requests.

The right to request that we amend your protected health information. We will attempt to notify you if we are unable to agree to your request.

The right to receive a copy of this notice. You may request a paper copy of this notice in writing.

Right to Revise Privacy Practices

As permitted by law, we reserve the right to change our privacy practices and to make those changes effective for all protected health information we maintain, including information created or received before the change.

Should our privacy practices change, we are not required to notify you, but we may post the revised notice at our offices, and you may obtain copies of the revised notice via written request.

Questions and Complaints

If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to: Clinical Director, Insight Associates, LLC, PO Box 893, Clyde, NC 28721. 
 
If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the above address. You may also file a complaint with the Department of Health and Human Services.

Contact Person

If you have questions and would like additional information, you may contact C. Richard Panther, LCSW, at Insight Associates, LLC, P.O. Box 893 Clyde, NC 28721