YOUR INFORMATION. YOUR RIGHTS.
OUR RESPONSIBILITY.

Privacy Policy

Your Rights

Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.




Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.




Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.




Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.




Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months




Get a copy of this privacy notice

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.




File a complaint if you feel your rights are violated

  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

In limited circumstances, we may deny your request to see or get copies of your records. If you are denied access to health information, you may request that the denial be reviewed by submitting a written request. Another licensed health care professional chosen by SFL will review your request and the denial, and we will comply with the outcome of the review.





Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.


In these cases, you have both the right and choice to tell us to:
  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory
  • If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.




In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes
  • In the case of fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again.





Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways.


Treat you
  • We can use your health information and share it with other professionals who are treating you.
  • Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  • Example: We use health information about you to manage your treatment and services.
Bill for your services
  • We can use and share your health information to bill and get payment from health plans or other entities.
  • Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/.

Help with public health and safety issues
  • We can share health information about you for certain situations such as:
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
Comply with the law
  • We can use or share your information for health research.
Do research
  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
  • We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
  • We can use or share health information about you:
  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Alcohol & drug abuse records

We will never share any substance abuse treatment records without your written permission. NCG is not able to confirm or deny your participation in any drug or alcohol abuse programs unless you have:

  • Provided NCG with written permission
  • We have received a court order
  • In the case of a medical emergency
  • For the purposes of program evaluation & quality assurance

Federal laws and regulations protect this information for you and any violation of this law is a crime.

If you are interested: See 42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3 for Federal laws and 42 CFR part 2 for Federal regulations





Our Responsibilities

Our Responsibilities


  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

We may contract with individuals or entities called Business Associates to perform various treatment, payment, and health care operations on our behalf. For example, we may disclose your health information to a Business Associate to assist us with claims processing for health care you received from us. To protect your health information, we require our Business Associates to appropriately safeguard your health information.

For more information see: Consumer Notice





For More Information

Privacy Officer


Please contact: Solutions For Life 9635 Souhern Pines, Blvd, Ste. 124 Charlotte, NC 28273 Phone: 980-999-5895

This information is provided by the US Department of Health and Human Services and describes patient rights and the rules that apply to all health plan and health care providers in the United States.

This notice applies to all Solutions For Life office locations.

Effective Date: August 1, 2017





The Notice explains how we fulfill our commitment to respect the privacy and confidentiality of your protected health information. This Notice tells you about the ways we may use and share your protected health information, as well as the legal obligations we have regarding your protected health information. The Notice also tells you about your rights under federal and state laws. The Notice applies to all records held by National Counseling Group, regardless of whether the record is written, electronic or in any other form. We are required by law to make sure that information that identifies you is kept private and to make this Notice available to you.

Solutions For Life Therapeutic Services

Locations:

Charlotte, NC

9635 Southern Pine Blvd., Ste. 124

Charlotte, NC 28273

Rock Hill, SC

648 S. Jones Ave., Ste. 103

Rock Hill, SC 29730

Chester, SC

2091 Jacochran Bypass

Chester, SC 29796

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