Notice of HIPAA Privacy Practices

Effective Date: February 20th, 2024

Holistic Healing Therapy & Coaching LLC
Kyrsti Tam, LMFT-A
10 Main St.
Berlin, CT 06037
860-613-5867
ktam@holistichealingtc.com

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.

Your Rights

As a client, you have the right to:

  • Get an electronic or paper copy of your medical record.
    You can ask to see or get a copy of your therapy record and other health information. We will provide a copy or a summary, usually within 30 days of your request. A reasonable fee may apply.

  • Ask us to correct your medical record.
    You can ask us to correct health information you think is incorrect or incomplete. 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, at a home or office phone) or to send mail to a different address. We will accommodate 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 healthcare operations. We are not required to agree, but we will comply if the law allows.

  • Get a list of those with whom we’ve shared your information.
    You can ask for a list of disclosures of your health information made in the past six years. We will include all disclosures except for those related to treatment, payment, and operations or those you asked us to make.

  • Get a copy of this privacy notice.
    You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

  • Choose someone to act for you.
    If you have given someone legal medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

  • File a complaint if you believe your privacy rights have been violated.

    • You can file a complaint with us using the contact information above.

    • You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at:
      www.hhs.gov/ocr/privacy/hipaa/complaints/
      or call 1-877-696-6775.
      We will not retaliate against you for filing a complaint.

Your Choices

You have some choices in how we use and share information when we:

  • Contact you for appointment reminders or follow-up

  • Share information with your family or others involved in your care (with your consent)

  • Share information for disaster relief purposes

  • Include your information in a therapy case consultation (only with de-identified data unless you provide written consent)

If you have a clear preference for how we share your information in these situations, talk to us. Tell us what you want us to do, and we will follow your instructions whenever legally possible.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

  • Treatment.
    We can use your health information to provide you with treatment and coordinate your care.

  • Payment.
    We can use and share your information to bill and receive payment from health plans or other entities.

  • Health care operations.
    We may use your information to improve our practice operations, conduct quality assessments, and comply with licensing or audit requirements.

Other Uses and Disclosures

We may also use or disclose your information in the following ways:

  • To comply with law enforcement or legal requests (court orders, subpoenas, etc.)

  • For public health and safety (preventing disease, reporting abuse or neglect, avoiding a serious threat to health or safety)

  • To comply with Connecticut or federal laws that require mandatory reporting (e.g., suspected child abuse, danger to self or others)

  • For health oversight activities (licensing boards, audits, or government investigations)

  • With your written authorization.
    Other uses and disclosures not covered by this notice will be made only with your written permission. You may revoke that permission in writing at any time.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will notify you 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.

Changes to This Notice

We reserve the right to change this notice and will make the new notice available upon request and post it on our website. The revised notice will apply to all health information we maintain, including that which we created or received before the change.

Questions or Complaints

If you have any questions about this notice, please contact:

Kyrsti Tam, LMFT-A
Holistic Healing Therapy & Coaching LLC
860-613-5867
ktam@holistichealingtc.com