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HIPPA NOTICE OF PRIVACY PRACTICES
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.
Effective date: April 14, 2003
Nadine Rosen, M.A., L.P.C., N.C.C. has been and
will always be totally committed to maintaining client's
confidentiality. I will only release healthcare information about you in
accordance with federal and state laws and ethics of the counseling
This notice describes our policies related to the
use and disclosure of your healthcare information.
Uses and disclosures of your health information
for the purposes of providing services. Providing treatment
services, collecting payment and conducting healthcare operations are
necessary activities for quality care. State and federal laws allows us
to use and disclose your health information for these purposes.
TREATMENT I may need to use or
disclose health information about you to provide, manage or coordinate
your care or related services. This could include consultants and
potential referral sources.
Information needed to verify insurance coverage and/or benefits with
your insurance carrier, to process your claims as well as information
needed for billing and collection purposes. I may bill the person in
your family who pays for your insurance.
I may need to
use information about you to review our treatment procedures and
business activity. Information maybe used for certification, compliance
and licensing activities.
Other uses or disclosures of your information
which does not require your consent There are some instances where I
may be required to use and disclose information without your consent.
For example, but not limited to: Information you and/or your child or
children report about physical or sexual abuse: then by North Carolina
state law, I am obligated to report this to the Department of Children
and Family Services, if you provide information that informs us that you
are in danger of harming yourself or others, information to remind you
of /or to reschedule appointments or treatment alternatives, information
shared with law enforcement if a crime is committed on our premises or
against our staff, or as required by law such as a court order.