Notice of Privacy Practices

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

Our Commitment to Your Privacy

Katie Pace Counseling and Consulting is required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice of our legal duties and privacy practices, and to abide by the terms of the notice currently in effect.

How We May Use and Disclose Your Health Information

For Treatment

We may use your health information to provide you with mental health treatment and related services, and may disclose it to other health care providers involved in your care — for example, to coordinate care with your physician or psychiatrist, with your consent where required.

For Payment

We may use and disclose your health information to bill and collect payment for services provided to you, such as providing information to your insurance company if you choose to seek reimbursement.

For Health Care Operations

We may use your health information for practice operations such as quality review, training, licensing, and business planning. Where possible we use information that does not identify you.

With Your Written Authorization

Uses and disclosures not described in this notice will be made only with your written authorization. Psychotherapy notes receive special protection and, with limited exceptions, will not be disclosed without your specific written authorization. You may revoke an authorization at any time in writing, except to the extent we have already relied on it.

Uses and Disclosures Permitted or Required by Law

• Abuse or neglect: We are required by Colorado law to report suspected abuse or neglect of children or at-risk adults.
• Serious threat to health or safety: We may disclose information when necessary to prevent a serious and imminent threat to you or another person.
• Judicial and administrative proceedings: We may disclose information in response to a court order or, in some circumstances, a subpoena.
• Health oversight and public health: We may disclose information to authorities authorized by law to oversee the health care system or protect public health.

Your Rights Regarding Your Health Information

• Right to inspect and copy your health record, with limited exceptions.
• Right to request amendment of information you believe is incorrect or incomplete.
• Right to an accounting of disclosures we have made of your information for purposes other than treatment, payment, or operations.
• Right to request restrictions on certain uses and disclosures. We are not required to agree to all requested restrictions.
• Right to request confidential communications — for example, that we contact you only at a certain phone number or address.
• Right to a paper copy of this notice at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Changes to This Notice

We reserve the right to change this notice and to make the revised notice effective for information we already have as well as information we receive in the future. The current notice will always be posted on this page.

Contact

Katie Pace Counseling and Consulting
224 E Willamette Ave, Colorado Springs, CO 80903-1114
719.357.6006