12 BECAUSE I DELIVERED THE POOR WHO CRIED FOR HELP, AND THE FATHERLESS WHO HAD NONE TO HELP HIM.13 THE BLESSING OF HIM WHO WAS ABOUT TO PERISH CAME UPON ME, AND I CAUSED THE WIDOW'S HEART TO SING FOR JOY.
"OUR DESIRE IS TO NOT TURN AWAY INDIVIDUALS, FAMILIES, COUPLES AND CHILDREN WHO ARE SEEKING HELP DUE TO FINANCIAL DIFFICULTIES."
New Hope Christian Counseling Foundation (main office)
1175 E. Garvey, Ste 102
Covina, CA 91724
or call (626) 967-6421 Ext 201 and contact Lynda Elberson
We depend on support and donations from individuals, families, businesses and churches.
All Donations are Tax Deductible and are greatly appreciated by the individuals and families that are supported by your generous donations. New Hope Christian Counseling Center is a 501(C3) Corporation.
Help Those Who Cannot Afford Counseling
We are committed to treating and using protected health information (PHI) about you responsibly. This Notice of Health Information Practices describes the personal information we collect, and how/when we use or disclose that information. It describes your rights as they relate to you protected health information. Notice effective April 14th, 2003, and applies to all protected health information as defined by federal regulations.
Understanding Your Health Record Information
Each time you visit us, a record of your visit is made. Typically, this record contains your symptoms, diagnosis, treatment and a plan for future care and treatment. This information, often referred to as your health or medical record, serves as a:
*Basis for planning your care and treatment
*A tool with which we can assess and continually maintain
*Means by which you or a third-party payer can verify services billed were actually provided
*Means of communication among the many
*A tool in education health professionals
Uses & Disclosures Related to Treatment, Payment or Health Care Operations Do Not Require Prior Written Consent. Your PHI can be used without your consent for the following reasons:
Treatment: We can used and disclose your PHI to physicians, psychiatrists, psychologists and other licensed health care providers who are involved in your care
To Obtain Payment: We can use and disclose PHI to bill and collect payment for services. This may include the insurance company, claims processing individual or companies
Health Care Operations: We can use PHI to operate our practice, such as evaluating performance of health care professionals or provide information to our accountant, attorney, or consultants to further health care operations
Patient Incapacitation: or Emergency: If you are incapacitated or if an emergency exists consent is not required as long as we try to get your consent after treatment is render
Federal, State or Local Laws Require Disclosure: For example, law enforcement and law require us to report information about victims of abuse or neglect
Judicial or Administrative Proceedings Require Disclosure: Disclosure may be made if you are involved in a lawsuit, worker’s compensation case or in response to a subpoena
Law Enforcement Require Disclosure: warrant
Public Health Activities Require Disclosure: We may provide PHI to report to a government official an adverse reaction to a medication
Health Oversight Activities Require Disclosure: We may provide PHI if the government is conducting investigations or inspections of a health care provider or organization
To Avert a Serious Threat to Health or Safety: We may have to use or disclose PHI to avert a serious threat to the health or safety of others and this information will be made only to someone able to prevent the threatened harm from occurring
Certain Uses & Disclosures Require You to Have the Opportunity to Object:
Specialized Government Functions: If you are in the military, we may disclose PHI for the national security purposes, including protecting the President of the United States or persons conducting intelligence operations
To Remind You About Appointments and to Inform You of Health-Related Benefits or Services: We may use or disclose your PHI to remind you about your appointments, or to inform you about treatment alternatives, or other health care benefits that we can offer to benefit you
Disclosure to Family, Friends or Others: We may provide PHI to a family member, friend or other person that you indicate is involved in your care or the payment of your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations
Other Uses & Disclosures Require Your Prior Written Authorization:
In any other situation not described in section A & B above, we will need your written authorization before using or disclosing any of your PHI. If you chose to sign an authorization, you can later revoke it in writing to stop any future uses and disclosures (to the extent that I haven’t take any action in reliance on such authorization) of your PHI. (our Health Information Rights) Though your health record is the physical property of New Hope Christian Counseling Centers, the information belongs to you.
Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522. You have the right to request restrictions & limitations on uses and disclosures for treatment, payment, health care operations and disclosures to family and friends. Submission must be made in writing, however we are not legal required to accept them. If we do not accept item, we will put them in writing and abide by them—except in emergency situations
Obtain a paper copy of this notice on information practices upon request & the right to have confidential information sent to alternative means or at alternative locations
Inspect and received a copy of your health record as provided for in 45 CFR 164.524. We will respond to your request within 30 days of receiving the written request. Inn certain situations, we may deny your request and will tell you in writing the reasons for the denial. For request of copies of PHI, there is a charge of $.25 per page. A summary or explanation of the PHI may be given as long as there is an agreed upon cost in advance
Obtain an accounting disclosure of your health information as provided in 45 CFR 164.528. Accounting of Disclosures will be responded to within 60 days of receiving the request and will include disclosures made in the last six years unless you request a short time. No charge will be made for the list although we may charge you a reasonable, cost-based fee for each additional request. Amend your health record as provided in 45 CFR 164.528. If you believe there is a mistake, or a piece of information is missing provided the request in writing and we will respond within 60 days. We may deny your request if the PHI is correct and complete, not created by us, not allowed to be disclosed or not part of the record. Written denial will state the reasons of the denial and explain your right to file a written disagreement with the denial. You have the right to receive a paper copy even if you agreed to have it sent via email.