Notice of Privacy Practices
This notice describes how your medical information may be used and disclosed, and how you can get access to this information.
Please review it carefully.
PURPOSE OF THIS NOTICE
We are required by law to maintain the privacy of your health information. Any information that concerns your treatment is considered confidential and is protected as confidential by Electric City Counseling. This Privacy Notice describes our legal duties and Privacy Practices, specifically the uses and disclosures Electric City Counseling may make of your treatment information and what rights you have with respect to your treatment information.
USES AND DISCLOSURES OF PROTECTED INFORMATION
Treatment. Your information may be used and disclosed by those involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors, treatment team members, or other health care professionals.
Payment. Payment refers to the activities undertaken by a health care provider to obtain or provide reimbursement for the provision of health care. We may use and disclose your health information as permitted or required by law so that we can receive payment for the treatment services provided to you. For example, staff involved with your care may participate in payment-related activities, such as (but not limited to): processing claims with your insurance company, making a determination of eligibility or coverage for insurance benefits, or reviewing services provided to you to determine medical necessity. If it becomes necessary to use a collection process due to lack of payment for services, we will only disclose the minimum amount of information necessary for purposes of collection.
Health Care Operations. Health Care Operations refers to regular management and administrative activities. We may use or disclose your health information in order to support our business activities including, but not limited to, monitoring of service quality, legal and financial services, staff training and evaluation, medical reviews, auditing functions, business planning, compliance programs, certification, licensing, credentialing activities, and other activities necessary to operate and improve our practice. We may share your health information with third parties that perform various business activities, provided we have a written contract with the business that requires safeguarding the privacy of your information.
Required by Law. Your health information may be disclosed when required by law or necessary for health care oversight. This includes, but is not limited to: medical emergencies, reporting suspected child abuse or neglect, responding to court order or other legal process, certain law enforcement or government requests, workers’ compensation or similar programs, certain public health or safety activities, taking action when necessary to reduce or prevent a threat to the health or safety of you or another person, and health care oversight activities, such as audits, investigations, licensing, or inspections. Treatment information made available shall be limited to that information which is minimum and necessary to the purpose for which the information is sought.
Substance Use Disorder Records. To the extent that we create, maintain, or receive substance use disorder patient records that are subject to 42 CFR Part 2, we will comply with the additional confidentiality protections that apply to those records. We will not use or disclose such records for investigations or legal proceedings against you without your written consent or as otherwise permitted or required by applicable law, including a valid court order and subpoena when required.
Family Involvement in Care. We may disclose information to family members, friends, caregivers, or other individuals directly involved in your care or payment for your care when permitted by law and consistent with your preferences or authorization. In situations where another person is present during a discussion with you, and it can reasonably be inferred that you do not object, relevant information may be disclosed in the course of that discussion. However, if you object, we generally will not disclose your protected health information unless otherwise permitted or required by law.
Client Authorization or Release Information. Except as described in this Notice or otherwise permitted or required by law, Electric City Counseling will obtain your written authorization before using or disclosing your protected health information for other purposes. When you sign an authorization or release of information, you may revoke it in writing at any time. Revocation does not apply to information already shared.
YOUR RIGHTS AS A CLIENT
Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your health information for treatment, payment, or health care operations. We are not required to agree to your request unless otherwise required by law. If you pay for a health care item or service out of pocket in full, you may request that we not disclose information about that service to your health plan for purposes of payment or health care operations, and we will honor that request.
Right to Request Confidential Communication. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may ask that we contact you only through a particular phone number, email address, mailing address, or other reasonable method. We will accommodate reasonable requests and will not ask you for an explanation of why you are making the request.
Right of Access to Inspect and Copy. You have the right to inspect and obtain a copy of your protected health information that we maintain in your medical or billing records, with limited exceptions. You may request your records in paper or electronic format. We may charge a reasonable, cost-based fee for copies. Psychotherapy notes maintained separately from your medical record are not generally available for inspection or copying. In certain circumstances, your request may be denied as permitted by law.
Right to Amend. If you feel that the health information we have about you is incorrect or incomplete, you may ask us to amend the information. We may require that your request be made in writing and that you provide a reason for the request. We may deny the request in certain circumstances. If we deny your request, we will provide you with a written explanation and inform you of your right to submit a statement of disagreement.
Right to an Accounting of Disclosures. You have the right to request an accounting of certain disclosures that we make of your health information. You may receive one accounting in a 12-month period at no charge. We may charge a reasonable fee for additional requests made within the same 12-month period.
Breach Notification. If there is a breach of unsecured protected health information concerning you, we will notify you as required by law.
Right to a Copy of this Notice. You have the right to receive a paper copy of this Notice, even if you agreed to receive it electronically.
COMPLAINTS
If you believe we have violated your privacy rights, you have the right to file a complaint with our Privacy Officer at 1418 Main St, STE 207, Peckville, PA 18452. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be retaliated against for filing a complaint.
TERMS OF THIS NOTICE
Electric City Counseling has a duty to maintain the privacy and security of your protected health information and to provide you with notice of its legal obligations and privacy practices with respect to your information.
Electric City Counseling is required to follow the terms of the Privacy Notice currently in effect. Where a more protective federal or Pennsylvania law applies, we will follow the applicable law.
Electric City Counseling reserves the right to amend or update this Privacy Notice as permitted or required by law. Any changes may apply to protected health information that we already maintain, as well as information received after the change. If this Privacy Notice is revised, the updated version will be made available upon request and posted on our website at www.electriccitycounseling.org/notice-of-privacy-practices.
The effective date of this notice is August 28, 2026.