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: November 1, 2024

Table of Contents

1. Who We Are
2. Our Pledge to You
3. Uses and Disclosures Without Your Authorization
4. Uses and Disclosures Requiring Your Authorization
5. Special Protections for Psychotherapy Notes
6. Your Rights Regarding Your Health Information
7. Maryland State Mental Health Law
8. Minors and Confidentiality
9. Telehealth Privacy Considerations
10. Changes to This Notice
11. Contact Information
12. Filing a Complaint

1. Who We Are

Complete Health Wellness Group LLC is a mental health practice providing individual, couples, family, and group therapy services. This Notice of Privacy Practices applies to all protected health information (PHI) created or received by our practice, including information collected during in-person sessions, telehealth appointments, and through our client portal.

Our practice locations include:

• 815 Ritchie Highway, Suite 205, Severna Park, MD 21146
• 30 E Padonia Road, Suite 202, Timonium, MD 21093

We also provide telehealth services to clients in Maryland and other states where our therapists are licensed.

2. Our Pledge to You

We understand that your health information is personal and private. We are committed to protecting your health information and maintaining your trust. By law, we are required to:

• Maintain the privacy of your protected health information (PHI)
• Provide you with this Notice of our legal duties and privacy practices
• Follow the terms of this Notice currently in effect
• Notify you if a breach occurs that may have compromised your PHI

We will not use or disclose your health information without your authorization, except as described in this Notice.

3. Uses and Disclosures Without Your Authorization

The following categories describe ways we may use and share your health information without your written authorization:

Treatment

We may use your health information to provide you with mental health treatment and services. For example, we may share information with another healthcare provider involved in your care, such as your primary care physician or psychiatrist, to coordinate your treatment.

Payment

We may use and disclose your health information to obtain payment for services. This may include providing information to your health insurance company to verify coverage or to obtain pre-authorization or payment for treatment. The information shared may include your diagnosis, treatment dates, and the type of services provided.

Healthcare Operations

We may use your health information for our healthcare operations, which include internal administration and planning necessary to run our practice. For example, we may use your information for quality assessment activities, licensing and credentialing, or training purposes.

Required by Law

We may disclose health information when required to do so by federal, state, or local law. Examples include mandatory reporting to government agencies and compliance with court orders.

Health and Safety

We may use or disclose your health information when necessary to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of another person or the public. Disclosures will be made only to someone who is able to help prevent the threat.

Abuse, Neglect, or Domestic Violence

We may disclose health information to appropriate authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence. We will make this disclosure only as required or authorized by law.

Judicial and Administrative Proceedings

We may disclose health information in response to a court or administrative order, subpoena, discovery request, or other lawful process under certain circumstances.

Law Enforcement

We may release health information to law enforcement officials for limited purposes, including reporting certain types of wounds, identifying or locating a suspect or missing person, or complying with a court order.

Coroners, Medical Examiners, and Funeral Directors

We may release health information to a coroner or medical examiner for identification purposes, determining cause of death, or performing other duties authorized by law. We may also release information to funeral directors as necessary.

Workers' Compensation

We may release health information for workers' compensation or similar programs that provide benefits for work-related injuries or illness.

4. Uses and Disclosures Requiring Your Authorization

Except as described above, we will not use or disclose your health information without your written authorization. You may revoke an authorization at any time, in writing, except to the extent that we have already taken action in reliance on your authorization.

Uses and disclosures that require your written authorization include:

• Most uses and disclosures of psychotherapy notes (see special protections below)
• Uses and disclosures of PHI for marketing purposes
• Disclosures that constitute a sale of PHI
• Other uses and disclosures not described in this Notice

5. Special Protections for Psychotherapy Notes

What are Psychotherapy Notes?

Psychotherapy notes are notes recorded by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session. These notes are kept separate from the rest of your medical record.

Psychotherapy notes receive special protection under HIPAA. We are required to obtain your written authorization before disclosing psychotherapy notes, with very limited exceptions, including:

• Use by the originator of the notes for treatment purposes
• Training programs for mental health students or practitioners
• Defense against a legal action brought by you
• Use by the Secretary of Health and Human Services for HIPAA compliance investigations
• As required by law (e.g., mandatory reporting of abuse)
• To prevent or lessen a serious and imminent threat to health or safety

Important: Psychotherapy notes are never disclosed to insurance companies for payment purposes. We will not disclose your psychotherapy notes to your health insurance company even if you authorize us to do so for payment purposes.

6. Your Rights Regarding Your Health Information

You have the following rights with respect to your protected health information:

1. Right to Request Restrictions

   You have the right to request restrictions on certain uses and disclosures of your health information. We are not required to agree to your request, except in limited circumstances. If we agree to a restriction, we will comply with it unless the information is needed to provide emergency treatment. If you pay for services entirely out-of-pocket, you have the right to request that we not share your health information with your health plan for payment or healthcare operations purposes, and we are required to honor that request.

2. Right to Confidential Communications

   You have the right to request that we communicate with you in a certain way or at a certain location. For example, you may request that we only contact you at work or by mail. We will accommodate reasonable requests.

3. Right to Inspect and Copy

   You have the right to inspect and obtain a copy of your health information, including your clinical record and billing records. You must submit your request in writing. We may charge a reasonable fee for copying, mailing, or other supplies. We may deny your request to inspect and copy in certain limited circumstances. If access is denied, you may request a review of the denial.

4. Right to Amend

   If you believe that information in your record is incorrect or incomplete, you may request that we amend your health information. Your request must be in writing and must include the reason you are requesting the amendment. We may deny your request if the information was not created by us, is not part of the record we maintain, is not available for inspection, or is accurate and complete.

5. Right to an Accounting of Disclosures

   You have the right to request a list of certain disclosures we have made of your health information. This list will not include disclosures made for treatment, payment, or healthcare operations, disclosures you authorized, or disclosures made directly to you. Your request must be in writing and state the time period for which you want the accounting (not longer than six years).

6. Right to a Paper Copy of This Notice

   You have the right to a paper copy of this Notice at any time, even if you agreed to receive it electronically. You may request a copy from our office.

7. Right to Be Notified of a Breach

   You have the right to be notified if there is a breach of your unsecured protected health information. We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.

7. Maryland State Mental Health Law

In addition to federal HIPAA requirements, Maryland state law provides additional protections for mental health records. Under Maryland law:

• Mental health records may only be disclosed with patient authorization or as otherwise permitted by law
• Court-ordered disclosures require that the court determine that disclosure is necessary
• Substance abuse treatment records receive additional federal and state protections under 42 CFR Part 2
• Communications between a therapist and client are privileged and protected from disclosure in legal proceedings, with limited exceptions

Where Maryland law provides greater protection than federal law, we follow the more protective standard.

8. Minors and Confidentiality

Generally, parents or legal guardians have access to the health information of minor children under 18 years of age. However, there are exceptions under Maryland law:

• Minors may consent to their own outpatient mental health treatment without parental consent
• In such cases, the minor controls access to their treatment information
• Therapists use clinical judgment to determine what information, if any, to share with parents when a minor consents to their own treatment
• We encourage open communication and work collaboratively with families when appropriate

We discuss confidentiality expectations with families at the start of treatment to establish clear boundaries and expectations.

9. Telehealth Privacy Considerations

We offer telehealth services using HIPAA-compliant video conferencing technology. When participating in telehealth sessions:

• We use encrypted, secure platforms that meet HIPAA security requirements
• Sessions are not recorded unless you provide explicit written consent
• You are responsible for ensuring privacy at your location during sessions
• We recommend using a private, secure internet connection
• The same confidentiality protections apply to telehealth sessions as to in-person sessions

Multi-State Practice: If you receive telehealth services while located in a state other than Maryland, the laws of that state may apply to your treatment. We will inform you of any differences in confidentiality protections.

10. Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in our offices and on our website. The Notice will contain the effective date on the first page.

11. Contact Information

Privacy Officer

If you have questions about this Notice or wish to exercise any of your rights, please contact our Privacy Officer:

Complete Health Wellness Group LLC
Attn: Privacy Officer
815 Ritchie Highway, Suite 205
Severna Park, MD 21146

Phone: (443) 367-1333
Email: privacy@chwellnessgroup.com

12. Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint.

To File a Complaint with Our Practice:

Contact our Privacy Officer using the contact information above.

To File a Complaint with the U.S. Department of Health and Human Services:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201

Toll-Free: 1-800-368-1019
TDD: 1-800-537-7697
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/

To File a Complaint with the Maryland Attorney General:

Office of the Attorney General
Health Education and Advocacy Unit
200 St. Paul Place, 16th Floor
Baltimore, MD 21202

Phone: (410) 528-8662
Toll-Free: 1-877-261-8807
Website: www.marylandattorneygeneral.gov

Acknowledgment of Receipt: You may be asked to sign an acknowledgment that you received this Notice of Privacy Practices. Your signature acknowledges only that you received a copy of this Notice. It does not authorize us to use or disclose your health information.

Related Policies:

• Website Privacy Policy — How we collect and use your personal information online
• Your Privacy Choices — Submit data access or deletion requests
• Non-Discrimination Notice — Our commitment to serving all individuals equally
• Communications Consent — Our electronic communications policies
• View All Legal Notices

Questions About Your Privacy?

If you have any questions about this Notice or how we protect your information, please contact us.

Contact Us