Notice of Privacy Practices
Caroline Camp Counseling
754 Lynwood Avenue, Nashville, TN 37203
(615) 953-0765
hello@carolinecampcounseling.com
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Uses and Disclosures of Protected Health Information (PHI)
For Treatment
Your PHI may be used and disclosed by those involved in your care for the purpose of providing, coordinating, or managing your treatment. I may consult with other health care providers with your written authorization. Without your consent, I cannot disclose your PHI to other professionals.
For Payment
I may use and disclose PHI to receive payment for services provided. This may include verifying insurance benefits, processing claims, or billing activities. If payment is not made and collections are required, I will only share the minimum necessary PHI for that purpose.
Payment Processing: I use Stripe through SimplePractice to process payments. This means Stripe may access limited information (such as your name and card details). To learn more about how Stripe protects your information, visit Stripe’s Privacy Policy.
For Health Care Operations
Your PHI may be used to support business operations such as quality assessment, licensing, and credentialing. Business associates who assist with these tasks are required by law to safeguard your information.
Required by Law
I must disclose PHI to you upon request and to the U.S. Department of Health and Human Services when required to demonstrate compliance with HIPAA.
Without Authorization
I may disclose PHI without your authorization only in the following circumstances:
When required by law or court order
To prevent a serious and imminent threat to your safety or the safety of others
To report child abuse, elder abuse, or dependent adult abuse, as required by law
Minors
If you are a minor, certain information may be shared with a parent or guardian, particularly if it involves safety or illegal/harmful acts.
With Authorization
Any other uses or disclosures of PHI will be made only with your written consent. You may revoke that consent at any time in writing.
Your Rights Regarding Your PHI
Right to Access: You may inspect or request a copy of your PHI, with limited exceptions if disclosure could cause serious harm. A reasonable, cost-based fee may apply for copies.
Right to Amend: You may request corrections to your PHI if you believe it is incomplete or inaccurate.
Right to an Accounting of Disclosures: You may request a list of certain disclosures of your PHI made after the effective date of this notice.
Right to Request Restrictions: You may request limits on how your PHI is used or disclosed. I am not required to agree to all restrictions but will consider them.
Right to Confidential Communications: You may request that I contact you in a specific way (e.g., only by phone, only at work).
Right to a Copy of this Notice: You may request a paper copy of this Notice at any time.
Questions or Complaints
If you have concerns about your privacy rights, you may contact me directly at hello@carolinecampcounseling.com or (615) 953-0765. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. I will not retaliate against you for filing a complaint.
Effective Date
This Notice is effective as of August 1, 2025. I may update it from time to time, and any changes will be posted on my website: www.carolinecampcounseling.com.