Notice of Privacy Practices (NPP)

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.

You have the right to a copy of this Notice and to file a complaint if you believe your privacy rights have been violated. For a copy, questions, or assistance, contact the BHC Privacy Officer at 8556078242 or compliance@bhclinic.com.

The terms of this Notice of Privacy Practices (“Notice”) apply to Behavioral Health Clinic (BHC), LLC, its affiliates and its employees. BHC will share protected health information of patients as necessary to carry out treatment, payment, and health care operations as permitted by law.

We are required by law to maintain the privacy of our patients’ protected health information and to provide patients with notice of our legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of this Notice for as long as it remains in effect. We reserve the right to change the terms of this Notice as necessary and to make a new notice of privacy practices effective for all protected health information maintained by BHC. We are required to notify you in the event of a breach of your unsecured protected health information. We are also required to inform you that there may be a provision of state law that relates to the privacy of your health information that may be more stringent than a standard or requirement under the Federal Health Insurance Portability and Accountability Act (“HIPAA”). A copy of any revised Notice of Privacy Practices or information pertaining to a specific State law may be obtained by mailing a request to the Privacy Officer at the address shown at the bottom of this notice.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION:

Additional Protections Under State Law: Wisconsin law provides additional confidentiality protections for mental health and substance use treatment records, including Wis. Stat. § 51.30 and Wis. Admin. Code ch. DHS 92, where applicable. We obtain informed written consent before releasing these records unless a specific legal exception permits or requires disclosure. A disclosure permitted by HIPAA will not be made if another applicable law prohibits it or requires consent that we have not obtained. These limits apply to every use and disclosure described below. We also follow other applicable state laws when they provide greater privacy protection or access rights.

Authorization and Consent: Uses and disclosures not described in this Notice will be made only with your written authorization. The uses and disclosures described below remain subject to applicable state law, protections for psychotherapy notes, and 42 CFR Part 2, including any required consent. You may revoke an authorization in writing by contacting the BHC Privacy Officer. Revocation is effective when received, except to the extent we have already acted in reliance on the authorization. If an authorization was obtained as a condition of insurance coverage, other law may allow an insurer to contest a claim or the policy.

Uses and Disclosures for Treatment: We will make uses and disclosures of your protected health information as necessary for your treatment, subject to applicable confidentiality laws and any required consent. Psychologists and counselors and other professionals involved in your care will use information in your medical record and information that you provide about your symptoms and reactions to your course of treatment that may include procedures, medications, tests, medical history, etc. We may record calls between patients and our staff to ensure quality care, improve training, and assist with billing or scheduling accuracy. We will notify you of all calls being recorded for quality assurance and training purposes at the beginning of our phone system menu. If a call contains protected health information (PHI), it will be treated with the same confidentiality as all other medical records. All recorded calls containing PHI are stored securely using encryption and access controls provided by our phone system. Only authorized personnel will have access to recordings. We do not share recorded calls with third parties unless required by law or with your written consent.​​

Uses and Disclosures for Payment: We may use and disclose your protected health information to bill for services and obtain payment, subject to applicable confidentiality laws and any required consent. For example, we may provide your health plan with information about services you received so it can process your claim. We will honor applicable restrictions on disclosures to your health plan for services paid in full.

Uses and Disclosures for Health Care Operations: We will make uses and disclosures of your protected health information as necessary, and as permitted by law and subject to any required consent, for our mental health care operations, which may include clinical improvement, professional peer review, business management, accreditation and licensing, etc. For instance, we may use and disclose your protected health information for purposes of improving clinical treatment and patient care.

Individuals Involved In Your Care: Subject to applicable state law and Part 2 consent requirements, we may share information directly relevant to a family member’s, friend’s, or other person’s involvement in your care or payment for care. When you are available and able to decide, we will obtain your agreement, give you an opportunity to object, or reasonably infer from the circumstances, using professional judgment, that you do not object. If you are unavailable or unable to decide because of incapacity or an emergency, we may use professional judgment to share directly relevant information when it is in your best interest and applicable law permits. We may also share limited information with authorized disaster-relief organizations to assist in notifying people involved in your care, subject to applicable legal requirements.

Business Associates: Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as auditing, accreditation, outcomes data collection, legal services, etc. At times it may be necessary for us to provide your protected health information to one or more of these outside persons or organizations who assist us with our health care operations. In all cases, we require these associates to appropriately safeguard the privacy of your information.

Appointments and Services: We may contact you to provide appointment updates or information about your treatment or other health-related benefits and services that may be of interest to you. You have the right to request and we will accommodate reasonable requests by you to receive communications regarding your protected health information from us by alternative means or at alternative locations. For instance, if you wish appointment reminders to not be left on voice mail or sent to a particular address, we will accommodate reasonable requests. With such a request, you must provide an appropriate alternative address or method of contact. You also have the right to request that we not send you any future marketing materials and we will use our best efforts to honor such requests. You must make such requests in writing, including your name and address, and send such writing to the Privacy Officer at the address below.

Language Assistance and Accessible Formats: Free language assistance and appropriate auxiliary aids and services are available to help you communicate with us and receive this Notice in an accessible format. To request assistance, contact 855-607-8242, email compliance@bhclinic.com, or speak with your provider or front-office staff. See the accompanying Notice of Availability at the end of this document.

Research: We may use or disclose protected health information for research only when applicable legal requirements are met. Where HIPAA permits research without your authorization, such as under an approved waiver or another legally permitted research pathway, we must still comply with any additional restrictions under Wisconsin law, 42 CFR Part 2, and other applicable law. An Institutional Review Board approval or a researcher’s representations do not by themselves override those restrictions. We obtain your written consent or authorization whenever applicable law requires it.

Other Uses and Disclosures: The following uses and disclosures may be permitted or required without your written authorization only when the conditions of the applicable legal exception are met. We comply with more protective state laws, psychotherapy-note restrictions, and Part 2 requirements, including the special limits on proceedings against you described below. A request alone does not authorize disclosure.

  • Any purpose required by law;
  • Public health activities such as required reporting of immunizations, disease, injury, birth and death, or in connection with public health investigations;
  • If we suspect child abuse or neglect; if we believe you to be a victim of abuse, neglect or domestic violence;
  • To the Food and Drug Administration to report adverse events, product defects, or to participate in product recalls;
  • To your employer only with your authorization or under a specific legal exception, such as certain legally required workplace medical-surveillance or work-related injury or illness disclosures. An employer’s request for an examination or treatment alone does not authorize disclosure;
  • To a government oversight agency for legally authorized oversight activities, subject to applicable confidentiality restrictions and the Part 2 limits on proceedings against you;
  • In response to a court or administrative order, or a subpoena or discovery request, only after applicable legal safeguards and any required consent, notice, protective order, or other conditions are satisfied. A subpoena or discovery request alone does not automatically authorize release. Part 2 records are subject to the additional court-order and legal-mandate requirements described below;
  • To law enforcement officials as required by law if we believe you have been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law;
  • If you are a member of the military, we may also release your protected health information for national security or intelligence activities; and
  • To a person reasonably able to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, when consistent with applicable law and professional ethical standards;
  • To coroners, medical examiners, or funeral directors for legally permitted duties related to a person’s death, subject to applicable confidentiality restrictions;
  • To organ procurement organizations or other legally authorized organizations for cadaveric organ, eye, or tissue donation and transplantation, when applicable and permitted by law;
  • To workers’ compensation agencies for workers’ compensation benefit determination.

DISCLOSURES REQUIRING AUTHORIZATION:

Psychotherapy Notes: Psychotherapy notes are a mental health professional’s separately maintained notes documenting or analyzing counseling conversations; they are different from ordinary progress notes in your medical record. We obtain your specific written authorization for most uses or disclosures of psychotherapy notes, including disclosure to another treating provider. Limited exceptions permitted by law include: (1) use by the professional who created the notes for your treatment; use or disclosure for BHC’s own supervised mental-health training programs; or use or disclosure to defend BHC in a legal action or proceeding brought by you; (2) disclosure to the Secretary of the U.S. Department of Health and Human Services to determine compliance; (3) uses or disclosures required by law; (4) legally authorized health oversight of the professional who created the notes; (5) permitted disclosures to coroners or medical examiners; and (6) disclosures necessary to prevent or lessen a serious and imminent threat to a person or the public, consistent with applicable law and professional ethics. More protective applicable laws continue to apply.

Special Protections for Substance Use Disorder Records

Some substance use disorder records are protected by 42 U.S.C. § 290dd-2 and 42 CFR Part 2. These protections apply to records covered by Part 2, including qualifying records BHC receives from a Part 2 program; a substance use diagnosis alone does not make every record a Part 2 record. We use or disclose Part 2 records only as Part 2 and other applicable law permit, including obtaining written consent when required.

Part 2 records, and testimony describing their contents, may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a court order meeting Part 2 requirements. The court-order process includes notice and an opportunity for you or the record holder to be heard, as required by Part 2. Before records are used or disclosed under that order, it must also be accompanied by a subpoena or another legal requirement compelling disclosure.

Marketing: We must obtain your authorization for any use or disclosure of your protected health information for marketing, except if the communication is in the form of (1) a face-to-face communication with you, or (2) a promotional gift of nominal value. Sale of Protected Information: We must obtain your authorization prior to receiving direct or indirect remuneration in exchange for your health information; however, such authorization is not required where the purpose of the exchange is for:

  • Public health activities;
  • Research purposes, provided that we receive only a reasonable, cost-based fee to cover the cost to prepare and transmit the information for research purposes;
  • Treatment and payment purposes;
  • Health care operations involving the sale, transfer, merger or consolidation of all or part of our business and for related due diligence;
  • Payment we provide to a business associate for activities involving the exchange of protected health information that the business associate undertakes on our behalf (or the subcontractor undertakes on behalf of a business associate) and the only remuneration provided is for the performance of such activities;
  • Providing you with a copy of your health information or an accounting of disclosures;
  • Disclosures required by law;
  • Disclosures of your health information for any other purpose permitted by and in accordance with the Privacy Rule of HIPAA, as long as the only remuneration we receive is a reasonable, cost-based fee to cover the cost to prepare and transmit your health information for such purpose or is a fee otherwise expressly permitted by other law; or
  • Any other exceptions allowed by the Department of Health and Human Services.

RIGHTS THAT YOU HAVE REGARDING YOUR PROTECTED HEALTH INFORMATION:

Access to Your Protected Health Information: You may inspect or obtain a copy of your medical, billing, and other health information in the designated record sets we maintain, subject to exceptions allowed by law. You may request an electronic copy in the form and format you request if readily producible, or another agreed readable electronic format. Contact the BHC Privacy Officer at 855-607-8242 or compliance@bhclinic.com for assistance submitting a written patient-access request. You do not need to sign a disclosure authorization to request access to your own records. We act on your request within 30 calendar days after receiving it, or sooner if applicable state law requires. If HIPAA permits an extension and no shorter applicable law controls, we may take one additional period of up to 30 calendar days. Before the initial deadline, we will give you written reasons for the delay and the date we will complete the request. If we deny access, we will explain the reason in writing and describe any right to review the denial and how to file a complaint. Inspection is free. Any copying fee will be reasonable and cost-based, limited to permitted copying labor, supplies, postage if requested, and an agreed summary or explanation. We do not charge for searching for or retrieving records. We will explain any applicable fee in advance.

Amendments to Your Protected Health Information: You have the right to request in writing that protected health information that we maintain about you be amended or corrected.

We may deny an amendment request only on grounds permitted by law, such as when the information is accurate and complete. We will act on your request within 60 calendar days after receiving it, or sooner if applicable law requires. If permitted, we may take one additional period of up to 30 calendar days; before the initial deadline we will explain the delay and completion date in writing. If we deny the request, we will give you a written explanation and describe how to submit a statement of disagreement or file a complaint. If we accept an amendment, we will make reasonable efforts to inform people you identify who need it and others who may have relied on the information to your detriment. Contact the BHC Privacy Officer at 855-607-8242 or compliance@bhclinic.com for help submitting a request.

Accounting for Disclosures of Your Protected Health Information: You may request an accounting of certain disclosures of your protected health information during the six years before your request, or a shorter period you choose. HIPAA excludes certain disclosures, including most disclosures for treatment, payment, or health care operations, disclosures to you, and disclosures made with your authorization. Additional rights under other applicable law are preserved. Submit a written request to the BHC Privacy Officer at 855-607-8242 or compliance@bhclinic.com for assistance. The first accounting in any 12-month period is free. A reasonable, cost-based fee may apply to additional accountings during that period; we will notify you in advance so you may withdraw or modify your request. We will provide the accounting within 60 calendar days after receiving your request, or sooner if applicable law requires. If permitted, we may take one additional period of up to 30 calendar days; before the initial deadline, we will give you written reasons for the delay and the date we will provide the accounting.

Restrictions on Use and Disclosure of Your Protected Health Information: You have the right to request restrictions on uses and disclosures of your protected health information for treatment, payment, or health care operations. We are not required to agree to most restriction requests, but will attempt to accommodate reasonable requests when appropriate. You do, however, have the right to restrict disclosure of your protected health information to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law, and the protected health information pertains solely to a health care item or service for which you, or someone other than the health plan on your behalf, has paid Behavioral Health Clinic in full. If we agree to any discretionary restrictions, we reserve the right to remove such restrictions as we deem appropriate. We will notify you if we remove a restriction imposed in accordance with this paragraph. You also have the right to withdraw, in writing or orally, any restriction by communicating your desire to do so to the individual responsible for medical records.

Personal Representatives and Minors: A person legally authorized to act as your personal representative may exercise your privacy rights within the scope of that authority. We verify that authority before providing access or acting on a request. Parents’ and guardians’ rights concerning a minor’s records depend on applicable law, including exceptions for certain confidential services and circumstances involving abuse, neglect, or endangerment. Contact the BHC Privacy Officer for help with a representative or minor-records request.

Right to Notice of Breach: We take very seriously the confidentiality of our patients’ information, and we are required by law to protect the privacy and security of your protected health information through appropriate safeguards. We will notify you in the event a breach occurs involving or potentially involving your unsecured health information and inform you of what steps you may need to take to protect yourself.

Paper Copy of this Notice: You have a right, even if you have agreed to receive notices electronically, to obtain a paper copy of this Notice. To do so, please submit a request to the Privacy Officer at the address shown at the bottom of this notice.

Complaints: If you believe your privacy rights have been violated, including rights concerning records protected by 42 CFR Part 2, you may file a complaint with the BHC Privacy Officer by emailing compliance@bhclinic.com or writing to Behavioral Health Clinic, Attn: Privacy Officer, 630 S. 36th Avenue, Wausau, WI 54401. Call 855-607-8242 for assistance. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at https://www.hhs.gov/hipaa/filing-a-complaint/index.html, by calling 1-877-696-6775, or by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201. You will not be retaliated against for filing a complaint.

For Further Information: To discuss this Notice, ask questions, or submit a privacy-rights request, contact the BHC Privacy Officer at 855-607-8242, compliance@bhclinic.com, or Behavioral Health Clinic, Attn: Privacy Officer, 630 S. 36th Avenue, Wausau, WI 54401.

We reserve the right to update or modify this Notice of Privacy Practices at any time, as permitted by law. Changes may reflect new legal requirements, operational practices, or privacy protections. The revised notice will be posted in our office and on our website at wibehavioralhealth.com.

You may request the latest Notice at any time from the BHC Privacy Officer at 855-607-8242 or compliance@bhclinic.com. We make revised notices available in our offices and on our website and provide additional notices when required by applicable law.

NOTICE OF AVAILABILITY OF LANGUAGE ASSISTANCE SERVICES AND AUXILIARY AIDS AND SERVICES

Behavioral Health Clinic, LLC

English

Free language assistance services and appropriate auxiliary aids and services are available to help you communicate with Behavioral Health Clinic and receive information in accessible formats. This includes qualified spoken-language and sign-language interpreters and information in other languages, large print, audio, or accessible electronic formats when needed for meaningful access or effective communication. To request help, call 855-607-8242, email compliance@bhclinic.com, or speak with your provider or front-office staff. You will not be charged for these services. You may use your preferred telecommunications relay service to contact us.

Español (Spanish)

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. También están disponibles de forma gratuita ayuda y servicios auxiliares apropiados para proporcionar información en formatos accesibles. Llame al 855-607-8242 o hable con su proveedor.

Lus Hmoob (Hmong)

LUS CEEV TSHWJ XEEB: Yog hais tias koj hais Lus Hmoob muaj cov kev pab cuam txhais lus pub dawb rau koj. Cov kev pab thiab cov kev pab cuam ntxiv uas tsim nyog txhawm rau muab lus qhia paub ua cov hom ntaub ntawv uas tuaj yeem nkag cuag tau rau los kuj yeej tseem muaj pab dawb tsis xam tus nqi dab tsi ib yam nkaus. Hu rau 855-607-8242 los sis sib tham nrog koj tus kws muab kev saib xyuas kho mob.

简体中文 (Chinese, Simplified)

注意：如果您说中文，我们可以免费提供语言协助服务，以及帮助您获取无障碍格式信息的适当辅助工具和服务。请致电 855-607-8242，或与您的医疗服务提供者联系。

繁體中文 (Chinese, Traditional)

注意：如果您說中文，我們可以免費提供語言協助服務，以及協助您取得無障礙格式資訊的適當輔助工具和服務。請致電 855-607-8242，或與您的醫療服務提供者聯絡。

Deutsch (German)

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlose Sprachassistenzdienste zur Verfügung. Entsprechende Hilfsmittel und Dienste zur Bereitstellung von Informationen in barrierefreien Formaten stehen ebenfalls kostenlos zur Verfügung. Rufen Sie 855-607-8242 an oder sprechen Sie mit Ihrem Provider.

العربية (Arabic)

تنبيه: إذا كنت تتحدث اللغة العربية، فستتوفر لك خدمات المساعدة اللغوية المجانية. كما تتوفر وسائل مساعدة وخدمات مناسبة لتوفير المعلومات بتنسيقات يمكن الوصول إليها مجانًا. اتصل على الرقم 855-607-8242 أو تحدث إلى مقدم الخدمة.

Русский (Russian)

ВНИМАНИЕ: Если вы говорите на русский, вам доступны бесплатные услуги языковой поддержки. Соответствующие вспомогательные средства и услуги по предоставлению информации в доступных форматах также предоставляются бесплатно. Позвоните по телефону 855-607-8242 или обратитесь к своему поставщику услуг.

한국어 (Korean)

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Tiếng Việt (Vietnamese)

LƯU Ý: Nếu bạn nói tiếng Việt, chúng tôi cung cấp miễn phí các dịch vụ hỗ trợ ngôn ngữ. Các hỗ trợ dịch vụ phù hợp để cung cấp thông tin theo các định dạng dễ tiếp cận cũng được cung cấp miễn phí. Vui lòng gọi theo số 855-607-8242 hoặc trao đổi với người cung cấp dịch vụ của bạn.

Deitsch (Pennsylvania Dutch)

Schprooch-Hilf, passende Hilfsmittel un Dienscht fer Informatione in zugängliche Formate sin gratis verfügbar. Ruf 855-607-8242 oder schwetz mit dei Provider.

ລາວ (Lao)

ເຊີນຊາບ: ຖ້າທ່ານເວົ້າພາສາລາວ, ຈະມີບໍລິການຊ່ວຍດ້ານພາສາແບບບໍ່ເສຍຄ່າໃຫ້ທ່ານ. ມີເຄື່ອງຊ່ວຍ ແລະ ການບໍລິການແບບບໍ່ເສຍຄ່າທີ່ເໝາະສົມເພື່ອໃຫ້ຂໍ້ມູນໃນຮູບແບບທີ່ສາມາດເຂົ້າເຖິງໄດ້. ໂທຫາເບີ 855-607-8242 ຫຼື ລົມກັບຜູ້ໃຫ້ບໍລິການຂອງທ່ານ.

Français (French)

ATTENTION : Si vous parlez Français, des services d’assistance linguistique gratuits sont à votre disposition. Des aides et services auxiliaires appropriés pour fournir des informations dans des formats accessibles sont également disponibles gratuitement. Appelez le 855-607-8242 ou parlez à votre fournisseur.

Polski (Polish)

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हिंदी (Hindi)

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Shqip (Albanian)

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Tagalog (Filipino)

PAALALA: Kung nagsasalita ka ng Tagalog, magagamit mo ang mga libreng serbisyong tulong sa wika. Magagamit din nang libre ang mga naaangkop na auxiliary na tulong at serbisyo upang magbigay ng impormasyon sa mga naa-access na format. Tumawag sa 855-607-8242 o makipag-usap sa iyong provider.