Helianthus Positive Behavior Supports LLC’s Notice of Privacy Practices provides information about how we may use or release personal health information. The notice contains a client’s rights section describing your rights under the law. You affirm by signing our HIPAA agreement that you have reviewed our notice before signing consent. The terms of the notice may change, and if so, you will be notified and given an updated copy to review and sign.
You have the right to restrict how your personal health information is used and released for treatment, payment or healthcare services. The HIPAA (Health Insurance Portability and Accountability Act of 1996) law allows for the use of the information by a healthcare processional for treatment, payment, or healthcare services. Consent in writing will be obtained for any further use or release of your health information.
By signing our HIPAA agreement, you consent to Helianthus Positive Behavior Supports LLC (HPBS) using and releasing your personal healthcare information for any use within our company and/or for the benefit of the client to include but not limited to; releasing to third-party entities such as your insurance agency, professionals contracted by HPBS, and those whom are in direct contact with the client or on the treatment support team.
You have the right to revoke consent at any time in writing and with a caregiver/guardian signature. However, revoking your consent will not be backdated; meaning any personal health information released or used prior to the withdrawal date will not be included in the withdrawal. HPBS cannot withdrawal any personal health information which has already been released.
Information about the client’s medical treatment may be released to other persons under the following circumstances only:
1. When a release of information is signed by you; or if under age 13 by a parent/ legal guardian.
2. To a parent or legal guardian, when the Client is under the age of 13.
3. When abuse or neglect of a child or a vulnerable/dependent adult must be reported by law.
4. When you are a danger to yourself or someone else or are critically disabled.
5. When HPBS deems it necessary or appropriate to disclose information to another physicians or health providers, unless you specifically request in writing for HPBS not to do so.
6. When HPBS deems it in accordance with good professional practice to disclose information to a family member, unless you specifically instruct the HPBS in writing not to do so.
7. When it is necessary to provide the information in a legal proceeding or disciplinary action.
8. When your insurance agency requests your records in order to process your insurance claim or provide treatment. HPBS client records are accessed by third-party entities for the purpose of treatment, payment, and healthcare operations. The contracted third-party entities are to abide by confidentiality laws, however, HPBS is not responsible for the actions of these third-party entities.
9. When your spouse, family member, or other persons attends a therapy session with you, we make every effort to maintain privacy, but their communication is not privileged or protected by law and can be released without their permission.
10. HPBS may resist releasing information to others or to you if we believe that the release would cause imminent harm.
*HPBS will provide a consent agreement to videotape and/or photograph your child. A notice will be given in writing for review before such action occurs. This is optional and you may decline consent, however, HPBS reserves the right videotape/photograph solely for HPBS clinical and training purposes to be viewed only within the company and its contracted agencies to benefit quality of care for your child.*
Helianthus Positive Behavior Supports LLC
Elizabeth City, NC - Chesapeake, VA
Copyright © 2021 Helianthus Positive Behavior Supports LLC - All Rights Reserved.
Powered by GoDaddy Website Builder
HPBS is proud to announce we have added a clinic location in Northeastern NC!!
NEW PROGRAMS ALERT!!!!
Check out information about our Social Skills Groups and Classroom Readiness Group! Head to the "Enrollment" tab now!