Notice of Privacy Practices

I. MY PLEDGE REGARDING HEALTH INFORMATION:

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

· Make sure that protected health information (“PHI”) that identifies you is kept private.
· Give you this notice of my legal duties and privacy practices with respect to health information.
· Follow the terms of the notice that is currently in effect.
· I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures, I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow healthcare providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any healthcare provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in the diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers, and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful processes by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

1. Psychotherapy Notes. I do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:
 a. For my use in treating you.
 b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
 c. For my use in defending myself in legal proceedings instituted by you.
 d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
 e. Required by law and the use or disclosure is limited to the requirements of such law.
 f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
 g. Required by a coroner who is performing duties authorized by law.
 h. Required to help avert a serious threat to the health and safety of others.
2. Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.
3. Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION.

Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
3. For health oversight activities, including audits and investigations.
4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.
5. For law enforcement purposes, including reporting crimes occurring on my premises.
6. To coroners or medical examiners, when such individuals are performing duties authorized by law.
7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
9. For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.
10. Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.
2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.
4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. You may request a copy by emailing me at hello@roottobloomtherapy.com. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost based fee for doing so.
5. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.
6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
8. The Right to Make a Complaint. You have the right to make a complaint about how this practice has used your PHI. To do so, please email me at hello@roottobloomtherapy.com

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on May 1, 2022

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Notice of Privacy Practices

Root to Bloom Therapy (Saulmon Counseling LLC) has professional social media pages @talkingwithtesa on Instagram, Facebook, Twitter, Pinterest, and TikTok.  

The intention for using social media is for marketing, education, advocacy, thought leadership, product recommendations, and providing content in a technologically changing field. We want to do this while making clients aware of the risks and benefits of engagement on social media where therapists and counselors are present. A therapeutic relationship is a professional relationship and in today's technological climate, a social media presence or following your therapist on social media is not to be confused with a relationship outside of therapy. Ethical, professional, and therapeutic boundaries must be followed and honored. 

A social media page created by a therapist is not psychotherapy, a replacement for a therapeutic relationship, or a substitute for mental health and medical care. A social media presence as a therapy professional is not seeking an endorsement, request, or rating from past or current clients. No social media posts should be considered professional advice. The information contained in posts is general information for educational purposes only.

Past and current clients risk breaching their privacy and confidentiality by following, liking, re-posting, commenting, and engaging on social media platforms with counselors. 

In order to honor professional boundaries, and ethical nuances, and not engage in and prevent any potential form of dual relationship, counselors will not follow or friend past or current clients on social media platforms. You are welcome to follow my professional accounts, but I will not follow you back. Please understand that you risk breaking your own confidentiality by engaging with my social media accounts. If you decide to unfollow me, I won’t be upset. If you have questions about this, please bring them up when we meet and we can talk more about it.

If there are things from your social media sites that you think would be helpful for your therapist to know, please share those things with your therapist during sessions directly. 

"Direct Messaging" is another risk to your privacy. Remember commenting and messaging between sessions is not a confidential or encouraged means of communication. Please schedule an official therapy session to discuss, explore, and ask any treatment related questions or concerns. Social media is not an appropriate medium for sharing therapeutic concerns, questions, comments, or reaching out in crisis to your counselor. Comments and DM’s are monitored by staff and are not confidential. 

Neither Root to Bloom Therapy (Saulmon Counseling LLC) nor its employees will solicit any clients to follow or engage with my accounts on social media. Any product recommendations, advertisements, or affiliate marketing is outside of the scope of my therapy practice Root to Bloom Therapy (Saulmon Counseling LLC), and are done as an individual person, Tesa Saulmon. Tesa Saulmon will disclose when she receives compensation as an affiliate or advertiser. Root to Bloom Therapy (Saulmon Counseling LLC), its owner, professionals, and other staff will not sell or recommend products to clients in therapy sessions or seek them out online/via email/etc to sell products to them. 

To ensure using technology, chat rooms, and/or social media in a professional manner and maintain appropriate professional boundaries, Root to Bloom Therapy (Saulmon Counseling LLC) professionals and staff do not engage in any "personal virtual relationships" that blur the professional boundary (dual relationships) by using personal accounts as the connection point for the virtual relationship with current or former clients. We respect the privacy of our current and former clients' presence on social media unless given consent to view such information only during a scheduled session.

Please consult your physician or mental health provider regarding advice or support for your health and wellbeing. 

If you are suicidal, please call your local 24-hour hotline or 911 or emergency services.

If you are suicidal, please call your local 24-hour hotline or 911 or emergency services.

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Disclaimer

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

● You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

● Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

● If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

● Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.