Privacy Policy

THIS NOTICE INVOLVES YOUR PRIVACY RIGHTS AND DESCRIBES HOW INFORMATION ABOUT YOU MAY BE DISCLOSED, AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Responsibilities of Atlantis Counseling

We are required to:

  • Maintain the privacy of your protected health information (PHI) as required by law and provide you with notice of our legal duties and privacy practices with respect to the protected health information that we collect and maintain about you.

  • Abide by the terms of this notice currently in effect. We have the right to change our notice of privacy practices and to make the new provisions effective for all protected health information that we maintain, including that obtained prior to the change. Should our information practices change, we will provide you with a copy.

  • Notify you if we are unable to agree to a requested restriction.

  • Use or disclose your health information only with your authorization except as described in this notice.

Your Protected Health Information (PHI) Rights

You have the right to:

  • Review and obtain a paper copy of the notice of information practices upon request and of your health information, except that you are not entitled to access, or to obtain a copy of, psychotherapy notes and a few other exceptions may apply. Copy charges may apply.

  • Request and provide written authorization and permission to release information for purposes of outside treatment and health care operations.

  • Revoke your authorization in writing at any time to use, disclose, or restrict health information except to the extent that action has already been taken.

  • Request in writing a restriction on certain uses and disclosures of protected health information, but we are not required to agree to the restriction request.

  • Request that we amend your health information by submitting a written request with the reasons supporting the request to Amanda Stenzel-Loucks. We are not required to agree to the requested amendment.

  • Obtain an accounting of disclosures of your health information for purposes other than treatment, payment, health care operations and certain other activities for the last six years.

  • Request confidential communications of your health information by alternative means.

    Disclosures for Treatment, Payment and Health Operations

    Atlantis Counseling will use your PHI, with your consent, in the following circumstances:

  • Treatment: Information obtained by your counselor will be recorded in your record and used to determine the management and coordination of treatment that will be provided for you.

  • Disclosure to others outside of Atlantis Counseling: If you give us a written authorization, you may revoke it in writing at any time but that revocation will not affect any use or disclosures permitted by your authorization while it was in effect. We will not use or disclose your health information without your authorization, except (as described below) to report serious threat to health or safety or child and adult abuse or neglect.

  • For payment, if applicable: We may send a bill to you or to your insurance carrier. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis to obtain reimbursement for your health care or to determine eligibility or coverage.

  • For health care operations: Counselors may use your information in your health record to assess the performance and operations of our services. e.g. sending a satisfaction follow up survey. This information will then be used in an effort to continually improve the quality and effectiveness of the mental health care and services we provide. At the time of your first appointment, you may be asked to sign a release so that we can mail you a follow up survey.

Atlantis Counseling will use your PHI, without your consent or authorization, in the following circumstances:

  • Child Abuse: If we have reasonable cause to suspect that a child seen in the course of professional duties has been abused or neglected, or have reason to believe that a child seen in the course of my professional duties has been threatened with abuse or neglect, and that abuse or neglect of the child will occur, we must report this to the relevant county department, child welfare agency, police, or sheriff’s department.

  • Adult and Domestic Abuse: If we believe that an elder person is the victim of abuse, neglect or domestic violence or the possible victim of other crimes, we may report such information to the relevant county department or state official.

  • Serious Threat to Health or Safety: If we have reason to believe, exercising best judgment and our professional care and skill, that you may cause harm to yourself or another person, we may take steps, without your consent to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition in order to protect you or another person from harm. This may include instituting commitment proceedings.

  • Judicial or administrative proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and we will not release the information without written authorization from you or your personal or legally-appointed representative, or a subpoena/court order. The privilege does not apply when you are being evaluated by a third party or where the evaluation is court ordered.

  • As required by law for national security and law enforcement: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence and other national security activities. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

  • Law/Health Oversight: As required by law we may disclose your health information. For example, if the Michigan Department of Regulation and Licensing requests that we release records to them in order for the Psychology Examining Board to investigate a complaint against a provider, we must comply with such a request.

  • Reminders: We may contact you to provide an appointment, if requested.

  • Worker’s Compensation: We may disclose health information to the extent authorized by you and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law; we may be required to testify.

  • As required by law for purposes of public health: e.g. as required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

  • Student Educational Records: If you are a student and Michigan state law and the federal Family Educational Rights and Privacy Act of 1974 (FERPA) permit the disclosure to institutional officials with a need to know, we may so disclose your personal health information to those persons. The privacy of student educational records is governed by FERPA.

  • Other uses and disclosures of information not covered by this notice or by the laws that apply to me will be made only with your written permission.

Complaints about your privacy rights or how Atlantis Counseling has handled your health

information should be directed to Amanda Stenzel-Loucks in writing:

Atlantis Counseling

6035 Executive Dr, Ste 201, Lansing, MI, 48911

(810)256-0117

amanda@atlantiscounselingmi.com

If you are not satisfied with the manner in which this office handles your complaint, you may

submit a formal complaint to:

Region V Office for Civil Rights US Department of Health and Human Services 233 N Michigan

Avenue, Suite 240 Chicago, IL 60601

312.886.2359