HIPAA Notice of Privacy Practices

North Star Psychology
116 Agnes Road, Ste 200, Knoxville, TN 37919
Email: info@northstarpsyc.com
Effective Date: December 4, 2024
Last Revised: April 8, 2025

This notice describes how your health information may be used and disclosed and how you can access this information. Please read it carefully.

I. Our Responsibilities Regarding Your Health Information

We are legally required to maintain the privacy of your protected health information (PHI) and to provide you with this notice of our privacy practices and legal duties. This notice applies to all records of your care created or maintained by North Star Psychology.

We are required to:

Maintain the confidentiality of your PHI under HIPAA
Give you this notice of our legal duties and privacy practices
Follow the terms of this notice currently in effect
Notify you in the event of a breach involving your unsecured PHI

We reserve the right to change the terms of this notice and apply the changes to all PHI we maintain. Any updates will be posted on our website and made available in your client portal. You may request a printed or digital copy at any time.

II. How We May Use and Disclose Your Health Information Without Authorization

We may use and disclose your PHI without your written authorization in the following situations:

For Treatment, Payment, and Healthcare Operations

To provide, coordinate, or manage your mental health care
To consult with other healthcare providers involved in your care
To bill and collect payment for services
To support administrative functions such as quality improvement, supervision, and internal auditing

Example: If your therapist consults with another licensed provider about your diagnosis, this disclosure is permitted without your written consent.

Public Health and Safety

To report abuse or neglect (e.g., child, elder, or dependent adult)
To prevent or lessen a serious and imminent threat to health or safety

Health Oversight Activities

For audits, licensing, and government inspections related to healthcare oversight

Legal Proceedings

In response to a court or administrative order
In response to a subpoena or discovery request, if efforts have been made to inform you or obtain a protective order

Law Enforcement

To report crimes on the premises
To comply with legal obligations under federal or state law

Research

For research approved by an Institutional Review Board, under strict confidentiality protections

Coroners and Medical Examiners

To identify a deceased person or determine cause of death

Specialized Government Functions

For national security or military missions
For protection of the President or correctional institution operations

Workers’ Compensation

To comply with workers' compensation laws, if applicable

Appointment Reminders and Health-Related Communications

To contact you about upcoming sessions or to inform you about treatment alternatives or health-related benefits

III. Uses and Disclosures That Require Your Authorization

We must obtain your explicit, written authorization to use or disclose your PHI for any reason not covered above, including:

1. Psychotherapy Notes

Your written authorization is required to release psychotherapy notes unless the use is:

For your treatment by your therapist
For training or supervision of clinicians
To defend against a legal action initiated by you
Required by law or government investigation
Necessary to avert a serious threat to health or safety

2. Marketing

We will not use your PHI for marketing purposes without your written authorization.

3. Sale of PHI

We will never sell your PHI.

You may revoke your authorization at any time in writing, except where we have already relied on it.

IV. Disclosures Requiring an Opportunity to Object

We may share limited PHI with a family member, friend, or caregiver involved in your treatment or payment for your care, unless you object. In emergency situations, we may make such disclosures and obtain your consent retroactively.

V. Your Rights Regarding Your Protected Health Information

You have the following rights under HIPAA:

1. Right to Access

You have the right to inspect and obtain a paper or electronic copy of your PHI, including medical and billing records, but not psychotherapy notes. Requests must be made in writing. A reasonable, cost-based fee may apply.

2. Right to Amend

You may request that we amend your health information if you believe it is inaccurate or incomplete. We may deny the request but will explain why in writing within 60 days.

3. Right to Restrict Disclosures

You can request restrictions on the use or disclosure of your PHI for treatment, payment, or operations. We are not required to agree unless the request involves PHI related to a service paid for entirely out-of-pocket and pertains solely to that service.

4. Right to Confidential Communications

You may request that we contact you in a specific way (e.g., only via email, or at a specific phone number). We will accommodate all reasonable requests.

5. Right to an Accounting of Disclosures

You may request a list of disclosures we’ve made of your PHI in the last six years, excluding those made for treatment, payment, or operations. The first request is free each year; additional requests may incur a reasonable fee.

6. Right to a Paper or Electronic Copy of This Notice

You have the right to receive this notice in printed or digital form at any time, even if you’ve previously agreed to receive it electronically.

VI. Telehealth and Your Privacy

All telehealth services conducted by North Star Psychology use HIPAA-compliant video conferencing platforms and secure electronic health record systems to safeguard your privacy.

VII. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

To file a complaint with us:

North Star Psychology
Email: info@northstarpsyc.com
Phone: (205) 797-1897

To file a complaint with HHS:

Office for Civil Rights
U.S. Department of Health & Human Services
https://www.hhs.gov/ocr/privacy/hipaa/complaints/