Privacy Policy

Contact Information

Questions regarding this Privacy Policy or privacy-related concerns may be directed to:

Privacy Officer
Sarah Lewakowski

Sarah@mosaiccounseling.com

Phone: (616) 842-9160

*********

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Mosaic Counseling is committed to protecting the privacy and confidentiality of your health information collected as part of our referral coordination, Employee Assistance Program (EAP) services, and school outreach services. This Notice describes how we may use and disclose your Protected Health Information (PHI), your rights regarding that information, and our legal responsibilities under the Health Insurance Portability and Accountability Act (HIPAA) and applicable Michigan law.

Our Commitment to Your Privacy

We understand that information about your mental health, treatment, referrals, and related services is personal. We are required by law to:

• Maintain the privacy and security of your Protected Health Information (PHI) and Electronic Protected Health Information e(PHI);
• Provide you with this Notice of our legal duties and privacy practices;
• Notify you if a breach occurs that may compromise the privacy or security of your information; and
• Follow the terms of this Notice currently in effect.

What Is Protected Health Information (PHI) and Electronic Protected Health Information (ePHI)?

Protected Health Information (PHI) includes information that identifies you and relates to:

• Your past, present, or future physical or mental health condition;
• Healthcare services provided to you;
• Payment for healthcare services;
• Referral, care coordination, case management, or support services.

PHI may exist in various forms, including:

• Written records
• Verbal communications
• Electronic records and communications

Electronic Protected Health Information (ePHI) refers to any PHI that is created, received, maintained, transmitted, or stored electronically. Examples may include:

• Electronic intake forms
• Scheduling records
• Referral coordination records
• Email communications
• Text messaging systems
• Electronic health records
• Insurance and billing information
• Information maintained within secure databases, cloud-based systems, or customer relationship management platforms

How We May Use and Disclose Your Information Without Your Written Authorization

Treatment and Care Coordination

We may use and disclose your PHI to coordinate, manage, or support your care and treatment.

Examples include:

• Referring to a therapist, counselor, psychiatrist, or other healthcare provider;
• Coordinating services with providers participating in Mosaic Counseling’s referral network;
• Communicating with healthcare professionals involved in your care;
• Coordinating care transitions and follow-up services.

Payment

We may use and disclose PHI to:

• Verify insurance coverage;
• Obtain prior authorization;
• Bill and collect payment;
• Process Employee Assistance Program (EAP) services;
• Coordinate benefits and payment arrangements.

Healthcare Operations

We may use PHI for activities necessary to operate our organization, including:

• Quality improvement activities;
• Program evaluation;
• Staff training and supervision;
• Accreditation and licensing activities;
• Compliance monitoring;
• Business planning and administration.

Appointment Reminders and Communications

We may contact you by:

• Telephone
• Voicemail
• Email
• Text message
• Mail

for appointment reminders, scheduling, referrals, and service coordination unless you request otherwise.

Individuals Involved in Your Care

With your permission, or when permitted by law, we may share relevant information with family members, guardians, caregivers, or others involved in your care.

Required by Law

We may disclose information when required by federal, state, or local law.

Public Health and Safety

We may disclose information:

• To report abuse or neglect;
• To prevent or lessen a serious threat to health or safety;
• To comply with public health reporting requirements;
• To cooperate with law enforcement when legally required.

Judicial and Administrative Proceedings

We may disclose information in response to court orders, subpoenas, warrants, or other lawful processes as permitted or required by law.

Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization before:

• Releasing information for purposes not described in this Notice;
• Disclosing psychotherapy notes when required by HIPAA;
• Using or disclosing information for marketing purposes when required by law;
• Sharing information with third parties outside treatment, payment, healthcare operations, or other legal exceptions.

You may revoke your authorization at any time in writing, except to the extent we have already relied upon it.

Special Protections for Minors

Michigan law allows certain minors age 14 and older to independently consent to outpatient mental health services under specific circumstances.

Information related to services provided under Michigan’s minor consent law will remain confidential except when:

• The minor authorizes disclosure;
• Disclosure is required by law;
• There is a substantial risk of harm to the minor or others;
• Abuse, neglect, or exploitation must be reported;
• A court orders disclosure.

Your Rights Regarding Your Health Information

Right to Access

You have the right to inspect and obtain a copy of your PHI, subject to limited exceptions.

Right to Request Amendment

You may request that we amend information you believe is incomplete or inaccurate.

Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your information. While we will consider all requests, we may not be required to agree to them.

Right to Confidential Communications

You may request that we communicate with you in a specific way or at a specific location.

Right to Receive an Accounting of Disclosures

You may request a list of certain disclosures of your PHI made by Mosaic Counseling.

Right to Receive a Copy of This Notice

You have the right to receive a paper or electronic copy of this Notice at any time.

Referral Coordination Services

As part of our mission, Mosaic Counseling may coordinate referrals and assist clients in identifying appropriate mental health, behavioral health, school-based, Employee Assistance Program, assessment, or related services.

Information necessary to facilitate referral coordination may be shared with participating providers and organizations involved in your care as permitted under HIPAA, applicable law, and any authorizations you provide.

Our Responsibilities

Mosaic Counseling is required by law to:

• Maintain the privacy and confidentiality of your Protected Health Information (PHI) and Electronic Protected Health Information (ePHI);
• Comply with the requirements of the HIPAA Privacy Rule, Security Rule, and Breach Notification Rule;
• Implement reasonable administrative, physical, and technical safeguards to protect your information from unauthorized access, use, disclosure, alteration, or destruction;
• Limit the use and disclosure of PHI and ePHI to the minimum necessary amount required to accomplish the intended purpose, when applicable;
• Train workforce members, contractors, interns, and authorized personnel regarding privacy and security requirements;
• Monitor and evaluate privacy and security practices to maintain compliance with applicable laws and regulations;
• Notify affected individuals, regulatory agencies, and others as required by law in the event of certain breaches involving unsecured PHI or ePHI; and
• Follow the privacy practices described in this Notice.

Mosaic Counseling utilizes secure technologies and works with approved vendors and business associates that support the protection of PHI and ePHI. While no electronic system can guarantee absolute security, we continuously work to maintain safeguards consistent with industry standards and legal requirements.

Changes to This Notice

We reserve the right to revise this Notice and make revised provisions effective for all PHI we maintain. Updated notices will be posted on our website and made available upon request.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, please contact:

Privacy Officer

Sarah Lewakowski

Sarah@mosaiccounseling.com

(616) 842-9160