Effective Date: 4/30/2012


This notice describes how individually identifiable information about you will be used and disclosed and how you can get access to this information.  Kovacs Counseling (THE PRACTICE) understands that your information is highly personal and is committed to safeguarding your protected health information. Please read this Notice of Privacy Practices thoroughly.  


THE PRACTICE is required by law to maintain the privacy of individually identifiable patient health information (this information is “protected health information” and is referred to herein as “PHI”) and to provide you with an explanation of how we handle your PHI. We will only use or disclose your PHI as permitted or required by applicable state or federal law. Upon request, THE PRACTICE can provide you with a more extensive explanation regarding our privacy practices and your rights. 




  • Treatment:  THE PRACTICE may use and disclose your PHI to those who have a legitimate need for such information in the provision and coordination of your care and treatment, which may include physicians, nurses, technicians, students or other health care providers.  This information is provided to carry out treatment functions at THE PRACTICE and also consultations or referrals with other providers or agencies. 
  • Payment:  THE PRACTICE may use and disclose PHI about you for our payment purposes to insurance companies and companies that we engage in obtaining payment for care for items such as: determining coverage, eligibility, billing, and reimbursement. THE PRACTICE may provide limited information for the billing purposes of other providers involved in your care, as needed, to ensure timely payment and claims processing. 
  • Health Care Operations: THE PRACTICE may use and disclose your PHI during routine health care operations including quality of care assessment and improvement activities, utilization review, activities to coordinate your care, legal, regulatory, accreditation and licensure activities, reviewing the performance or qualifications of health care providers for credentialing and evaluation purposes. 
  • Appointment Reminders:  THE PRACTICE may use and disclose PHI to contact you as a reminder that you have an appointment for services at THE PRACTICE or with another service provider. 
  • Family and Friends:  As directed by you, THE PRACTICE may disclose PHI about you to a friend or family member who is involved in your care or to someone who helps you pay for your care. You can request a limitation or restriction on the disclosure of your PHI for some or all of your friends or family.
  • Disaster Relief: Unless you request a restriction or limitation, we may disclose your medical information to a public or private entity, for example the Red Cross, authorized by law or by it’s charter to assist in disaster relief efforts. 
  • Inmates:  If you are an inmate of a correctional institute or under the custody of a law enforcement officer, THE PRACTICE will release your PHI to the correctional institute or law enforcement official.
  • Law Enforcement Purposes:  THE PRACTICE may disclose your PHI for law enforcement purposes, such as responding to a court order or subpoena, identifying a suspect or a missing person, or providing information about a crime victim or criminal conduct, when required by law. 
  • Required by Law:  THE PRACTICE will disclose PHI about you when required to do so by federal, state or local law. Such examples could include reporting of infectious diseases, neglect and abuse as required by law. THE PRACTICE is also required to provide information for judicial and administrative proceedings, and specialized governmental functions, to process Worker’s Compensation claims, for vital statistics purposes, to health oversight agencies. In Ohio the state offers greater protections, which are addressed in the following statutes governing specific entities or medical conditions: hospitals, insurance records, and mental health records. All of Ohio’s state laws regarding its consent requirement continue to apply.  State law also allows the disclosure of PHI regarding the following specific conditions: anatomical gifts, cancer registry, genetic information, HIV / AIDS testing, long-term care residents, mental illness and mental retardation. THE PRACTICE will abide by the most stringent state and federal laws. 
  • Coroners, Medical Examiners, Funeral Directors:  THE PRACTICE will release, if necessary, your PHI to a coroner, funeral director or medical examiner. 
  • Health or Safety:  THE PRACTICE will use and disclose PHI to avert a serious threat to the health and safety of a person or the public.
  • Other Uses:  Any other uses or disclosures will be made only with your written authorization.  


PATIENT HEALTH INFORMATION RIGHTS:  Although all records concerning your services obtained at THE PRACTICE are property of THE PRACTICE, you have the following rights concerning your PHI: 


  • Right to Confidential Communications:  You have the right to receive confidential communications of your PHI by alternative means or at alternative locations.  For example, you may request that THE PRACTICE only contact you at work or by mail. 
  • Right to Request Restrictions:  You have the right to request restrictions on certain uses and disclosures of your PHI: 1) to carry out treatment, payment or health care operations functions; or 2) to family members, relatives, close personal friends or other individuals involved in your care.  THE PRACTICE will consider your request, but is not required to agree to your requested restrictions. 
  • Right to Inspect and Copy:  You have the right to inspect and copy your PHI (with some exceptions) as long as we maintain the information. In certain limited situations, THE PRACTICE may be required to deny your request. Copying requires that you pay a reasonable copying charge. 
  • Right to Amend:  You have the right to request an amendment of your PHI (with some exceptions) for as long as THE PRACTICE maintains it.  
  • Right to an Accounting:  You have a right to receive an accounting of certain disclosures of your PHI (with some exceptions) that THE PRACTICE made. 
  • Right to Receive a Copy of this Notice: You have the right to receive a paper copy of this Notice of Privacy Practices, upon request. 


SHARING AND JOINT USE OF YOUR HEALTH INFORMATION:  THE PRACTICE may share PHI with Business Associates that are contracted to perform business functions for The Practice. These arrangements require Business Associates to keep your information confidential.  


COMPLAINTS AND FURTHER INFORMATION:  If you believe your privacy rights have been violated, you may file a complaint with The Practice or with the Secretary of the Department of Health and Human Services.  To obtain additional information or to file a complaint with Kovacs Counseling, please contact THE PRACTICE’s Privacy Officer, at (614) 245-5544.  All complaints must be submitted in writing directly to THE PRACTICE’s Privacy Officer at: 4030 Easton Station, Suite 225, Columbus, OH 43219.  The Practice assures you that there will be no retaliation for filing a complaint. 


CHANGES TO THIS NOTICE:  THE PRACTICE will abide by the terms of the notice currently in effect for PHI in our possession including medical records generated by us.  THE PRACTICE reserves the right to change the terms of its notice and to make the new notice provisions effective for all PHI that it maintains. You will receive the most current Notice at your next scheduled visit. We are required to post this Notice in a prominent location within our facilities. 

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