Privacy Statement

1. Right to access your record - You may request to inspect or obtain a copy (paper or electronic) of your medical record and other health information we maintain about you. 

- Once a request has request for records has been made, we will respond within 30 days of your request.
- We may charge a reasonable, cost based fee for physical copies of your records.

2. Right to request amendment - You may request that we correct information you believe is inaccurate or incomplete.

- We may deny your request, but we will provide a written explanation within 60 days

3. Right to request confidential communications - You may request that we communicate with you in a specific way (for example, only via cell phone or at a specific address).

- We will accommodate all reasonable requests.

4. Right to Request Restrictions - You may request limitations on how we use or disclose your information for treatment, payment, or healthcare operations.

- We are not required to agree to all requests.
- If you pay out-of-pocket in full for a service, you may request that we not disclose that information to your health plan. We will honor that request unless disclosure is required by law.

5. Right to an accounting of disclosures - You may request a list of disclosures of your health information made in the past six years, excluding disclosures for treatment, payment, healthcare operations, and certain other permitted uses.

- One accounting per year is provided free of charge

6. Right to a copy of this notice - You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.

7. Right to Designate a Personal Representative - If someone has legal authority (such as a healthcare power of attorney or guardianship), that person may exercise your rights on your behalf.

8. Right to File a Complaint - If you believe your privacy rights have been violated, you may file a complaint

You may file an internal compliant with KPM's Privacy Officer:
Grace Kim, PhD, LP

P: (612) 268-5928

E: Admin@KPMCounseling.com

Or by Mail: 

KPM Counseling and Consultation, PLLC
ATTN: Grace Kim
825 Nicollet Mall STE 1950
Minneapolis, MN 55402

You may file an external compliant with the U.S. Department of Health and Human Services

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Ave., S.W.
Washington D.C. 20201

P: 1-877-696-6775

www.hhs.gov/hipaa

We will not retaliate against you for filing a complaint.

We may use and disclose your information to bill and receive payment from health plans or other payers.

Example: Submitting claims to your insurance company.

We may use your information to operate our practice, improve services, and ensure quality care.

Example: Internal quality review or supervision consultation.

We may disclose your information when required by federal or Minnesota law.

This includes:
- Mandatory reporting of abuse or neglect
- Threats of serious harm to self or others
- Court orders or subpoenas
- Health oversight activities

Public Health and Safety - We may disclose information to:

- Prevent or reduce serious threats to health or safety
- Report certain injuries or communicable diseases when required

Lawsuits and Legal Proceedings - We may disclose your information in response to a court or administrative order, or subpoena, consistent with applicable law.

Special Protections for Mental Health Records (Minnesota Law) - Minnesota law provides additional protections for mental health treatment records. In most cases, we will not release your mental health records without your written authorization, except:

- For treatment, payment, or healthcare operations
- When required by law
- In cases involving risk of serious harm
- For mandatory reporting obligations

We will comply with all applicable Minnesota statutes governing release of mental health information (Minn. Stat. §§ 144.291–144.298 and related provisions).

Psychotherapy notes (as defined by HIPAA) are maintained separately from your general medical record and receive additional protection.  We will not use or disclose psychotherapy notes without your written authorization except as permitted by law.

We may communicate with you using secure electronic systems, including secure email or a client portal. While we take reasonable safeguards, electronic communication carries inherent risks.

You may request alternative communication methods at any time.

We are required by law to notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

We reserve the right to change this notice. Any revised notice will apply to all information we maintain and will be available in our office and upon request.