### Shan Counseling LLC – Privacy & Your Rights (Summary) **Effective Date:** `[November, 21, 2025]` This is a **plain-language summary** of how we protect your information and your rights. It does **not** replace our full, legal **Notice of Privacy Practices**. > **Important:** This summary was **not written by a lawyer**. It may not cover every detail of federal or Pennsylvania law. If you have legal questions, please talk to a **licensed attorney** or review the official laws and regulations on the appropriate government or legal websites. --- #### 1. Who We Are **Shan Counseling LLC** provides outpatient mental health counseling in Pennsylvania. - Address: `[756, Adams Ave, Philadelphia PA 19124]` - Phone: `[215-533-3660]` - Privacy contact: `["Alice" Ying Shan / MA LPC, 267-205-3977, AliceYingShan@gmail.com]` We must follow the **HIPAA** Privacy, Security, and Breach Notification Rules and relevant **Pennsylvania privacy and mental health laws**. --- #### 2. What “Protected Health Information” (PHI) Means PHI is information that: - Identifies you (name, date of birth, address, etc.), **and** - Relates to your physical or mental health, the care you receive, or payment for that care. Examples: your diagnosis, treatment plan, session dates, insurance information, and billing records. Some information gets **extra protection** under federal and Pennsylvania law: - Mental health treatment records - Substance use disorder treatment records (42 C.F.R. Part 2) - HIV-related information - Some services minors can consent to on their own --- #### 3. How We Use and Share Your Information We may use and share your PHI to: 1. **Treat you** – coordinate your care within Shan Counseling LLC, and with other health providers if you agree or the law allows. 2. **Get paid** – bill your insurance or you directly, verify coverage, and handle claims. 3. **Run our practice** – quality improvement, licensing, training, audits, and business operations. We may also: - Send **appointment reminders** or information about services by phone, text, mail, or email (you can ask us to use specific methods). - Share limited information with **family or friends involved in your care** if you agree, do not object, or in some emergencies where it is in your best interest and allowed by law. We may disclose information **without your written permission** when the law requires or clearly allows it, for example: - To report suspected **child or vulnerable adult abuse or neglect** - To address **serious and imminent threats** to your safety or others’ safety - For **public health** and **health oversight** activities - In response to certain **court orders** or legal requirements - To report **crimes on our premises** or certain injuries Whenever Pennsylvania law is **stricter than HIPAA**, we follow the stricter rule. --- #### 4. When We Need Your Written Permission We generally must get your **written authorization** before using or sharing: - **Psychotherapy notes** (with limited exceptions) - Most **substance use disorder treatment** information (if Part 2 applies) - Most **HIV-related information** under Pennsylvania law - Your information for **marketing** or any **sale of PHI** - Any uses or disclosures not otherwise described in our full Notice or required/permitted by law You can **refuse** to sign an authorization. If you do sign one, you can **revoke** it in writing at any time (except for actions already taken based on it). --- #### 5. Your Rights You have important rights regarding your PHI: 1. **Right to a copy of our full Notice** - You can get a paper or electronic copy of our full **Notice of Privacy Practices** at any time. 2. **Right to see and get copies of your records** - You can request to review or get copies of most of your records. - Some limits apply (e.g., psychotherapy notes, information prepared for legal proceedings, information that might cause serious harm). - We may charge a reasonable fee as allowed by law. 3. **Right to ask for corrections** - If you think something is wrong or incomplete, you can ask us to amend your record. - If we deny your request, we’ll explain why and note your disagreement in the record. 4. **Right to a list of certain disclosures** - You can ask for an “accounting” of certain times we shared your PHI in the last six years (excluding things like treatment, payment, and routine operations). 5. **Right to request limits on sharing** - You can ask us to limit how we use or share your PHI for treatment, payment, and operations, or with certain people. - We don’t have to agree to most limits, but if we do, we will follow them (except in emergencies or if the law requires disclosure). - **Special rule:** If you **pay in full out-of-pocket** for a service and tell us not to share that service information with your health plan, we must follow that request unless the law requires us to disclose it. 6. **Right to request confidential communication** - You can ask us to contact you in specific ways or at specific locations (for example, only at a certain phone number, or by mail to a P.O. Box). We will usually honor reasonable requests. 7. **Right to be notified of a breach** - If there is a breach of your unsecured PHI, we will notify you as required by HIPAA and Pennsylvania law. 8. **Right to complain (no retaliation)** - If you believe your privacy rights have been violated, you can complain: - To **Shan Counseling LLC** (Privacy Officer: `[contact info]`), and/or - To the **U.S. Department of Health and Human Services, Office for Civil Rights**. - We will not retaliate against you for making a complaint. --- #### 6. Special Notes for Pennsylvania Patients Because we are in **Pennsylvania**, some laws may give you **extra protections**, especially for: - **Mental health** records - **Substance use disorder** treatment records - **HIV-related** information - **Minors’** records when minors can legally consent to their own care In those cases, we follow the **most protective rule** that applies. --- #### 7. Questions, Concerns, or Legal Advice - For questions about **how Shan Counseling LLC uses or protects your information**, or to exercise any of your rights, contact: **Privacy Contact:** `[Ying Shan / MA, LPC]` – `[267-205-3977]` – `[AliceYingShan@gmail.com]` - For questions about **your legal rights** under HIPAA or Pennsylvania law, you should: - Talk with a **licensed Pennsylvania attorney**, and/or - Review the official laws and regulations on public sites (for example, the U.S. Department of Health and Human Services, the Commonwealth of Pennsylvania websites, or official Pennsylvania Code/Bulletin sites). > **This page is a simplified summary and is not legal advice.** > It does not replace the full **Notice of Privacy Practices** or official federal and Pennsylvania laws. If you are unsure about your rights or our responsibilities under the law, please consult a **qualified attorney** or review the official legal documents from government and regulatory sources.